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infection: • Transplacental • Ascending infection • Bacterial colonization • Environmental Clinical Manifestation: • Hypothermia • Apnea, respiratory distress • Failure to feed • Vomiting and jaundice Management: Antibiotic (Gentamycin 5-7mg (kg) TID for 14) Neonatal meningitis: is an infection of brain caused by sepsis or bacteria in the blood stream. Pediatric Nursing and child health care 52 Management: • Ampicillin 200mg/kg. 24 hr in 4 divided dose • Gentamicin 5-7 mg/kg/ 24 hrs TID 14 days • Neonatal pneumonia: is an infection of lung tissue in neonatal period. Route of infection: • Transplacental • Amniotic fluid infection • Environment • Instrument Other Neonatal problems: • Congenital abnormalities • Prematurity and related problems • Jaundice • Birth Trauma 4.4 Post neonatal and infant morbidity: Causes of infant morbidity: • Acute upper respiratory infection • Diarrhea • Hypertrophy of tonsils and adenoids • Bronchopneumonia Pediatric Nursing and child health care 53 • Pyrexia of unknown origin • Acute Bronchitis • Malaria • Inflammatory disease of eye • Accidents • Other helemintisis Toddler (1-3 year) • ARI • Diarrhea • Measles • Malnutrition • Preschool • ARI • Measles • Diarrhea • Malaria • Malnutrition • Whooping cough • Parasitosis • Skin disease • TB • Accident Pediatric Nursing and child health care 54 4.5. Neonatal resuscitation: During the initial resuscitation efforts, a 100 % oxygen concentration is administered to the neonate. As soon as the infants condition is stabilized, the concentration is adjusted to maintain the PO2 (partial pressure of oxygen in the blood) within acceptable limits. This adjustment is essential, since elevated pao2 levels can cause irreparable damage to retinal vessels. Furthermore, high oxygen concentrations can directly injure lung tissue premature infants with immature lungs and eye vessels are at particular risk for two conditions that are a direct result of oxygen toxicity: retrolental fibroplasia and bronchopulmonary dysplasia. 4.6 Fever: Fever in children is common and can have many causes. In many cases you will make the diagnosis of non- specific virus infection. This may be true, but such a diagnosis is difficult to prove and should never be made without taking a careful history and performing a proper examination in any child with fever. NB. Remember to ask for any contact with infectious diseases. Pediatric Nursing and child health care 55 Think of malaria and take a blood film. If you still do not have a definite cause for the fever, rule out: A. Malaria: one negative blood film report does not exclude malaria B Early measles: look for koplik’s spots C Pneumonia: look at the child for flaring of nostrils, rate of breathing, Lower chest in drawing D Otitis media: check eardrums E Meningitis: neck stiffness, irritability F Urinary tract infection: check urine G Tonsillitis: look at the throat H Relapsing fever: take blood film for haemo parasite 4.7 Convulsions: Convulsions are much common during the first two or three years of life than at any other period. This is not only due to congenital malformation or perinatal injury to the central nervous system but also the frequency of “febrile “convulsions in response to a rapid rise of temperature at the onset of acute infective illnesses Pediatric Nursing and child health care 56 Causes: 1. In the neonatal period the major causes of convulsions are • Congenital defect of the brain • Cerebral damage occurring during the process of birth from hypoxia or trauma both account for 90 % of the cases. The remaining 10 % includes: • infection of the brain ( meningitis ) • hypoglycaemia • hyperbillirubinaemia with kernicterus etc 2. during early childhood (until about the age of 6 years) • Infections both (intra and extra cranial) are the most frequent causes of convulsions • Febrile convulsions between age of 6 months and 3 years and rare after this period • At the age of two idiopathic epilepsy begins to accounts for an increased proportion of cases. 3. at later childhood and adolescence • 50 % of recurrent convulsions have idiopathic origin The remainders are organic and most frequently have originated from some brain injury sustained in the early year of life Pediatric Nursing
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