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181 Cards in this Set

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  • Back
Newborn pulse
100 – 175
3 months - 2 years pulse
80 - 150
3 years - 9 years pulse
70 – 110
10 years to Adult pulse
55 – 90
In children, which is the best to start the assessment?
It is best to auscultate first and finish with the blood pressure and temperature.
Infant and Toddler Vital Sign Procedures

- start with what and how?
1) Count respirations FIRST
(before disturbing the child)

2) Count apical HR SECOND

3) Measure BP (if applicable) THIRD

4) Measure temperature LAST

1) Oral route not used until age 5

2) Rectal route is used as a last option
When can you take a radial pulse on a child?
Accurate radial pulses may be take on children 2 years or older
Infants respiration's are....

How do you obtain the respiratory rate?
Irregular and diaphragmatic


-AUSCULTATE for 1 minute
Normal Respiration Rate for Newborn
35
Normal Respiration Rate for 1 year
30
Normal Respiration Rate for 2 years
25
Normal Respiration Rate for 4 years
23
Normal Respiration Rate for 6 years
21
Normal Respiration Rate for 10 years
16-20
How are blood pressure’s obtained on infants and children?
If children enter an acute care facility BP is obtained on admission to the unit, PRN and QAM unless otherwise ordered by the physician.
Width of the cuff should equal.....
40% of the circumference of the arm
The cuff length should cover...
80% of the arm
Pulses that can be used in the lower extremities are the?
Popliteal artery (above the knee) or the dorsalis pedis or the posterior tibial arteries (above the ankle) arteries
In regard to BP, _______ is considered abnormal and should be followed up with a physician.
If the BP is lower in the lower extremities

VS normal

which is when the lower extremity BP should be 10 mmHG higher
If using a manual cuff, diastolic is found at the....
4th Kortikoff sound (muffled sounds) if child is under 12 years of age
Once 12 years, use the.....
5th Krotokoff sound, which is when the sounds disappear
To assess BP, first place cuff above the _________ pulse. Rapidly inflate the cuff to about ________ above the point that the radial pulse disappears. (30mmHG is used in adults)
radial; 20 mm HG
What are the norms for finding a systolic BP number in a child?
Systolic

1 – 7 years (age in years +90)
8 – 18 (2 X age in years plus 83)
What are the norms for finding a diastolic BP number in a child?
Diastolic

1-5 years 56
6 – 18 years age in years + 52
What is a normal BP for a newborn?
1 month 86/54
What is the normal BP in a 1 year old?
96/65
What is the normal BP for a 2yr old?
100/65
What is the normal BP for a 4 yr old?
107/64
What is the normal BP for a 6 yr old?
110/60
What is the normal BP for a 10 yr old?
115/74
What is the normal BP for a 16 yr old?
120/65
Axillary temperatures are used for infants and children up to age?
5
Care must be used when obtaining rectal temperatures. The rectal probe can only be inserted _______ cm
2.5 cm
Rectal temps are usually one degree ______ and axillary temps are usually one degree _______
higher; lower
One gram of diaper weight equals ____ ml of output.
one;

Be sure to subtract the weight of the dry diaper.
What are some of the abnormalities in a child upon assessment?
dull, flat, irritable, no eye contact, listless, uncoordinated movements, does not recognize caregiver, caregiver is not able to sooth/comfort child. Abnormalities should be followed up with by an physician.
Turgor- rapidly recoils

What is normal?

Longer than 2-3 seconds can indicate what?
less than 2 seconds;
dehydration
Anterior fontanel closes at ______ months
18 – 24 months (4 – 6 cm in diameter)
Posterior fontanel closes at ______ months
2 months( 1 -2 cm)
Eyelids in neonates (birth to 1 month) are?
edematous
Visual acuity around 12 months is....
20/100
Visual acuity around 2 to 4 is.....
20/40
Visual acuity around 6 yrs and up is....
20/20
Visual acuity around birth is.....
20/400
Low set ears (10 degrees lower than pinna) may indicate...............
Downs Syndrome
What are Sun Set eyes?
Sclera above iris indicative of hydrocephalus, also called Sun Set eyes. The lids should be at the top of the iris, not above
Skin tags at ear level can indicate?
kidney problems
Blue sclera can indicate?
Blue Sclera: Osteogenesis imperfecta (genetic bone disorder)
What is Cat’s eye reflex?
Most retinoblastoma patients have a white pupil reflex or leukocoria instead of a normal black pupil or red reflex. This abnormal white pupillary reflex is sometimes referred to as a cat's eye reflex.
What is a Corneal Light Reflex aka Hirschenberg test ?
used to test malalignment in eyes; shine a flashlight or light into eyes directly from a distance about 16 inches
What are Brushfield spots?
small white or grayish/brown spots on the periphery of the iris in the human eye. A feature of the chromosomal disorder Down syndrome.
What is Dacryocytitis?
- Lacrimal duct obstructed and causes infection
Tear ducts are patent when?
2-4 weeks
A bluish tinge around the umbilicus may indicate?
intra-abdominal bleeding
During auscultation: _____ bowel sounds a minute is normal for an infant.
5 or

-or one every 10 to 30 seconds is normal.
What is Epidadis?
opening of urethra on the dorsal or above where the normal opening would be
What is Hyposadisis?
abnormal opening of urethra on underside or ventral, undersurface of penis
What is the pot belly due to?
Pot belly due to lumbar lordosis
What are some abnormalities of the joints?
Limited ROM
Painful ROM
Warmth
Edema
Deformities
When is the Knee-jerk (Patellar) reflex present?

Biceps Reflex?

Achilles Reflex?
present at birth

present at birth

present at 4 month
What is the Denver II Developmental Screening?

need what?
A tool assesses children’s personal-social, fine motor-adaptive, language, and gross motor skill

*Need correct age calculation*
Up to 24 months, allowances are made for infants born prematurely by subtracting the number of weeks of missed gestation from their present age
Example:

Pt Born: 10/ 20/00

Full term gestational age: 11/7/00
( 3 weeks early)

Test date: 4/20/01
(Six months of age)

Based on this info at what age would be tested on his 6 month bday?
Age tested at: 5 months 1 week

Why? Because he was born 3 weeks early
What are some abnormal findings pertaining to the A's & B's of the ABC?
Nasal flaring, retractions, RR above 60 and under 20, Cyanosis, stridor, snoring, and grunting,
Shallow breathing, or see-saw breathing, Tripod position,
Circumoral cyanosis,
Asymmetry chest movement,
Abnormal vital signs
Who was known as the founder of community health nursing. Also established the role of the first school nurse. The nurses were able to teach parents and children about basic preventative health and first aid.
Lillian Wald
___________ studied economical and social factors that impacted children’s well being
US Children’s Bureau
The data that came out of the studies brought about better standards of care for mothers and children and ______________ was passed.
The Maternity and Infancy Act
In 1935, _____________ was passed and created a state and federal partnership. This partnership provided grants to states to support prenatal, post natal and child health clinics. In today's society, the money pays for: Medicaid, WIC, Education for All Handicapped Children Act, Family and Medical L eave Act, and Aid to Families with Dependent Children.
Title V of the Social Security Act
___________ is the assessment, diagnosis, treatment, and evaluation of human responses to actual and potential
health problems related to infants and children
Pediatric nursing
What is the Role of the Pediatric nurse?
The focus is on protecting children from illness and injury and to assist them to attain optimal levels of
health. Pediatric nurses provide direct patient care, patient education, advocacy, and case management.
Describes incidence or number of individuals who have died over a specific period
Mortality
What is the #1 cause of death in infants in regard to mortality death?
Congenital anomalies
What is the #1leading cause of death in children?
accidents
What is the #1 mortality of unintentional injuries in females <1 yrs old?


males <1 yrs old?
both are from mechanical suffocation
What is the #1 mortality of unintentional injuries in females 1-24 yrs old?

males 1-24 yrs old?
both from motor vehicle accidents
What is the 3rd leading cause of death among adolescents and young adults 10 to 19 yrs old?
Suicide
What is the 2nd leading cause of death in the 15-19 yr old group?
Homicide
What cause of death has been declining in children?
infectious diseases
What is the 2nd leading cause of death from injury in boys and the 3rd in girls ages 5-14 yrs old?
drowning
What are the 2nd leading cause of death from injury in girls and the 3rd in boys ages 1 to 14 yrs old?
burns
What is essential in assessing intentional injury from abuse or neglect?
the history of the injury
What are the feelings and behaviors of infants r/t Divorce?
effects of reduced mothering or lack of mothering; inc irritability; disturbance in eating, sleeping, and elimination; interference with attachment process
What are the feelings and behaviors of early preschool (2-3) r/t Divorce?
frightened and confused; blame themselves for the divorce, fear of abandonment; inc irritability, whining, tantrums, regressive behaviors (thumb sucking, loss of elimination control), separation anxiety
What are the feelings and behaviors of later preschool (3-5) r/t Divorce?
fear of abandonment, blame for themselves for the divorce, dec self-esteem, bewilderment regarding human relationships, become more aggressive in relationships with others (sibs, peers), engage in fantasy to seek understanding
What are the feelings and behaviors of early school-age (5-6) r/t Divorce?
depression and immature behavior, loss of appetite and sleep disorders, may be able to verbalize some feelings and understand some divorce related changes, inc anxiety and aggression, feel abandoned by departing parent
What are the feelings and behaviors of middle school-age (6-8) r/t Divorce?
panic reactions, feeling of deprivation-loss of parent, attention, money, and secure future, profound sadness, depression, fear, and insecurity, fear of abandonment and rejection, fear regarding future, difficulty expressing anger at parents, intense desire for reconciliation of parents, impaired capacity to play and enjoy activities, decline in school performance, altered peer relationships-become bossy, irritable, demanding, manipulative, freq crying, loss of appetite, sleep disorders, disturbed routine, forgetfulness
What are the feelings and behaviors of later school-age (9-12) r/t Divorce?
more realistic understanding of divorce, intense anger at parents, divided loyalties, able to express feelings of anger, ashamed of parental behavior, feel the need for revenge, feel lonely, rejected, and abandoned, altered peer relationships, decline in school performance, somatic complaints, may lie or steal, temper tantrums, dictatorial attitudes
What are the feelings and behaviors of adolescents (12-18) r/t Divorce?
able to disengage themselves from parental conflict, feel a profound sense of loss, feelings of anxiety, worry about themselves, parents, siblings, express anger, sadness, shame, embarrassment, may withdraw from family and friends, disturbed concept of sexuality, may engage in acting-out behaviors
The two goals of Health People 2010 are?
To increase the years and quality of life for Americans and to eliminate the health disparities
When parents ask us for advice regarding limit setting, we should tell them to be _______ with what ever form of discipline they choose
consistent
What is response burst?
is a phenomenon that occurs when the undesired behaviors increases after ignoring is initiated because the child is "testing" the parents to see if they are serious about the plan
What is the rule for 'time-out length'?
is one minute per year of age; use a kitchen timer with bell to record time
What is the most important factor between divorced parents?
is the continuing conflict between the divorced parents which is ongoing and r/t problems of social development, emotional stability, and cognitive skills for the child
How should a child of a divorced parent approach or send a message to a parent?
by stating "I messages"

ex) "I feel uncomfortable......

this empowers the child to feel in control
What is a primary group?
is characterized by intimate, continued, face to face contact, mutual support of others and the ability to order or constrain a considerable proportion of individuals members' behavior.

ex)family and the peer group
What is a secondary group?
groups that have limited, intermittent contact and in which there is generally less concern for members' behaviors

ex) professional association and church organizations
What is the top score in a Pediatric coma?

What does it assess?
Top score is 15

-Eyes, Verbal, Motor Response, also assess motor strength, muscle tone, and affect
When assessing the ABCs in children, what probems can arise with the C?
-Heart rate above 180 or below 80 if under 5years old

-Heart rate above 160 if over 5 if over 5 yearsold

-Hypotension that falls more than 10 mm Hg

-Absence of peripheral pulse = poor perfusion

-Decreased urinary output

-BP below 80 systolic in children older that 1year
What are some other misc critical signs to look for?
Deceased LOC, Pupils, Agitation, anxiety, lethargy, no eye contact, Irritable that progresses to passive, Flaccid extremities, Does not recognize parents, Pupil dilation, Sunken fontanels, No tears, Gray color, mottled skin, weak suck
feeding recommendation-preschoolers?
90 kcal/kg for approx. 1800 cals /day
Anticipatory guidance for injury prevention/preschoolers?
-less prone to falls and have some awareness of dangers and parental rules

-emphasis is on education for safety, preschoolers tend to imitate - parents should practice what they preach
source of infection for chicken pox?
primary secretions of resp tract of infected persons, skin lesions (scabs not infectious)
how is chicken pox transmissive?
direct contact, droplet (airborne spread), and contaminated objects
incubation period for chicken pox?
2-3 weeks, usually 14-16 days
what is the period of communicability?
prob 1 day before eruption of lesions (prodromal period) to 6 days after 1st crop of vesicles when crust have formed
what is the prodromal stage include iwth chk pox?
slight fever, malaise, and anorexia for the 1st 24 hrs; rash highly pruritic, begins as macule, rapid progress to papule then vesicle with red base, breaks easily and forms crusts; all 3 stages (papule, vesicle, crust) present at one time
distribution of chk pox?
centripetal, spreading to face and proximal extremities but sparse on distal limbs and less on areas not exposed to heat
drug to treat chicken pox?
acyclovir (Zovirax) or varicella zoster immune globulin (VZIG);
benadryll for itching
nursing considerations for chk pox?
strict isolation; keep child in home until vesicles have dried (usually 1 wk after onset of disease); admin skin care, give bath change linens, topical calamine lotion, keep nails short mittens; remove loose crusts, apply pressure; NO ASPIRIN
chicken pox bacteria or virus?
virus: Varicella-zoster virus...respiratory
prevent complications with chicken pox?
prevent secondary skin infections from scratching
what is caused by bacteria that proliferate in the respiratory tract and multiply on dead tissue in the throat; producing exotoxin and exudate consisting of a tough fibrous membrane across the respiratory tract; this results in a mechanical airway obstruction
Diphtheria
incubation period in diphtheria?
2-5 days, possible longer
what are the s/s of diphtheria?
resembles common cold, frank epistaxis, malaise, anorexia, sore throat, low grade fever, white/gray membrane, "bulls neck", fever, hoarseness, cough, airway obstruction, cyanosis,
tx for diphtheria?
antitoxin, ABx: penicillin or erythromycin; poss tracheostomy, treat infected & carriers
nursing care for diphtheria?
strict isolation, senstitivity testing, have epinephrine available, maintain bed rest & complete care, suction as needed, admin humidified o2, look for s/s of obstruction
is rubeola (measles) a virus or bacteria?

how do you get it?
virus; usually direct contact with droplets of infected person; from respiratory tract secretions, blood, urine of infected person
incubation period for measles?
10-20 days
Measles diagnosis based on:
–generalized rash lasting 3 or more days
–fever > 38.3 (100.9)
–cough, coryza, conjunctivitis (3c’s)
–Koplik spots
Measles eruptive stage:
-deep red blotchy rash on face and neck which descends down; rash starts as discrete lesions then becomes confluent and salmon colored
–when rash subsides, a faint brown stain on skin remains & desquamation of skin begins
Measles period of communicability?
from 4 days before to 5 days after rash appears but mainly during prodromal (catarrhal) stage
Koplik spots are what?
small, irregular red spots with a minute, bluish white center 1st seen on buccal mucosa opposite molars 2 days before rash
what is Whooping cough (pertussis)?
Highly contagious bacterial infection ;Infection occurs following person to person contact from respiratory tract
what is evident in Whooping cough (pertussis)?
paroxysmal or spasmodic cough followed by high pitched crowing sound or “whoop”. cheeks flush, eyes bulge, tongue protrudes, thick mucous plug may dislodge
Whooping cough (pertussis)? Signs and symptoms:
Catarrhal stage – mild URI symptoms with cough for approximately 2 weeks
lParoxysmal stage- sever coughing episodes with inspiratory “whoops”
treatment Whooping cough (pertussis)?
treatment: patent airway, increase oxygen and humidity, bedrest, hydration,erythromycin
German measles (rubella) period of communicability:
period of communicability: 7 days before to about 5 days after rash appears
German measles (rubella) incubation:
incubation 14-21 days
German measles (rubella) transmission:

source:
transmission: direct contact and spread via infected person; source: nasopharyngeal secretions
nursing considerations German measles (rubella)
isolate child from pregnant women due to tetragenic effects on unborn fetus
Tell me about Mumps
Mumps
defn respiratory tract virus usually lasts 7 to 10 days
;symptoms: swelling in the parotid glands and painful swallowing ;potential consequences: aseptic meningitis, orchitis and epididymitis in older males
Nursing care for scarlet fever
resp. precautions until 24 hrs p antibiotics initiated
quiet activities
relieve discomfort of sore throat
encourage fluids
Complications- glomerulonephritis; rheumatic heart disease
scarlet fever prodromal stage:
prodromal stage:
abrupt high fever, vomit, h/a chills, malaise, abd pain
scarlet fever treatment
treatment is a full course of penicillin
pinworms Tx?
treatment- medication Vermox 100mg orally for one dose; repeat in 2 weeks
nursing considerations for pinworms?
–whole family needs to be treated
–Nursing care/prevention= teach handwashing, avoid thumb sucking, nails short, launder in hot H2o
-scotch tape test
Tx for ADD
CNS stimulant medications: commonly used Ritalin, Cyclert
uside effects: appetite reduction,weight loss, assess child’s growth every 3-4 months
–chlamydia trachomatis
bacterial sexually transmitted disease
mucopurulent exudate with erythema, edema of cervix (women) and meatal erythema, tenderness, itching, dysuria and urethral discharge (males)
risk factors are young age, multiple partners, presence of other STD’s, oral contraceptives
ages 15-24 may deny incidence of exposure and delay treatment; due to restricted access to health facilities
S/S- lower abd pain, abnormal vaginal discharge, dysuria, frequency
–chlamydia trachomatis tx?
Tx: oral doxycycline
–gonorrhea - Neisseria gonorrhoeae
usually have a concurrent infection with chlamydia
asymptotic in the early disease stage
SS -abnormal vaginal discharge, dysuria, frequency
–gonorrhea tx?
Tx: Ceftriaxone single dose IM
herpes - Herpes simplex virus (HSV)?
small painful vesicles on genital area, buttocks and thighs; itching usually
no known cure
pt teaching to use condoms to avoid spread of infection/ infection can be transmitted to infant at birth
herpes - Herpes simplex virus (HSV) tx?
Tx: acyclovir
Trichomonas Vaginalis?
pruritus and edema of external genitalia; foul smelling, greenish vaginal discharge
may be asymptomatic especially in males
Trichomonas Vaginalis tx?
Tx: metronidazole
_____ a chronic eating disorder characterized by loss of 15% of body weight
Anorexia-
what are the characteristics of anorexia?
–disturbed body image
–inaccurate perception of hunger
–culture emphasis
–high achiever; conformer
–self imposed starvation
–vigorous exercise is used to lose weight
–lowered body temp, bp, bradycardia, fatigue, anemia, cold sensitivity
School age 6-12 years old
industry, inferiority, peer relations, lying, stealing, concrete operations, reversibility, classification, cooperative play, “latch key"
School age 6-12 years old
Industry Vs. inferiority
School age 6-12 years old
Piaget: stage of concrete operations
–marked by inductive reasoning, logical operations, reversible concrete thought and conservation
School age 6-12 years old: specific characteristics of this stage include:
movement from egocentric to objective thinking, seeing other’s points of view; seeking validation; asking questions
-difficulty dealing with remote, future or hypothetical matters; learns alphabet, reading, tells time, relates to timing of events of history
-development of various mental classifying and ordering activities
-development of the principle of conservation of volume, weight, mass and numbers
-collecting and sorting objects
-ordering items according to size, shape, weight, and other criteria.
School age 6-12 years old
peer groups
socialization
school adjustment
Tasks the adolescent must complete:
a. achieve more mature relations with friends ( both sexes) and build meaningful relationships b. assume masculine/feminine role c. accept one’s physique
-develop an identity d.achieve emotional independence from parents e. prepare for a career/marriage/family life f. develop a set of values and ethics to base socially responsible behavior
Cognitive stages of adolescent
Erikson- identity Vs. role diffusion ;

Piaget- formal operations. Adolescent has ability to reason from possible to actual; rules are important for functioning; but rules can change. Nothing is sacred about rules. Serious questioning of existing moral values
Social development in adolescents
social activities- peer group gives a sense of belonging; peer group becomes important to judge ideas, morality,dress code and activity participation ; sources of stress from peer group: body image, sexual conflicts, scholastic pressure, competitive pressures, relationship with family ; health risks from peer pressure: sexual experimentation, use of drugs, alcohol, cigarettes, potential dangerous physical activities
characteristics of mistreating adult
adult has difficulty controlling anger, aggression, violence; often is socially isolated; few family supports; dysfunctional parenting;failure of adult to attach emotionally to child; inadequate knowledge of realistic expectations of child’s development, whether the parent was physically abused by his/her parents
social situations that increases risk for abuse
stress which becomes chronic - divorce, separation, economic problems, inadequate housing, substance abuse/addiction
–birth of an additional child may place other siblings at risk
–working parents with multiple commitments; substitute caregivers may be abusers
clinical findings with abuse
history and type of injuries do not match
–conflicting stories of how injuries occurred
–accident described and injury inconsistent with child’s developmental ability
–physical signs, burns; presence of physical injuries in various stages of healing
–under nutrition, poor hygiene
diagnostic findings with abuse
–history to determine onset, types of injuries; precise documentation required
–photos; X-rays may be necessary
–complete physical exam
–observation of child’s behavior
management with abuse
–hospitalization if necessary
–refer to Child Protective Services, reporting is mandatory
–utilize team approach
Prevention with abuse
–educate parents for realistic expectations of the child
–identify negative attitudes toward child/pregnancy
–identify the vulnerable child
–identify predisposing social, environmental factors
–identify violent behavior, substance abuse
–recognize knowledge deficits in child behavior, development
Gross motor skills mastered in preschoolers
3 y/o rides tricycle; goes up stairs using alternate feet, may still come down using both feed on step
–4y/o skips and hops on one foot
–catches ball reliably
–throw ball overhand
–walks downstairs using alternate footing
–5 y/o skips and hops on alternate feet
–throws and catches ball well
–jumps rope
–balances on alternate feet with eyes closed
Fine motor skills mastered in preschoolers
–3 y/o - build tower of nine of ten cubes
–4 y/o - can lace shoes, uses scissors successfully to cut out picture
–5yo - tie shoelaces
Psychosocial - tasks of preschooler?
tasks of the preschooler
–learns how to interact with other children
–learns socially acceptable behavior
–learns right from wrong and reward and punishments
–develops a conscience
what kind of thinking do preschoolers have?
magical thinking-
thinking is egocentric and transductive reasoning , they believe that thoughts are all-powerful; preschooler cannot logically reason the cause and effect of an event; 4 y/o tells stories exaggerated & questions are at a peak
Cognitive thinking in preschoolers?
Erikson
–initiative vs. guilt

Piaget
–pre operational 2-7 years
–preconceptual 2-4 years
–intuitive phase 4-7 years
exhibits intuitive thought
Language of a preschooler?
uses many words appropriately but w/o a real knowledge of their meaning
-vocabulary increase to more than 2100 words at the end of 5 years.
Nutrition patterns/feeding recommendations for a toddler?
daily needs -100 kcal/kg/day - decrease the milk intake to facilitate the intake of solid food
-physiologic anorexia
-4 food groups in small portions, several times a day
–vary time, texture, temperature
–limit sweets and empty calories
–avoid using food as a reward or punishment
anticipatory guidance for injury prevention -toddler?
-MVA
-drowning
-hot liquids
-poisonings
-falls
-aspiration
-environmental dangers
Anticipatory guidance for injury prevention/preschoolers?
less prone to falls and have some awareness of dangers and parental rules
-emphasis is on education for safety, preschoolers tend to imitate - parents should practice what they preach
clinical findings pinworms?
–nocturnal anal pruritis
–vaginal itching, discharge, dysuria
–irritability
–insomnia
pinworms transmitted how?
usually affects children; more common in crowded environments
transmitted fecal - oral route; drink, fomites and inhaled dust
-most common intestinal parasite in the U.S.?
giardiasis: more common in children and adults
difficult to isolate; may take more than specimen to isolate
-common in daycare when hygienic practices are lacking; hand to mouth
treatment for giardiasis?
flagyl (metronidazole), quinacrine (Atabrine), furazolidone (Furoxone)
which drug has the highest frequency of S/E, esp N/V, temp yellow staining of skin, sclera, and urine, and a very bitter taste
quinacrine (Atabrine)
how can you reduce the S/E of quinacrine (Atabrine)?
crush tablets and mix with them a strong flavoring such as jam or syrup with or after meals
how can you test for giardiasis?
string test; child swallows a gelatin capsule with a nylon string attached and removed several hours later
oR

stool samples with EIA
what is the most common helminth infection?
pinworms
vision in toddler eyes?
20/50 (by 3 years)
why the “pot-bellied appearance” of toddler hood:
-pot-bellied bow leggedness -protruding abdomen results from undeveloped muscles; bow leggedness persists through toddler-hood since the legs must bear the weight of the relatively large trunk
period of communicability of scarlet fever
during incubation period and clinical illness, approx 10 days; during 1st 2 wks of carrier phase; although may persist for months
Complications of scarlet fever?
Complications- glomerulonephritis; rheumatic heart disease, otitis media, sinusitis