vaccines such as Bacillus Calmette Guerin or the BCG, Hepatitis B Vaccine, Pentavalent

Vaccine (DPT-HepB-Haemophilus Influenza), Oral Polio Vaccine (OPV), Pneumococcal

Conjugate Vaccine (PCV), and Measles Mumps Rubella (MMR) vaccine.

some communicable diseases such as Diphtheria, Pertussis, Tetanus, Measles, German measles,
Mumps or Parotitis, Poliomyelitis, and Chicken pox.

challenges in parenting.

 Failure to thrive - difficulty of a child to gain weight. Due to disrupted maternal and child
relationship.

Signs that the child have failure to thrive

1 sleep disturbance
2 rumination, voluntary __
3 history of parental isolation and social crisis

Delay in growth and development

1 decrease vocalization
2 low interest in environment
3 posture (stiff or floppy)
4 resist cuddling

Interventions
1 Provide consistent care
2 Teach parent positive feeding techniques
3 Involve parents in care
4 Refer to appropriate community agencies

 Child abuse - can be physical, emotional, and sexual. Can also be intentional, non-
accidental action or intentional, accidental acts of omission.

80% of children abused know their abuser

Reasons
1 Inability or limited capacity of the parents to cope with, provide for, and relate to the child
2

According to the discussion, abuse is a cycle. Those who do abuse, they were also abused in their
childhood.
Abuse doesn’t have class. There are abuse among the poor, rich, and middle class.
10% of abusers have psychological disturbance. They have low self-esteem and low tolerance of
emotion.

Abuse is most common among the toddlers.

Assessment findings
1 history may be indicated of child abuse
History of inconsistent with injury
Delay in seeking medical attention
History changes with repetition
No explanation for injury
2 skin injuries are most common

Interventions
1

It is our responsibility to report any abuse.

 Learning disability - dysfunction or difficulty in learning; affects all aspects of learning,
not just academics

Boys are affected 6 times more often than girls

4 categories of learning disability

Receptive sensory: perceptual problem (dyslexia, visual misperception)
Integrative: difficulty processing information (__ organization, sequencing, abstract thought)
Expressive: motor dysfunction (aphasia, writing difficulties, difficulty in sports or games)
Diffuse: combination of above

Interventions
1 environmental manipulation for behavior management
Limit external stimuli
Maintain predictable routines
Enforce limits on behavior
2 teaching strategies tailored for child’s specific defects
Repeat direction often
Elicit feedback from child
Give time to ask questions
Keep teaching sessions short
Do not give nonessential information

 Sudden infant death syndrome (SIDS) - unexpected death; with no reason; cannot be
predicted and prevented;

Peaks at 3 months, 99% at 6 months

Condition usually occurs during sleep
Dies silently
Unknown cause of death, but usually due to suffocation

Assessment
1 prematurity
2 born with low birth weight
3 multiple birth
4 siblings with SIDS
5 mother doing substance abuse
6 neurological problems
7 abnormal respiratory function
8 co-sleeping with parents
9 children doing the prone position

Pillows beside the baby is prevented because it can cause suffocation.

Interventions
1

If the baby is not christened, we should do christening even if the baby is dead.

We have also discussed the Death and Dying.

Parental response to death

1 experience grief
5 stages of grief
Denial
Anger
Depression
 Bargaining
Acceptance
2

Child’s response to death

1 infants and toddlers
Live only in present

When communicating with a dying child

Use child’s language
Do not use euphemism
Do not expect an immediate response
Do not give up on hope

Care guidelines at impending death

Do not leave child alone
Do not whisper in the room
Know that touching child is important
Let the child and family talk and cry
Continue to read favorite stories to child or play favorite music
Let parents participate in care as far as they are emotionally capable
Be aware of the needs of siblings who are in the room with the family