-More and more kids developing type 2
-*More kids have type 1: They need insulin teaching, rotating sites, checking sugars, etc
More activity = more insulin and more food
-Eat and take insulin B4 activity
-Change diet to meet needs
-HgA1C < 8%
-Every infant screened after 24 hrs old.
-Checking phenylalanine levels
-Lack enzyme to break down protein
How do you treat? Special diet restricting protein
Untreated = profound mental retardation
-Typically caused by trauma to vasopressin neurons, neoplasms, autoimmune or infectious diseases
-Classic S/S: Polyuria and Polydipsia
-Treatment: Depending on cause --Fluid replacement may be enough. May require medications such as DDAVP
-Important to educate kid, as well as let know school of circumstances, etc.
-Increased metabolism = increased activity, etc.
-Most common casuse of hyperthyroidism in children is Graves Disease. Believed to be caused by autoimmune response to TSH receptors but no specific etiology.
Hypothyroidism occurs when the thyroid gland produces a deficient amount of the thyroid hormones, resulting in a lowered basal metabolism.
-Become sluggish, overweight, etc.
S/S, way to care for child, HOW TO HELP KID REACH POTENTIAL
-Profound deafness likely to be diagnosed in infancy. Concerns for speech development.
S/S: lack a startle reflex, failure to awakened by loud environmental noise, absence of babbling by age 7 months, general indifference to sound, lack of response to spoken word.
-Hearing aid, face them when speaking, .......
Teaching instructions regarding care of child with acute conjunctivitis (pink eye):
-Warm compress to site, wipe secretions inside to outside
-eye is sensitive to light, most of the time it resolves on its own.
What behavior might you observe in a 5 yr old with a developmental disorder:
-Acting out, not speaking at all, at younger then they are,
Best ways to administer oxygen to 3 yr old
Shock, S/S, Treatment
S/S: Cool, clammy, increased pulse, hypotension, profuse sweating, rapid/shallow breathing, cyanosis, etc.
*Important to determine cause (ie. hypovolemia)
Treatment: Increase 02, trendelenburg position, etc. (DEPENDS ON CAUSE)
Care of child S/P
-Head trauma, # 1 Neuro/C-Spine ----PROTECT NECK. DO NOT MOVE!
What is the most likely cause of cardiac arrest in infant and children?
What would you assess next after ABC's?
-Sudden Infant Death Syndrome = Sudden Respiratory Arrest
-Has been on the decrease since 1995 due to the teaching on putting babies on their back for sleep.
Care of child with Epiglottitis
The uppermost cartilage of the larynx, located immediately posterior to the root of the tongue.
It covers the entrance of the larynx when the individual swallows, thus preventing food or liquids from entering the airway.
***-Do not inspect back of throat with tongue blade
-Keep pt calm
-Put absolutely nothing in the mouth
-Bring trach kit with you with doc. this is a life threatening position
Care of child Post tonsillectomy
-Give nothing hot
-Give soft foods
-Give plenty of fluids
*Pop Sickles (not red, dont want to mistake for blood)
Who is at greatest risk fo suicide?
-People who have a plan, the means, and the ability.
Eye care (S/P getting irritant in eye)
-flush with copious amounts of water and make sure not to wash in other eye. Make sure to get eval after flush.
Choking (S/S, Care)
-Gasping, can't talk, etc.
Treatment: Head down and pat on back
CPR (Infant, toddler, child)
ABC (Airway, breathing circulation)
What is the drug of choice in treating cardiac arrest?
-Goal is to dislodge. If they become unconsious then take them to the floor.
Cognitive Impairment: When should child be referred for stim and education?
As soon as the diagnosis is made
Cognitive Impairment: What is major consideration when selecting toys?
Select for developmental age cognitively (not normal age)
Consent Forms for treatment of children
-Every pt regardless of age for invasive procedure needs a consent form signed.
What it entails...
1) What procedure (risk, why doing, possible death, etc.)
2) If its a child = parent or legal guardian, life/death situation can be by two doctors