Pediatric

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PEDIATRIC A child with HIV-positive blood should receive inactivated poliovirus vaccine (IPV) rather than oral poliovirus vaccine (OPV) immunization. o To achieve postural drainage in an infant, place a pillow on the nurse’s lap and lay the infant o o o o o o across it. A child with cystic fibrosis should eat more calories, protein, vitamins, and minerals than a child without the disease. Infants subsisting on cow’s milk only don’t receive a sufficient amount of iron (ferrous sulfate), which will eventually result in iron deficiency anemia. A child with an undiagnosed infection should be placed in isolation. An infant usually triples his birth weight by the end of his first year. Clinical signs of a dehydrated infant include lethargy, irritability, dry skin decreased tearing, decreased urinary output, and increased pulse. Appropriate care of a child with meningitis includes frequent assessment of neurologic signs (such as decreasing levels of consciousness, difficulty to arouse) and measuring the circumference of the head because subdural effusions and obstructive hydrocephalus can develop. Expected clinical findings in a newborn with cerebral palsy include reflexive hypertonicity and criss-crossing or scissoring leg movements. Papules, vesicles, and crust are all present at the same time in the early phase of chickenpox. Topical corticosteroids shouldn’t be used on chickenpox lesions. A serving size of a food is usually 1 tablespoon for each year of age. The characteristic of fifth disease (erythema infectiosum) is erythema on the face, primarily the cheeks, giving a “slapped face” appearance. Adolescents may brave pain, especially in front of peers. Therefore, offer analgesics if pain is suspected or administer the medication if the client asks for it. Signs that a child with cystic fibrosis is responding to pancreatic enzymes are the absence of steatorrhea, improved appetite, and absence of abdominal pain. Roseola appears as discrete rose-pink macules that first appear on the trunk and that fade when pressure is applied. A ninety degree-ninety degree traction is used for fracture of a child’s femur or tibia. One sign of developmental dysplasia is limping during ambulation. Circumcision wouldn’t be performed on a male child with hypospadias because the foreskin may be needed during surgical reconstruction. Neonatal abstinence syndrome is manifested in central nervous system hyperirritability (for example, hyperactive Moro reflex) and gastrointestinal symptoms (watery stools). Classic signs of shaken baby syndrome are seizures, slow apical pulse difficulty breathing, and retinal hemorrhage. An infant born to an HIV-positive mother will usually receive AZT (zidovudine) for the first 6 weeks of life. Infants born to an HIV-positive mother should receive all immunizations of schedule. Blood pressure in the arms and legs is essentially the same in infants. When bottle-feeding a newborn with a cleft palate, hold the infant’s head in an upright position.

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Because of circulating maternal antibodies that will decrease the immune response, the measles, mumps, and rubella (MMR) vaccine shouldn’t be given until the infant has reached 1 year of age. Before feeding an infant any fluid that has been warmed, test a drop of the liquid on your own skin to prevent burning the infant. A newborn typically wets 6 to 10 diapers per day. Although microwaving food and fluids isn’t recommend for infants, it’s commonplace in the United States. Therefore the family should be toughs to test the temperature of the food or fluid against their own skin before allowing it to be consumed by the infant. The most adequate diet for an infant in the first 6 months of life is breast milk. An infant can usually chew food by 7 months, hold spoon by 9 month, and drink fluid from a cup by 1 year of age. Choking from mechanical obstruction is the leading cause of death (by suffocation) for infants younger than 1 year of age. Failure to thrive is a term used to describe an infant who falls below the fifth percentile for weight and height on a standard measurement chart. Developmental theories include Havighurst’s age periods and developmental tasks; Freud’s five stages of development; Kohlberg’s stages of moral development; Erikson’s eight stages of development; and Piaget’s phases of cognitive development. The primary concern with infusing large volumes of fluid is circulatory overload. This is especially true in children and infants, and in clients with renal disease. Certain hazards present increased risk of harm to children and occur more often at different ages. For infants, more falls, burns, and suffocation occur; for toddlers, there are more burns, poisoning, and drowning for preschoolers, more playground equipment accidents, choking, poisoning, and drowning; and for adolescents, more automobile accidents, drowning, fires, and firearm accidents. A child in Bryant’s traction who’s younger than age 3 or weighs less than 30 lb (13.6 kg) should have the buttocks slightly elevated and clear or the bed. The knees should be slightly flexed, and the legs should be extended at a right angle to the body. The body provides the traction mechanism. In an infant, a bulging fontanel is the most significant sign of increasing intracranial pressure.

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