INFANT

CARE &
FEEDING
ABOUT ME

DIANNE GAY LEAÑO

23 years old

FSUU BS Nursing
Batch 2017

Top 17 November 2017

PNLE (85.20)
 References

●Fundamentals of Midwifery

●Oxford Handbook of Midwifery

●Pediatric Lecture Presentation

 01
CARE OF THE
NEWBORN
Table of Contents
Management for Preterm
Baby
Examination of the Newborn
Bed Sharing
Growth and Development
Skin Care and Hygiene
Neonatal Temperature
Control Birth Injuries

Screening Tests Disorders of the Newborn

Management of Small for Basic Resuscitation

Gestational Age
Safeguarding Children
Management
for Preterm 06
Baby
Definitions
 MANAGEMENT FOR PRETERM
BABY
Definitions
• A preterm baby is any baby born
before 37 completed weeks of
gestation.

• The legal age of viability is 24 weeks.

Main Aims of
Management
 MANAGEMENT FOR PRETERM
BABY
Main Aims of Management
• To provide an appropriate environment
where normal homeostasis can be
maintained and where emergencies can be
responded to in an appropriate way.
 MANAGEMENT FOR PRETERM
BABY
Main Aims of Management

• To support the physical,

developmental, psychological, and
emotional welfare of the babies.
 MANAGEMENT FOR PRETERM
BABY
Main Aims of Management

• To provide support for the families of

babies nursed within these contexts.
Management
and Care
 MANAGEMENT FOR PRETERM
BABY
Management
Initially most preterm babies and
will be nursed Care
in an
incubator for:
• Temperature control
• Humidity control
• Easier observation
• Oxygenation
• Barrier to infection
• To cut down on handling
Preventing
Infection
 MANAGEMENT FOR PRETERM
BABY
The baby’s immune system will be immature,
Preventing resulting
Infection
in an increased susceptibility to infection.
• Early recognition and treatment with antibiotics is
important.
• If infection is suspected, carry out a full infection
screen and commence the baby on a 10-day course of
antibiotics.
 MANAGEMENT FOR PRETERM
BABY
Preventing Infection
• Scrupulous handwashing and drying by staff and
visitors has been proved to be the most effective way of
reducing the risk of infection.
• All equipment is sterilized and used only for one baby.
• Each baby has its own personal equipment for day-to-
day care.
Observations
 MANAGEMENT FOR PRETERM
BABY
Make constant observations of: Observations
• Color/activity
• Temp/RR/BP and O2 sat
• Incubator and inspired O2 humidity and temp
• Fluid intake
• Ventilator settings and O2 concentrations
Environment
 MANAGEMENT FOR PRETERM
BABY
Environment
Babies can be affected by constant exposure to:
• Noise
• Light
• Pain from invasive procedure
• Excessive handling
• Separation from their parents
Parental Needs
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Faced with separation, which is not

normal for most parents with a new
baby
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Require a constant stream of up-to-

date information and reassurance about
their baby’s progress
 MANAGEMENT FOR PRETERM
BABY
Parental Needs
• Need an honest and realistic
prognosis, which is difficult at first and
can alter drastically if the baby
develops any problems
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Need facilities for rest, sleeping,

food, and drinks
 MANAGEMENT FOR PRETERM
BABY
Parental Needs
• Need open visiting and a gradual
involvement with the decision making
as their understanding of their baby
increases
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Need access to other medical

personnel, such as health visitors and
social workers
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Need help to give the baby its care

and to take on more as their
confidence increases
 MANAGEMENT FOR PRETERM
BABY
Parental Needs

• Need to involve the baby’s

siblings and the support of their
wider family
 Legal age of viability.
P OP
QUI
Z 51
24 WEEKS
 Preterm babies does not
need psychological
P OP support.
QUI
Z 52
FALSE
 Constant exposure to
light can affect preterm
P OP babies.
QUI
Z 53
TRUE
 It is normal for parents
and baby to be separated
P OP after birth.
QUI
Z 54
FALSE
 Days of antibiotic
P OP treatment.
QUI
Z 55
10-DAY COURSE
 Preterm babies are put
inside an incubator as
P OP barrier to infection.
QUI
Z 56
TRUE
 Midwives should put the
mother in charge of the
newborn’s care right after
P OP birth.
QUI
Z 57
FALSE
 Observations should be
recorded _________ over
P OP a 24h period.
QUI
Z 58
HOURLY
 Handwashing is a must in
taking care of preterm
P OP babies.
QUI
Z 59
TRUE
 A preterm baby is born
P OP before _____ weeks.
QUI
Z 60
37
Bed Sharing 07
Recommendations
while in Hospital
 BED SHARING
Recommendations while in Hospital
Mothers should be CONSTANTLY
SUPERVISED if bed sharing and co-sleeping if
they are:
• Under the effects of a general anesthetic
• Immobile due to a spinal anesthetic
• Taking drugs that may cause drowsiness
 BED SHARING
Recommendations while in Hospital

• Seriously ill (high temp, large blood loss, severe HPN)

• Excessively tired
• Have a condition that affects mobility, sensory, or
spatial awareness (multiple sclerosis, blindness)
 BED SHARING
Recommendations while in Hospital

• Very obese
• Likely to have temporary loss of
consciousness (diabetic or epileptic)
 BED SHARING
Recommendations while in Hospital

Bed sharing and co-sleeping is

CONTRAINDICATED if:
• A mother is a smoker
• The baby is preterm or ill
Advise to
Mothers at
Home
 BED SHARING
Advise to Mothers at Home

WHEN MOTHERS
SHOULD NOT SLEEP
WITH THEIR BABIES
 BED SHARING
Advise to Mothers at Home

If they or their partners:

• Are smokers
• Have drunk alcohol
• Have taken any drug (legal or illegal) which
makes them drowsy
 BED SHARING
Advise to Mothers at Home

• Have a condition that affects their

awareness of their baby
• Are overtired to the point that they could
not readily respond to their baby
 BED SHARING
Advise to Mothers at Home

REDUCING THE RISK

OF ACCIDENTS AND
OVERHEATING
 BED SHARING
Advise to Mothers at Home

• Parents should never sleep with their

baby on a sofa or armchair.

• The bed must be firm and flat.

 BED SHARING
Advise to Mothers at Home

• Ensure the baby can not fall out of bed or

get stuck between the mattress and wall.

• Make sure the room is not too hot (16–18 °

C is ideal).
 BED SHARING
Advise to Mothers at Home

• The baby should not be overdressed.

• Bedclothes must not overheat the baby or

cover the baby’s head.
 BED SHARING
Advise to Mothers at Home

• Never leave the baby alone in or on

the bed.

• The partner should be informed if the

baby is in bed.
 BED SHARING
Advise to Mothers at Home

• If an older child is also bed sharing, there

should be an adult between the child and the
baby.

• Never share your bed with pets and your

baby.
 Mother is under the
P OP effects of GA.
QUI
Z 61
CONSTANTLY
SUPERVISE
 Mother is a smoker.
P OP
QUI
Z 62
CONTRAINDICATED
 Ideal room temp.
P OP
QUI
Z 63
16 TO 18 DEG C
 Diabetic mother
P OP
QUI
Z 64
CONSTANTLY
SUPERVISE
 Baby is preterm
P OP
QUI
Z 65
CONTRAINDICATED
Skin Care
08
and Hygiene
 SKIN CARE AND HYGIENE

-ruddy
-acrocyanosis mottling
-generalized mottling (Cutis
Marmorata) may be seen
-desquamation (drying of skin)
SKIN CARE AND HYGIENE
 SKIN CARE AND HYGIENE

Abnormal skin findings:

1.Pallor
2.Gray
3.Jaundice
 SKIN CARE AND HYGIENE

Treatment of Pathologic Jaundice:

1.Phototherapy
-10 pcs 20-watt daylight/blue fluorescent lights at 30” above
-cover eyes and scrotum with an opaque mask
-monitor temperature
-adequate hydration
-turn q 2H to expose all body areas
-measure I & O

2.Exchange transfusion
Common Skin
Marks of the
Newborn
SKIN CARE AND HYGIENE

1.Desquamation
- peeling of skin
- indicates post-maturity
SKIN CARE AND HYGIENE

2.Mongolian spots
- bluish-black/slate gray
pigmentation
- sacrum or buttocks
- disappear by SCHOOL AGE
SKIN CARE AND HYGIENE

3.Vernix caseosa
- cheese-like material
- serves as insulator
SKIN CARE AND HYGIENE

4.Lanugo
- fine, downy hair
- shoulders, back and
upper arms
- disappear by 2 weeks
SKIN CARE AND HYGIENE

5.Milia
- plugged or unopened sebaceous
gland
- cheek or across the bridge of the
nose
- disappear by 2-4 weeks
SKIN CARE AND HYGIENE

6.Nevi (Stork bites)

- pink or red flat areas of
capillary dilatation
- upper lids, nose, upper
lip, nape and neck
- disappears at 1st and
2nd year
SKIN CARE AND HYGIENE

7.Erythema toxicum
- aka fleabite rash
- pink papules with vesicles
- nape, back and buttocks
- appears usually 2nd day
- no treatment needed
SKIN CARE AND HYGIENE

8.Nevus flammeus
- aka portwine stain
- red to purple in color
- do not blanch on pressure
and do not disappear
SKIN CARE AND HYGIENE

9.Strawberry hemangioma
- elevated areas formed by
immature capillaries and
endothelial cells
- complete disappearance by 10
yrs old
SKIN CARE AND HYGIENE

10.Cavernous hemangiomas

- dilated vascular spaces

- do not disappear with time
SKIN CARE AND HYGIENE

11.Forceps marks
- disappears in 1-2 days
HYGIENE
 SKIN CARE AND HYGIENE

BATHING
 SKIN CARE AND HYGIENE
Bathing
-does not need a daily bath except in very hot weather
-serves many functions:
a. to promote cleanliness
b. to provide opportunity for the baby to exercise and
kick
c. to give parents time to talk, touch and communicate
with the baby
d. to give the baby the opportunity to learn
different textures and sensations
 SKIN CARE AND HYGIENE

DIAPER-AREA
CARE
 SKIN CARE AND HYGIENE
Diaper-Area Care

-do not wear soiled diapers for a lengthy

time

-skin should be washed thoroughly with

water and mild soap
 SKIN CARE AND HYGIENE

CARE OF TEETH
 SKIN CARE AND HYGIENE
Care of Teeth

-water level should have 1 ppm Fluoride

-begin "brushing" even before teeth erupt by

rubbing a piece of gauze over the gum pads

-toothpaste is not necessary

 SKIN CARE AND HYGIENE

DRESSING
 SKIN CARE AND HYGIENE
Dressing

-should be easy to launder and simply

constructed

-clothing should suit infant’s activity level

SKIN CARE AND HYGIENE

SLEEP
 SKIN CARE AND HYGIENE
Sleep
-need 10-12 hours of sleep a night

-one or several naps during the day

-don't place pillows to avoid possibility of

suffocation
 SKIN CARE AND HYGIENE

EXERCISE
 SKIN CARE AND HYGIENE
Exercise

-outings in a carriage or stroller: sunlight = Vit D

-best time: early mornings and late afternoons

-use of infant walkers must be closely supervised

 Indicates post maturity
P OP
QUI
Z 66
DESQUAMATION
 Common in Asians
P OP
QUI
Z 67
MONGOLIAN SPOT
 Plugged sebaceous gland
P OP
QUI
Z 68
MILIA
 AKA portwine stain
P OP
QUI
Z 69
NEVUS FLAMMEUS
 Forcep marks disappears
P OP in ____ days.
QUI
Z 70
1-2
Birth
09
Injuries
Head Injury
 BIRTH INJURIES
Head Injuries
HYPOXIA
 Most common cause of cerebral injury
following birth
 Results in intracranial hemorrhage or
edema; cerebral palsy
 Linked to pre-eclampsia
 BIRTH INJURIES
Head Injuries
TENTORIAL TEARS
 D/t fetal skull exposed to excessive, rapid,
or abnormal moulding
 Tearing of tentorium cerebelli and falx
cerebri
 Bleeding: ruptured great cerebral vein
BIRTH INJURIES
Head Injuries
 BIRTH INJURIES
Head Injuries
FRACTURED SKULL
 Extremely rare
 Severely immobilized sacrococcygeal joint and
coccyx > small depressed fracture of one of the
frontal bones
 Unusual/excessive moulding > fine linear
fracture
 Neither of these injuries requires treatment
 BIRTH INJURIES
Head Injuries
FACIAL PARALYSIS
 Caused by trauma at delivery.
 Damage to a branch of the facial nerve as
the head emerges at delivery
 Affected side:
- no movement when the baby cries
- eye is permanently open
- mouth droops
Other Injuries
 BIRTH INJURIES
Other Injuries
DISLOCATION AND FRACTURES
 Humerus or clavicle: difficult shoulder
dystocia
 Femur may be fractured
 Mismanaged breech delivery: fetal hip
dislocation.
 BIRTH INJURIES
Other Injuries
STERNOMASTOID HEMATOMA
 Cause: traction during delivery of head or
shoulders
 Swelling of sternomastoid muscle
 Torticollis or wry neck
 Takes several weeks to subside and rarely
causes permanent damage
 BIRTH INJURIES
Other Injuries
KLUMPKE’S PALSY
 Cause: traction on the arm when
delivering the shoulders
 Damage to the lower brachial plexus
 Paralysis to the hand and wrist drop;
sometimes a fracture is apparent
 Main treatment: Physiotherapy
 Recovery: usually slow
 BIRTH INJURIES
Other Injuries
ERB’S PALSY
 Cause: excessive traction on the neck during a breech/cephalic
presentation
 Damage to the upper brachial plexus
 Arm hangs loosely from the shoulder with the palm of the
hand turned backwards in the ‘waiter’s tip’ position
 Main treatment: Physiotherapy
 Recovery: slow but condition does usually resolve completely
 BIRTH INJURIES
Other Injuries

INJURY TO ABDOMINAL
ORGANS
 Occurs after inappropriate handling of the
baby during a breech delivery
 Rupture of the liver or spleen
 BIRTH INJURIES
Other Injuries
SKIN INJURIES
 Bruising/abrasions: application of forceps,
scalp electrode during labor
 More extensive bruising accompanied by soft
tissue swelling: ventouse delivery
 Small superficial hemorrhages of head, face,
and neck: trauma or precipitate delivery
 Linked to pre-eclampsia
P OP
QUI
Z 71
HYPOXIA
 Bleeding in tentorial tears
is due to the rupture of
P OP ___________.
QUI
Z 72
GREAT CEREBRAL
VEIN
 Fractured skull is
P OP common during delivery.
QUI
Z 73
FALSE
 Wry neck is seen in
P OP _____________.
QUI
Z 74
STERNOMASTOID
HEMATOMA
 Recovery of Erb’s Palsy
is slow but resolves
P OP completely.
QUI
Z 75
TRUE
Disorders of
10
the Newborn
Minor Health
Problems
 DISORDERS OF THE
NEWBORN
1.Constipation
Minor Health Problems
- more common among bottle-fed
Mgt:
a. add more fluids or carbohydrates/sugar
b. if anal sphincter tight; dilate 2-3X daily with gloved
little finger

2.Loose stools
- management depends on cause
 DISORDERS OF THE
NEWBORN
3.Colic Minor Health Problems
Causes:
-overfeeding -gas distention
-too much carbohydrates -tense and unsure mother
Mgt:
a. feed by self-demand
b. burp the baby twice during a feeding
c. feed in upright position
d. change milk formula if needed
e. reduce sugar content
 DISORDERS OF THE
NEWBORN
Minor Health Problems
4. Spitting up
- due to poorly developed sphincter
Mgt:
a. feed in upright position
b. position on right side after feeding
c. burp more frequently
 DISORDERS OF THE
NEWBORN
5. Skin irritation Minor Health Problems
- may be due to poor hygiene, or irritation from
urine, feces or laundry products
Mgt:
a. expose to air
b. careful washing and rinsing of skin
c. starch bath (for Miliaria or prickly-heat rash)
 DISORDERS OF THE
NEWBORN
Minor Health Problems
6. Seborrheic dermatitis/cradle cap
- involves sebaceous glands; due to poor hygiene
Mgt:
a. apply mineral oil or Vaseline on the scalp at
night
b. giving shampoo bath in the morning
 DISORDERS OF THE
NEWBORN
Minor Health Problems
7. Clothing
-If mother feels warm, keep the baby cool
-If the mother feels cold, keep the baby warm

8. Sleep patterns
-need 16-20 hours of sleep a day
Neonatal
Infection
 DISORDERS OF THE
NEWBORN
Neonatal Infection

Most common causes:

• Maternal contact
• Contact with hospital personnel (cross infection)
• Contact with inanimate objects
 DISORDERS OF THE
NEWBORN
Neonatal Infection
COMMON SIGNS OF INFECTION:
Pallor Abdominal distension
Poor Feeding Apnea
Tachycardia/arrhythmia Lethargy
Decreased peripheral perfusion Hyperbilirubinemia
Tachypnea Unstable temperature
Unstable BP Grunting/cyanosis
 DISORDERS OF THE
NEWBORN
Neonatal Infection
UNCOMMON SIGNS OF INFECTION:
Purpura Bulging fontanelle
Omphalitis Splenomegaly
Vasomotor instability Rash
Bleeding Diarrhea
Pustules Seizures
 DISORDERS OF THE
NEWBORN
Management:
Neonatal Infection
 Supportive therapy and broad-spectrum
antibiotics
 Ventilation
 Cardiovascular support
 Volume replacement
 Acid-base balance
 Fluid and electrolyte balance
Developmental
Dysplasia of the
Hip (DDH)
 DISORDERS OF THE
NEWBORN
Risk Factors: DDH
 Breech presentation
 Family hx of hip dysplasia
 Inc. birthweight
 Females more at risk than males
 First baby more at risk than subsequent
babies
 DISORDERS OF THE
NEWBORN
DDH

Diagnosis:
 Physical Examination
 Ultrasound Scan (confirmatory)
 DISORDERS OF THE
NEWBORN
DDH
Ortolani’s Maneuver: detects a dislocatable
but reducible hip

Barlow’s Maneuver: provocation test for an

unstable hip
 DISORDERS OF THE
NEWBORN
ORTOLANI DDH
1. Baby must be relaxed and on a firm surface.
2. Hip is flexed to 90 degrees and then gently
abducted.
3. The examiner’s finger on the outer part of the
hip can detect the ‘clunk’ as the head of the
femur slides into the hip socket.
 DISORDERS OF THE
NEWBORN
DDH
BARLOW
1. Hip is flexed to 90 degrees.
2. Leg is adducted and gently pushed backwards.
3. The hip will ‘clunk’ as the head of the femur
dislocates.
 DISORDERS OF THE
NEWBORN
DDH

Treatment:
 Pavlik’s harness or hip spica cast
DISORDERS OF THE
NEWBORN
DDH
DISORDERS OF THE
NEWBORN
DDH
Respiratory
Distress
Syndrome
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome
 One of the main causes of morbidity and
mortality in preterm infants.

 The lungs of babies born at 28 weeks or less

will be immature, having few alveoli and
reduced surfactant production.
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome

Onset:
 Usually w/in 4 hours of birth
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome
Signs:
 Grunting on expiration
 Increased RR
 Intercostal, sternal and subclavicular
recession
 DISORDERS OF THE
NEWBORN
Signs: Respiratory Distress Syndrome
 Nasal flair
 Chin tug
 Cyanosis
 Apnea
 Diminished breath sounds
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome

Diagnosis:
 Chest XRAY shows “ground glass”
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome

Treatment:
 Maternal steroids prior to delivery
 Surfactant replacement therapy at birth
 Ventilation if baby is <30 weeks gestation
 DISORDERS OF THE
NEWBORN
Respiratory Distress Syndrome

Recovery:
 Usually between 48 hours and 72 hours after
birth
Intussusception
 DISORDERS OF THE
NEWBORN
Intussusception
- telescoping of the intestines
S/sx:
Sausage-shaped mass
Abdominal pain (intermittent)
Currant jelly stool
 DISORDERS OF THE
NEWBORN
Intussuception
Management:
- NPO status
- NGT
- Hydrostatic Reduction Surgery
- Resection & Anastomosis
Hirshsprung’s
Disease
 DISORDERS OF THE
NEWBORN
- aka Aganglionic Megacolon
Hirshprung’s Disease
S/Sx:
- Abdominal distention & pain
- Ribbon-like stool
- Fecaloid vomitus
- Pseudodiarrhea
- Constipation
 DISORDERS OF THE
NEWBORN
Management: Hirshprung’s Disease
- Do not treat diarrhea
- Increase fluid intake
- Give laxative/enema
- Temporary colostomy
- Resection & Anastomosis
Cleft Lip/Palate
Wilm’s Tumor
 DISORDERS OF THE
NEWBORN
- kidney cancer in kids
Wilm’s Tumor
- 2nd most common cancer in pedia
S/sx:
Unilateral; bilateral in late stage
Painless
Increase in abd. size
Soft, easily ruptured
 DISORDERS OF THE
NEWBORN
Wilm’s Tumor
Management:
- NO PALPATION
- Chemotherapy
- Nephrectomy
Cryptorchidism
 DISORDERS OF THE
NEWBORN
Cryptorchidism

- undescended testes (8 mos in

womb)
- common in premature babies
 DISORDERS OF THE
NEWBORN
Cryptorchidism

2 Types:
1. Unilateral - testicular CA
2. Bilateral - sterility
 DISORDERS OF THE
NEWBORN
Management: Cryptorchidism
- Orchiopexy/Orchioplasty
> before 2 yo (bladder training)
> does not dec. risk for CA
- Do testicular exam -> same
day/month
 Sudden Infant
Death Syndrome
 DISORDERS OF THE
NEWBORN
SIDS
- unexplained death, usually during
sleep, of a seemingly healthy baby less
than 1yo

- “crib death”
 DISORDERS OF THE
NEWBORN
SIDS
Physical factors:
- Brain defects
- Low birth weight
- Respiratory infection
 DISORDERS OF THE
NEWBORN
SIDS
Sleep environmental factors:
- Sleeping on the stomach or side
- Sleeping on a soft surface
- Sharing a bed
- Overheating
 DISORDERS OF THE
NEWBORN
Risk factors:
SIDS
Family history
Age: Between 2nd and 4th months of life
Race: Nonwhite infants
Being premature
Sex: Boys
Secondhand smoke
 DISORDERS OF THE
NEWBORN
Prevention: SIDS
1. Sleep on back
2. Keep the crib as bare as possible
3. Don't overheat your baby
4. Have your baby sleep in in your room
 DISORDERS OF THE
NEWBORN
Prevention: SIDS
5. Breast-feed your baby
6. Don't use baby monitors and other
commercial devices that claim to reduce the
risk of SIDS
7. Offer a pacifier
8. Immunize your baby
 Mental
Retardation
 DISORDERS OF THE
NEWBORN
Classification IQ Levels Features
Mild 50-69 > slow as comparedMental Retardation
with other children
> achieve basic reading and math skills up to 6th grade level
> with special training: vocational skills, self-maintenance and
independent living (with assistance during stress)

Moderate 35-49 > delay in motor dev’t

> no progress in reading and math up to 2nd grade level
> poor communication skills
> incapable of self-maintenance
Severe 20-34 > dependent on others for self-care
> can conform to routine
Profound Less than 20 > gross retardation
> needs care
> has basic emotional response
 Neonatal
Conjunctivitis
 DISORDERS OF THE
NEWBORN
Neonatal Conjunctivitis

- Usually caused by irritation,

infection or blocked tear duct
 DISORDERS OF THE
NEWBORN
Neonatal Conjunctivitis
1. Chlamydial Conjunctivitis
- chlamydia trachomatis
- sx appear 5 to 12 days after birth
- bacteria can infect lungs and nasopharynx
- Oral antibiotics
 DISORDERS OF THE
NEWBORN
Neonatal Conjunctivitis
2. Gonococcal Conjunctivitis
- neisseria gonorrhoeae
- sx appear 2 to 4 days after birth
- Bacteremia, meningitis
- IV antibiotics
 DISORDERS OF THE
NEWBORN
Neonatal Conjunctivitis

3. Chemical Conjunctivitis
- eye drops
- sx lasts for only 24 to 36 hours
 If anal sphincter is tight,
P OP dilate ______ daily.
QUI
Z 76
2 TO 3 TIMES
 Colic is caused by too
P OP much CHON.
QUI
Z 77
FALSE
 Needs ______ hours of
P OP sleep a day
QUI
Z 78
16 TO 20
 Females are more at risk
P OP for DDH than males.
QUI
Z 79
TRUE
 Confirmatory diagnosis
for DDH is physical
P OP examination.
QUI
Z 80
FALSE
 Onset of RDS is usually
P OP w/in 4h of birth.
QUI
Z 81
TRUE
 Currant jelly stool
P OP
QUI
Z 82
INTUSSUSCEPTION
 Ribbon-like stool
P OP
QUI
Z 83
AGANGLIONIC
MEGACOLON
 NO PALPATION
P OP
QUI
Z 84
WILM’S TUMOR
 At what month should the
testes descend while in
P OP the womb?
QUI
Z 85
8 MONTHS
Basic
11
Resuscitation
Safeguarding
12
Children
 Expanded
Program on
Immunization
 SAFEGUARDING CHILDREN
EPI
ASAP (1ST 2 MONTHS) BCG
ASAP (1ST 12 HOURS) HEP B (MONOVALENT)
6 WEEKS PENTAVALENT 1, OPV 1, PCV 1, ROTAVIRUS 1
10 WEEKS PENTAVALENT 2, OPV 2, PCV 2, ROTAVIRUS 2
14 WEEKS PENTAVALENT 3, OPV 3, PCV 3, ROTAVIRUS 3,
IPV (SINGLE DOSE)
9 MONTHS MEASLES
12 MONTHS MMR
 SAFEGUARDING CHILDREN
EPI

COLD CHAIN
LOGISTICS
 SAFEGUARDING CHILDREN
EPI

MOST SENSITIVE TO HEAT (-15 C to -25 C)

> Measles and OPV

LESS SENSITIVE TO HEAT (2 C to 8 C)

> TT, DPT, Hepa B, BCG
 SAFEGUARDING CHILDREN
EPI

SPECIAL
CONSIDERATIONS
 SAFEGUARDING CHILDREN
EPI
BCG
> 1st purpose: TB Meningitis, Leprosy
> Clean site: Water only
> Koch’s Phenomenon: SCAR
> If no scar, repeat dose
> S/E: Abscess (put INH powder);
Deep abscess (I&D then INH
powder)
 SAFEGUARDING CHILDREN
DPT EPI
S/E:
> Fever: Paracetamol q 6hr for 24hr
> Local tenderness: warm compress

A/E:
> Encephalopathy: convulsions w/in 3 days
!DO NOT GIVE DPT 2,3!

If with Seizure Disorder/high grade fever

(>38.5C): DO NOT GIVE DPT DOSES
 SAFEGUARDING CHILDREN
EPI
 USA
OPV
Types:
1. Sabin: Oral If spit: give again
 Live attenuated If vomit w/in 30mins: give
 Philippines again
2. Salk: Parenteral (IM) If vomit after 30mins: do not
 Inactivated microorganism give
If w/ diarrhea: give but don’t
record
Burns
 SAFEGUARDING CHILDREN
Burns

Burns
- younger children: scald burns
- older children: flame burns
 SAFEGUARDING CHILDREN
Burns
Prevention:
1. Smoke alarms
2. Have an escape plan
3. Cook with care
4. Check water temperature
 Carbon
Monoxide
Poisoning
 SAFEGUARDING CHILDREN
CO Poisoning

- odorless, colorless gas

- found in fumes
- cars, small engines, stoves, lanterns,
grills, fireplaces and gas ranges
 SAFEGUARDING CHILDREN
CO Poisoning

S/sx:
headache dizziness
weakness upset stomach
chest pain pass out
 SAFEGUARDING CHILDREN
CO Poisoning
Susceptible Individuals:
1. Infants
2. Elderly
3. Heart Disease
4. Anemia
5. Breathing Problems
 SAFEGUARDING CHILDREN
CO Poisoning
Prevention:
1. CO detector
2. Have all appliances serviced by a
qualified technician every year.
3. Do not use portable flameless heaters
indoors.
 SAFEGUARDING CHILDREN
CO Poisoning

Prevention:
4. Make sure gas appliances are vented
properly.
5. Never burn charcoal indoors.
6. Never mix household products together.
Child Abuse and
Neglect
 SAFEGUARDING CHILDREN
Child Abuse and Neglect

1.Physical
2.Sexual
3.Emotional
 SAFEGUARDING CHILDREN
Child Abuse and Neglect

Risk Factors for Victimization:

- Children younger than 4 y.o.
- Special needs
 SAFEGUARDING CHILDREN
Child Abuse and Neglect
Risk Factors for Perpetration: Individual
1. Lack of understanding of child’s needs,
development and parenting skills
2. History of child abuse or neglect
3. Substance abuse or mental health issues
 SAFEGUARDING CHILDREN
Child Abuse and Neglect

Risk Factors for Perpetration: Individual

4. Young age, low education, single
parenthood, large # of children, low income
5. Nonbiological caregivers
 SAFEGUARDING CHILDREN
Child Abuse and Neglect

Risk Factors for Perpetration: Family

1. Social isolation
2. Stress, divorce/separation, violence
3. Parenting stress, poor parent-child
relationship
 SAFEGUARDING CHILDREN
Child Abuse and Neglect

Risk Factors for Perpetration:

Community
1. Community violence
2. Concentrated neighborhood disadvantage
 SAFEGUARDING CHILDREN
Child Abuse and Neglect
Prevention:
1. Strengthen household financial security
2. Education campaigns
3. Early childhood home visitations
4. Enhanced primary care
5. Behavioral parent training programs
Car Safety
 SAFEGUARDING CHILDREN
Car Safety

- Rear-facing car seat (birth until 2 to 4

years old)
- Back seat
 Emergency
Preparedness
 SAFEGUARDING CHILDREN
Emergency Preparedness

- Plan ahead
- Stay healthy
- Stay calm
- Stay connected
- Stay informed
Food Safety
 SAFEGUARDING CHILDREN
Food Safety

1. Clean
2. Separate
3. Cook
4. Chill
 Home and
Recreational
Safety
 SAFEGUARDING CHILDREN
Home and Recreational Safety
1. Remove choking hazards around house or play
area.
2. Learn how to swim.
3. Store medicine out of reach of children.
4. Give medications only as directed.
5. Childproof the house.
Insect Repellent
 SAFEGUARDING CHILDREN
Insect Repellent

1. Dress in clothing that covers arms and

legs.

2. Cover strollers and baby carriers w/

mosquito netting.
 SAFEGUARDING CHILDREN
Insect Repellent

3. Use screens on windows and doors.

4. Repair holes in screens to keep

mosquitoes outdoors.
 SAFEGUARDING CHILDREN
Insect Repellent
5. Use air conditioning if possible.

6. Once a week, empty and scrub, turn over,

cover or throw out items that hold water.
(tires, buckets, planters, toys, pools,
flowerpots or trash containers)
 SAFEGUARDING CHILDREN
Insect Repellent
7. Do not wear sweet smelling
colognes/perfumes.

8. Sleep under mosquito bed net if the

room does not have screens.
Lead Poisoning
 SAFEGUARDING CHILDREN
Lead Poisoning

- Sources: toys, jewelry, imported

candies, aviation gas, stain glass
work
 SAFEGUARDING CHILDREN
Lead Poisoning
Effects:
1. Damage to the brain and nervous
system
2. Slowed growth and development
3. Learning and behavior problems
4. Hearing and speech problem
Medicine Safety
 SAFEGUARDING CHILDREN
Medicine Safety

1. Only take prescription medications.

2. Never take larger or more frequent
doses.
3. Never share prescriptions.
 SAFEGUARDING CHILDREN
Medicine Safety

4. Follow directions on label.

5. Keep medicines in their original
bottles or containers.
6. Dispose unused, unneeded or expired
drugs.
 Birthday dose
P OP
QUI
Z 86
MMR
 OPV should be stored at
P OP 2 to 8 C.
QUI
Z 87
FALSE
 Lead can be found in
P OP stained glass works.
QUI
Z 88
TRUE
 Airconditioning increases
P OP mosquito population.
QUI
Z 89
FALSE
 1 month old baby should
be put in the _______
P OP seat.
QUI
Z 90
BACK
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YOU
FOR
LISTENING!
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