ONE QUEST REVIEW CENTER

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PEDIATRIC IN NURSING
(CARE OF THE NEWBORN IN THE_______________)
• __________________________
 After expulsion or the baby is totally out from the mother’s body, place on a
 With the head extension, clear the
 Suction gently and briefly for______ seconds from
 Deep suctioning is contraindicated because this may cause
 Oxygenate between suctioning with 20-40% but not more than 40% of oxygen concentration because this
may result to oxygen toxicity leading to
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• __________________________

 dry, warm and wrap the newborn to prevent _________________________________

 first sign of cold stress or hypothermia is the increase in
 Newborn babies are prone to hypothermia because they are born wet, cooled blooded, inadequate
subcutaneous tissues and not yet capable for shivering.
 The newborn’s high temperature at birth drops quickly because of the processes of ___________
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PROCESSES OF HEAT LOSS
_______________ – loss of heat as liquid leaves the newborn body
_______________ – loss of heat to cold surface with direct contact (ex. Air conditioned room)
_______________ – loss of heat to cool surfaces not in contact (ex. Cool ceiling, wall or walls). Radiation is the
common process of heat loss in the newborn.
_______________- loss of heat when it is dissipated by air current
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• APGAR SCORING Criteria & Definition Score of 0 Score of 1 Score of 2

A is for the
P is for
G is for
A is for
R is for the

* the most important in APGAR scoring-

* the least important-
INTERPRETATION OF APGAR SCORE
SCORE CONDITION MANAGEMENT

0-3 POOR – severely depressed

4-6 FAIR – moderately depressed

7-10 GOOD
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - -
• PROPER IDENTIFICATION

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CARE OF THE NEWBORN IN THE _________________
• Skin care - done to prevent skin infection (oil bath for premature) (soap & water bath for normal full term

• Cord Dressing - observe strict asepsis, always check for the vessels (1 vein and 2 arteries), check for the absence of normal
abdominal wall in the region of umbilicus (omphalocele) and cord bleeding in 24hrs.
-_______________________- is a cord infection caused by
- this can be prevented through TT, given to pregnant mother and strict asepsis in cord dressing.

• ________________________ (eye care) - done to prevent infection of the eyes -_______________________

or gonorrheal conjunctivitis which is caused by neisseria gonococcus, bacteria from infected mother
*delay for 1 – 2 hours to promote early bonding.

• ____________________ - done to prevent bleeding

- best site for injection-

• Weighing and Taking of Antropometric Measurements:

> weight - > height - > chest circumference (CC) -
> head circumference (HC) - > abdominal circumference (AC) -
- bulging fontanel indicates -
- Sunken fontanel indicates -
- Caput succedanum -
 Vital signs – check when infant is asleep or quiet

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PROMOTION OF BONDING
* show the newborn the mother after delivery, *allow and encourage touching and cuddling,
* breastfeeding on the DR table is primarily to promote early bonding *verbalize similarities between
mother and infant, *rooming-in, and
*________________(skin & eye to eye contact in breastfeeding is the most important requirement in bonding).

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NEWBORN SKIN MARKS

 Lanugo – line downy hair, more in preterms.

 Vernix caseosa – whitish cheesy odorless usually on folds of skin, more on full terms
 Protects skin and prevent heat loss
 Milia – white pinpoint papules on the nose, chin and cheeks.
 Disappear in 2-4 weeks
 Mongolian spot – grayish blue patch at the lower back from accumulation of pigment melanocytes.
 Disappears by school age
 Stork bites (nevi) – red spots found at the back of the neck and above eyelids
 Disappears spontaneously after 1 year
 Newborn rash – (______________________________________) harmless pink popular rash appearing on the body
within 24 – 48 hours after birth.
 Desquamation – dry peeling of the skin particularly on the palm and soles, more in post terms
 Hemangiomas – vascular tumor of the skin, strawberry hemangiomas is common type
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PERCEPTION OF DEATH IN PEDIA
•
•
•
•

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GROWTH AND DEVELOPMENT
GROWTH – increase in physical size of structure or whole -
Height – 1 inch per month for the first 6 months and ½ inch for 7 – 12 months,
- 50% during first year of life and 25% average increase in height
Weight – after day 10, weight gain of __________________________________________
- 6 months-
- 1 year-
- toddler age-
DEVELOPMENT – increase in the skills and capacity to function -
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• Neonate –
• 1 month – dance reflex appears, &
• 2 months –
• 3 months – , follows object midline, grasp and tonic – neck reflex are fading, hand regard
• 4 months –
• 5 months – handles rattles well, teething rings, moro reflex disappears on 4-5 mos.
• 6 months – , uses palmar grasp, reaches out in anticipation of being picked up, eruption of
• 7 months – transfers object hand to hand, &
• 8 months – , plantar reflex disappears &
• 9 months – , fear of stranger beginning to disappear, grasp reflex disappears,
(neat fincer), mama dada – combined two syllables.
• 10 months – , understands the word “no”, can respond to own name, pat a cake since can
• 11 months – can
• 12 months – , drink from a cup, cooperate in dressing, says the two word
plus mama and dada, pats and pans, pull toy
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TODDLER 1 – 3 years old

• 15 months – (late in walking can be a sign of mental retardation), puts small pellets into
small bottles, scribbles voluntary with pencils, holds a spoon well, sits self on chair, creep upstairs, 4 – 6 words.
• 18 mos. – 1 ½ yrs. – height of possessiveness (akin yan, akin to, amin to, amin yan), can run and jump in place,
walks up and down the stairs with assistance, typically places both feet on 1 step before advancing, &

• 24 mos. or 2 years – can open door by turning door knobs, unscrew lids, walks upstairs alone still using both feet at the
same time, 50 – 200 words &
• 30 mos. Or 2 ½ yrs – can jump down from stairs, knows full name, holds up fingers to show age, beginning of tooth
brushing with a little assistance (6 yrs. Alone), copy a circle, makes simple lines with a pencil, temporary teeth complete-
• 36 mos. Or 3 yrs. – (trusting three), unbutton buttons, draw a cross, knows full name and sex, ride a tricycle,
300 – 900 words, speaks fluently, learns how to share
• 4 yrs. (furious four) – aggressive, stormy, noisy, button buttons, knows the basic colors, 1500 words
• 5 yrs. (frustrating five) – 2100 words, copy a triangle &

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REFLEXES

 Rooting reflex – if the cheek or corner of the mouth is touched, the infant turns to that side for food location.
- Disappears at 3 – 4 months but could last until 7 months.

 Sucking reflex – anything that touches the lips, the infant sucked. Disappears at 6 months.

 Blink reflex – rapid eyelid closure when strong light is shown (to protect the eye). Never disappear

 Palmar grasp reflex – infant will grasp any solid object when placed on his palm. Disappears within 3 months

 Plantar grasp reflex – the infant will grasp any object that touches the sole of a newborn’s foot at d base of the
toes. Disappears at 6 – 10 months in preparation for walking.

 Step or walk – in place reflex (dance reflex) – when an infant is placed on a vertical position with their feet
touching a hard surface will take a few quick and alternating steps. Disappears on 6 – 9 months in
preparation for walking.

 Landau reflex – while on a prone position and support the trunk, the child will exhibit some muscle
tones, which is present at 3 months. (Parachute reflex- 8months)

 ____________________________– when a newborn lies on his back, his head turned to one side or the other, his
arm and leg on that side extend and the opposite arm and leg flex and contract. Disappears in

 ____________________________– a loud voice or jarring the bed crib, the infant will presume a letter __ position
or embracing motion of the arms. Disappears in
• Best index for -

 ____________________________ -

________________________________________________________________________________________________
Principles of Toilet Training-
Child requisites-
Mother requisites-

3phases of separation anxiety-

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COMMON DISORDERS, DYSFUNCTIONS & DISEASES
IN PEDIA
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■ – is the frequent passage of loose and abnormally watery stools usually caused by bacteria such as
escherichia coli, salmonella, shigella.

- implementation & health teachings:

- administer oral rehydration therapy and IV fluids as ordered.
- monitor daily weight and fluid intakeand output
- avoid BRAT diet
- theach the children and family for proper handwashing.

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■ – is the excessive loss of water from the body tissues.

- implementation & health teachings:
- administer oral rehydration therapy and IV fluids as ordered - monitor daily weight and fluid intake and output

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 ONE QUEST REVIEW CENTER

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■ – are tissue injuries caused by contact with fire, chemicals, electricity, radiation, lightning or extreme cold.
- depth of injury:
- 1st degree burn –
- 2nd degree burn –
- 3rd degree burn –

- implementation & health teachings:

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■ – is an autoimmune inflammatory disease which synovial joints are primarily involved.

- common signs & symptoms:

- systemic - pain in any joints, _______________________
- pauciarticular - pain at the lower extremities, ______________________
- polyarticular - pain at smaller joints, ___________________
- laboratory finding:

- implementation & health teachings:

- provide heat to painful joints ( warm soaks & tub baths)
- encourage physical activity but avoid overexercising painful joints
- maitain joint extension to reduce flexion deformity
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■ – is an infection of the meninges in which the bacteria enter the meninges through the bloodstream
and spread through the CSF.

- Bacterial meningitis is fatal if not treated immediately while viral meningitis is a self-limiting disease lasting for 7-10 days

- common signs & symptoms:

- for below 2 years old: fever, high-pithched cry, poor feeding, irritability, lethargy, opisthotonos and
- for older children: headache, nuchal rigidity (stiff neck), kernig sign, brudzinski sign and

- complications: increase ICP, cerebral edema, hydrocephalus, deafness, blidness and paralysis

- laboratory & diagnosis:

- implementation & health teachings:
- _____________________________- monitor vital signs, I & O, fluid and electrolyte balance- nothing by
mouth for children with diminished consciousness, - fluid intake my be limited to prevent cerebral edema-
measure head circumference to monitor hydrocephalus and other complications- implement isolation with
respiratory precautions for 1 to 2 days after antibiotic administration begins to prevent infection to others
and keep the room quiet to decrease environmental stimuli
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■ – is the sudden unexpected death of any infant.

- implementation & health teachings:

- monitor infants at risk for apnea and allow parents to verbalize feelings
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■ – is a chronic multisystem disorder of the exocrine glands characterized by abnormally thick

pulmonary secretions which affects the respiratory system, gastrointestinal tract, reproductive tract,
salivary glands and the pancreas.

- common signs & symptoms:

- dyspnea, cyanosis, atelectasis, _____________________________generalized obstructive emphysema, sinusi\tis,
bronchopneumonia, partial or complete intestinal obstruction, right sided heart enlargement, hyponatremia and
increase concentrations of sodium and chloride in sweat
- implementation & health teachings:
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 ONE QUEST REVIEW CENTER

- encourage breathing exercises, use of aerosol treatments and bronchodilators to promote adequate oxygenation
and normal breathing pattern - diet –
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■ – is the inflammation and narrowing of the laryngeal and tracheal areas.

- common signs & symptoms:
- severe respiratory distress, inspiratory stridor, wheezing, rales, ronchi, hoarseness, pallor, cyanosis, restlessness

- implementation & health teachings:

- assess for airway obstruction, _________________ - intubation tray near the bedside - promote desired fluid intake
- administer increase atmospheric humidified oxygen - for barklike cough – tell the parents to place the child in the
________________________________________
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■ - is an inflammation of the epiglottis which may cause hypoxia and obstruction leading to sudden death.

- common signs & symptoms:

- dyspnea, sudden onset of fever, lethargy, restlessness, anxiety, tripod position, severe sore throat, refusal to drink,
stridor, hoarseness, rapid thready pulse, late signs –

- implementation & health teachings:

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■ – is a malabsorption syndrome that occurs when the mucosa of the proximal small intestine is sensitive to gluten

- it can be acquired from either an inborn error of metabolism or an abnormal immunologic response to the gluten factor of
- accumulation of the amino acid glutamine causing the intestinal villi to atrophy, reduce the absorptive surface of the small
intestine, leading to electrolyte imbalance, severe acidosis and rapid dehydration.
- common signs & symptoms:
- anorexia, abdominal pain, diarrhea (watery stools and very foul smell), vomiting, constipation, ______________________

- laboratory & findings:

- biopsy- reveals flat mucosal surface with hyperplastic villous atrophy and presence of antigliadin/antireticulin/antiendomysium
implementation & health teachings:
- promote adequate hydration, ________________________________
- foods to be avoided:
grains- ___________________________
(bread, rolls, cookies, cakes, crackers, cereal, spahetti, macaroni and noodles) milk-(ice cream, malted milk), beer/ale
- foods allowed: ___________________________________________
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is a group of chronic, severe, genetic, hemolytic diseases associated with hemoglobin S which
transform RBCs into a sickle (crescent) shape when blood oxygenation is decreased resulting to
______________________________________________________
- 25% chance of each child will have the disease if both parents has the trait
- common signs & symptoms:
- hematuria, bone weakness, dactylitis (symmetric swelling of the hands and feet), inability to concentrate urine,
enlarged spleen and liver, /growth retardation, MI and recurrent severe infections
- implementation & health teachings:
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is characterized by pancytopenia and bone marrow hypoplasia (incomplete development of tissue/organ)

- implementation & health teachings:

◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is a group of hereditary bleeding disorders characterized by a deficiency in a blood-clotting factor.

- malfunction in blood clotting factor causes abnormal bleeding and impaired ability to form a fibrin clot.
- types:
- signs & symptoms:
- easy bruising, epistaxis, spontaneous hamaturia, hemarthrosis, prolonged bleeding from wounds, when injured, in
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trauma or surgery, excessive bleeding from the umbilical cord or after circumcision (suspected in newborn)
- complications- osteoporosis, muscle atrophy, bone changes, intracranial bleeding, gastrointestinal hemorrhage,
hematomas in the spinal cord resulting to paralysis
- management & health teachings:
- for hemophilia A & vWd - administration of desmopressin (DDAVP) - to increase promote the release of factor
VIII and von Willebrand factor
- to prevent bleeding- teach about injury prevention, use soft tooth brush, avoid aspirin & contact sport
- to control bleeding- apply pressure, cold, elevate and immobilize the injured site
- monitor for signs of hypovolemia - demonstrate passive ROM exercises

◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is a group of disabilities which are seizures, sensory impairment and mental retardation caused
by injury or insult to the brain either before or during birth or in early infancy.
- it has 4 classifications:

- common signs & symptoms:

- abnormal motor performance, posture & reflexes:
- asymmetrical crawl, poor sucking, opisthotonus - severe backward arching from neck to heel)
- implementation & health teachings:
- provide safe environment, promote mobility and self care, promote adequate fluid and nutritional intake, help
promote a positive self-image in the child and optimal family functioning.

◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is a group of disorders that cause progressive degeneration and weakness of

skeletal muscles due to absence of ____________
- dystrophin is
- common signs & symptoms: (begins between 3 & 5 years old)
- initial- delays in motor development, difficulties in running
- walking ability ceases when the child s between 9 and 12 & - presence of _______________ and cardiac problems
- laboratory & findings:

- implementation & health teachings:

-
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ – is an enlargement of the head due to accumulation of CSF. This is because of imbalance

production, absorption & obstruction of CSF in the ventricular system (due to meningitis & brain
tumor)
- common signs & symptoms:
- in infants- ____________________, unequal pupils, macewen’s sign-__________________, abnormal reflexes, irritability and lethargy
- in children- ______________, headache when awakening with emesis, strabismus, papilledema, apathy irritability, and lethargy
Complication- ___________, mild to severe brain damage that may lead to death

- implementation & health teachings:

- ETV-Endoscopic Third Ventriculostomy: surgical operation to create small hole (VP shunt) to provide drainage of
the CSF to flow to relieve pressure
- (nonshunting treatment) - assess and check for head circumference, fontanelles, LOC and signs of increase ICP
- monitor for shunt infection and malfunction which are characterized by rapid onset of vomiting, fever, redness
and fluid around the site - advice to avoid contact sports and frequent medical checkups
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ REYE’S SYNDROME – is an acute multi-system disorder with viral infection such as influenza or varicella
- common signs & symptoms: stage 1- vomiting confusion, liver dysfunction & lethargy, stage 2- combativeness/halucinations
stage3- hyperventilation & coma, stage 4- deepened coma & brainstem dysfunction, stage5- DTR loss, seizure & respiratory arrest

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- implementation & health teachings:

◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

4 Types of Spina Bifida:

■ MENINGOCELE -
■ MYELOMENINGOCELE -

■ SPINA BIFIDA OCCULTA -

■ SPINA BIFIDA CYSTICA -

- common signs & symptoms:

- implementation & health teachings:

◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ _________________________ - is the narrowing of the pyloric sphincter that may lead to obstruction, gastric distention, dilatation & hypertrophy

- common signs & symptoms: _____________, vomiting, weight loss, upper abdominal distention, malnutrition & dehydration
surgical treatment- _________________- incision of the pylorus to split the muscle to ___________________
- implementation & health teachings: promote _______________________ & prevent ____________
every after feeding: position the infant in
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ _______________________ - invagination or telescoping of a portion of intestine to the adjacent portion causing obstruction

- common signs & symptoms: _______________ stool, severe paroxysmal abdominal pain, vomiting, distended abdomen &
possible palpable mass
- implementation & health teachings: promote ______________________________, encourage intake of clear liquids after surgery

◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ HIRSCHSPRUNG DISEASE - absence of nerves to a section of the intestines resulting to obstruction due to inadequate motility

- common signs & symptoms: ___________________ stool

- newborn- failure to pass meconium, abdominal distention & bile stained emesis
- infant- constipation, abdominal distention & vomiting
- older children- ribbon-like stool, abdominal distention, palpable fecal mass, poor growth & anemia

- implementation & health teachings: promote ________________________, assess bowel functioning, administer enema
to decrease constipation, provide comfort (elevate head & change position frequently)
surgical treatment:___________________________________________________

◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

■ _________________- failure of soft tissue in the upper lip to fuse during embryonic development
- surgical management-

■ _________________- failure of soft tissue in the palate to fuse during embryonic development
- surgical management-

- implementation & health teachings:

- feed small amount gradually, burp frequently, position on the side after feeding, always keep suction equipment &
bulb syringe at bedside, teach the mother the ESSR method of feeding
- enlarge the nipple hole, stimulate sucking & swallow, then rest after signal
Post operative care for cleft lip-
Post operative care for cleft palate-
◙ ◙ ◙ ◙◙ ◙ ◙ ◙◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙ ◙

EPISPADIAS-

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HYPOSPADIAS-

CRYPTORCHIDISM-