Pediatric Healthcare Quiz

Common Health Challenges & Hospitalization

• Learning Objectives:
  • Identify common childhood illnesses and their characteristics.
  • Understand developmental milestones pertinent to unwell/hospitalized children.
  • Analyze the role of a pediatric nurse.
• Resources:
  • Ministry of Child and Youth Ontario (URL provided)
  • Safe Kids Canada (URL provided)
  • Sick Kids Hospital Health resources (URL provided)
• Common Illnesses (by age group):
  • Infant: Hyperbilirubinemia, Acute Otitis Media, RSV
  • Toddler/Preschooler: Febrile Seizures, Acute Gastro, Tonsillitis
  • School-age: Pneumonia, Autism, Asthma
  • Adolescent: Eating Disorders, Depression/Suicide, Substance Abuse
• Hyperbilirubinemia:
  • Excess bilirubin deposits in tissues, causing jaundice.
  • Physiological jaundice is related to fetal RBC breakdown after delivery.
  • Pathological jaundice presents within the first 24 hours, usually due to blood incompatibility.
  • Risk factors include prematurity, infant of a diabetic mother, polycythemia, and blood type incompatibility (Rh+/−).
  • Treatment involves maintaining hydration and phototherapy.
• Acute Otitis Media:
  • Middle ear inflammation often following respiratory infections.
  • Common in children between 6 months and 2 years, but can occur at any age.
  • Symptoms include pain, irritability, fever, pulling at ear, and diarrhea.
  • Eustachian tube problems frequently play a role.
  • Surgical management may include myringotomy or tympanostomy.
• Otitis Media (symptoms/treatment):
  • Ear infections occur when mucus from a cold blocks the eustachian tube, causing fluid buildup, and eardrum bulging.
  • Symptoms include ear pain, crying, poor sleep, fluid draining from ear, and fever (1 out of every 10-20 cases can result in eardrum rupture).
  • Treatment involves pain relief (acetaminophen or ibuprofen) to lessen earache and fever; antibiotics may be necessary.
• RSV (Respiratory Syncytial Virus):
  • Highly contagious virus, commonly causing common cold symptoms in older children; severe in infants.
  • Causes bronchiolitis and pneumonia, often seasonal (Nov-April).
  • Symptoms include runny nose, cough, sneezing, mucous, and fever.
  • Synagis (Palivizumab) is an antibody injection for high-risk infants aiding prevention of severe disease.
• RSV Treatment:
  • Supportive care focused on managing symptoms.
  • Adhering to infection prevention & control measures.
  • Oxygen administration.
  • Hydration maintenance.
  • Monitoring for tachypnea & tachycardia.
  • Assessing work of breathing, chest sounds, and oxygenation.
  • Intravenous fluids may be necessary in severe cases.
• Hospitalized Infant: Strategies for minimizing frustrations and supporting regression include maintaining a sense of trust with the child, promoting sensorimotor activities, and supporting home routines and schedules.
• Toddler/Preschooler Exam: Involving caregivers and employing a patient-centered approach is essential.
• Febrile Seizures:
  • Seizures accompanied by infections (Otitis media, Upper respiratory tract infection, Meningitis).
  • Sudden muscle contractions and relaxation.
  • Common presentation is a sudden onset involving arms, legs, and facial muscles early in a high fever.
  • Treatment (if seizure persists) includes Diazepam, and antipyretics (Tylenol and/or ibuprofen), and family education.
• Acute Gastroenteritis:
  • Inflammation of the stomach and intestines, typically including diarrhea and vomiting.
  • Causes include malnutrition, intolerance (lactose), Viruses (rotavirus, norovirus, adenovirus), Bacteria (Shigella, Salmonella, Campylobacter, E.coli, Clostridium difficile, Yersinia), and Parasites (Giardia lambia, Crytosporidium, Entamoeba histolytica).
  • Diagnosis includes symptoms(fever, nausea, vomiting, watery/green diarrhea, dehydration, electrolyte imbalances), taking a history and performing an exam.
• Dehydration (in Acute Gastroenteritis):
  • Key to prevention and management.
  • Symptoms signify dehydration: weight loss, rapid/weak pulse, decreased peripheral circulation, dry mucous membranes, decreased urine output, depressed fontanel, skin turgor loss, diminished tear production.
• Tonsillitis:
  • Tonsil inflammation (lymphoid tissue) resulting from pharyngitis.
  • Tonsils progressively enlarge from age 2-10, diminishing during pre-adolescence.
  • Infection can cause the tonsils to become enlarged enough to interfere with breathing and swallowing.
  • Symptoms include enlarged bright-red tonsils, frequent sore throats, mouth breathing, bad breath (halitosis), nasal speech, fever, and difficulty swallowing and snoring.
• Tonsillitis Treatment
  • Medical treatment involves analgesics (pain relief), antipyretics, and antibiotics (if streptococcal infection).
  • Surgical management is called a tonsillectomy & adenoidectomy (T&A).
  • Pre- and post-operative care are critical for children.
  • Post-op care includes monitoring vital signs, fluid intake/output, and signs of bleeding.
• Hospitalized Toddler: Reassure parents, maintain trust, allow experiences via play and soothing techniques, and support familiar home routines/habits.

Specific Illnesses and Conditions

• Autism Spectrum Disorder:
  • Neurodevelopmental disorders with difficulties in social interaction, communication, and repetitive behaviors.
  • Several different subsets exist, including Autistic Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), and Asperger's Disorder.
  • Early intervention is beneficial.
  • Cause unknown; suspected genetic link.
  • Frequent assessments by a team of professionals (speech-language pathologist, development pediatrician, psychologist, psychiatrist) are necessary.
  • Early signs may include no babbling/pointing by 12 months, no 2-word phrases by 24 months and loss of previously attained social/language skills.
  • Treatment focuses on education, medication (as needed), and monitoring for side effects.
• Asthma:
  • A chronic lung condition characterized by inflammation, constriction, and hyperactivity of air passages (often causing wheezing).
  • Often develops before age 5 (80% prevalence).
  • Symptoms include coughing, wheezing during exhalation, shortness of breath, and chest tightness & itchiness in neck & chest & air hunger (nostrils flaring), accessory muscle use, orthopnea, and perspiration (especially at night).
  • Treatment involves medications (bronchodilators and anti-inflammatory drugs), avoiding triggers (dust mites, excessive humidity, and irritants), and monitoring activity tolerance.
• Hospitalized School-age child: Usually tolerate separations from parents easily but forced dependence can be difficult; involve these children in their own care & provide opportunities for play (drawings, role-playing).
• Hospitalized Adolescent: Concern about body image, peer relationships, gender expectations, and future plans.
• Mood Disorders (in adolescents):
  • Depression can manifest as behavioral changes (such as not caring about schoolwork, grades, and activities), a prolonged change in baseline behavior, and difficulty in interpersonal relationships, which can affect school, family, and daily activities.
  • Important to look out for warning signs like giving away possessions, talking/writing about suicide, and withdrawal from family and friends.
• Warning Signs of Suicide: Major life changes, feelings of hopelessness, giving away possessions, reduced performance in school or at work, mood swings, withdrawal from friends, and loss of interest in personal appearance.
• Substance Abuse: Drug or alcohol use, often indicated by an increased frequency, and potential damage to the developing brain.
• Child Abuse (types): Emotional abuse involves verbal acts damaging self-esteem; neglect involves ignoring critical needs for emotional/social development; sexual abuse involves sexual exploitation of a child; physical abuse involves physical injury, and neglect involves failing to meet basic physical needs.
• Risk Factors for Abuse: Variables that can increase the likelihood of abuse.
• Professional Responsibility (Suspected Abuse): Procedures and protocols to follow in suspected cases of child abuse.
• Reporting Abuse: Laws and guidelines concerning child abuse reporting in Ontario involving the Children's Aid Society (a legal and responsibility obligation, with particular attention to the age guidelines).

Test your knowledge on pediatric healthcare topics, including post-operative care, signs of anxiety in children, and understanding Autism Spectrum Disorders. This quiz covers symptoms, effective treatment practices, and potential signs of abuse. Perfect for students and professionals in the field of pediatric medicine.