chapter 19 pediatric diseases and disorders

8/8/2019 Chapter 19 Pediatric Diseases and Disorders

1/5

Chapter 19 Evaluation and Care of the Pediatric Patient

Common Pediatric Diseases and Disorders

There are many diseases and disorders seen in a pediatric practice. The following table lists someof the more common ones along with their symptoms and usual treatment.

Disease Description Signs and Symptoms Usual Treatment

Asthma Lung disease in which

the airways become

inflamed and

obstructed as aresponse to various

stimuli, including

allergens

Airway obstruction,

wheezing, coughing,

inability to speak,

fatigue and cyanosis,

which may result in

severe distress

Bronchodilators

Beta agonists

Corticosteroids

Theophylline

Diaper

dermatitis

A rash anywhere in

the groin region or

gluteal folds of thebuttocks which may

become infected with

bacteria or yeast

Patches of reddened

skin that may contain

fluid and pustules

Frequent diaper

changes

Application of

protectivebarrier

ointments

Eczema Skin inflammationresulting from

allergies and irritatants

Vesicles, redness,oozing, crusting,

scaling and itching

Removal ofoffending

agent,

astringents,antihistamines,

corticosteroids

Gastroenteritis A syndrome ofvomiting and diarrhea

that may cause

dehydration and

electrolyte imbalance

Diarrhea, vomiting,dehydration,

lethargy, anorexia,

weight loss, fever

and decreasedurination

Give fluids

Antibiotics ifcaused by a

bacterial

infection

Impetigo Superficial skin

infection characterized

by vesicles andpustules

Lesions on the skin,

exudate, crusting,

and itching

Systemic and

topical

antibiotics

Otitis media Bacterial or viralinfection of the middle

ear

Severe earache,fever, nausea and

vomiting, and

diarrhea

Antibiotictherapy

Pinworms

(Enterobius

vermicularis)

Small worms that

infest the large

intestine

Irritation of the anal

region, allergic skin

reaction, intense

Oral medication

for the entire

family,


2/5

itching, and

secondary infection

thorough

cleansing of the

house, bedding,and sleepware,

topical

medication forirritation

Scabies Contagious skin

infestation caused bythe itch mite

Severe itchy rash

characterized by finewavy dark lines.

Lesions may occur

between the fingers,

at the wrist or elbow,in the axilla, and on

the trunk or

extremities

5% permethrin

cream

Strep throat Severe throat infection

caused by the

Streptococcus genusof bacteria

Red, sore throat,

pustules, and high

fever

Antibiotics

Urinary tract

infection

An infection of the

kidneys, ureters, orbladder caused by

microorganisms

Painful and frequent

urination, foul-smelling urine, and

hematuria

Antibiotics

Other Pediatric Conditions

In todays society, we hear a lot about issues that can have a profound effect on the pediatric

patients learning abilities and social interactions. Conditions such as ADHD, autism, Downs

syndrome, cerebral palsy and childhood obesity are more prevalent now and need to be dealt

with in a professional but helpful manner.

Attention-Deficit Hyperactivity Disorder (ADHD)Although first described in 1845, this condition appears to be on the increase in current years. Itmay first be apparent in preschool, while others cases are diagnosed in late adolescence and even

adulthood. The most classic symptoms of ADHD are:

Being overly impulsive

Unable to maintain attention during important tasks

Hyperactivity


3/5

Usually the child is viewed as one who is disruptive and highly active. Another child withADHD might be a day dreamer. Poor concentration is a term often used to describe the patient.

This condition is difficult to diagnose as these symptoms may also be an indication of other

physical or emotional problems. If diagnosed, the patient can be treated with medication andsupport by the health care team.

Autism

Autism is a brain disorder that hinders a persons ability to communicate or relate to others. It is

thought to be a genetic disorder, as it often runs in families. This disorder can also affect how achild understands and processes information that is sensory in nature.

Autism is usually diagnosed by the time a child reaches the age of three; however, some

cases are not diagnosed until later. Typically parents are the first to notice the signs and seek the

advice of their pediatrician. There are diagnostic guidelines that have been established by theAmerican Academy of Child and Adolescent Psychiatry (AACAP) which the clinician will use

to determine if the child has the core symptoms of autism. Signs and symptoms may include:

Toddlers who do not begin to talk or do not interact like other children do

Little or no eye contact with others

Plays alone

Delayed language development

Repetitive patterns of behavior such as, rocking, keeping to a certain routine or ritual, and

resistance to any change

There is no mold that all persons with autism fit into. Some need help with the simplest

aspects of daily living, while others are able to function at a level high enough that permits themto attend school in a regular class and participate in sports and other activities.

Treatment methods include: behavioral, speech, and occupational therapy, parent

education, and sometimes medications. Since each child with autism is different, treatment

methods are usually individualized. Collectively, most children with autism need to be in astructured and specialized educational program in order to achieve their highest potential.

Down Syndrome

Down syndrome is a common birth defect that occurs in approximately one in every 800 to 1,000

newborns. This syndrome includes mild to moderate mental retardation and other healthproblems such as cardiac valvular disease, along with specific physical characteristics which

include a sloping forehead, low-set ears, and short, broad hands.

The most common form of Down syndrome, trisomy 21, is caused by the presence of an

extra 21st chromosome. The cause of the occurrence of this extra chromosome is unknown butappears to be related to the age of the mother and usually occurs in women over the age of 40.


4/5

Cerebral Palsy

Cerebral palsy is a term that is used to describe a range of disorders that impairs control of

movement due to damage to the brain during its developmental stage. It is one of the most

common causes of disability in children. While CP is not a progressive disease, symptoms mayget better for a time only to worsen later on. The exact cause of CP is unknown but is thought to

be related to the oxygen levels in the brain before, during, and after birth, infections, and injuries

occurring during the birth process. Children with CP not only have physical disabilities, but mayalso have some level of retardation, learning disabilities, and vision, speech, hearing, and

language problems.

Patient Tutor

Parents, especially first-time parents, and caregivers may need to beprovided with educational information on infant and child safetyissues, including car seats, cribs, animals/pets, etc. Brochures andpamphlets are useful tools along with information about communityresources available to assist the parent with these issues.

Pediatric Disorders Related to Abnormal Vital Signs andMeasurements

The following table identifies some possible medical conditions related to abnormalmeasurements. The medical assistant should be familiar with pathology related to pediatric

patients. Familiarity with common diseases and disorders helps to increase communication

opportunities with patients and family members, thus enabling better patient education andpatient compliance.

Abnormal Vital Sign Possible Pediatric Pathology

Low Weight (less than 5th

percentile)

GI disease, neurological disorder, environmental

influences, failure to thrive

Low Height, Short Stature

Endocrine disorder, growth hormone deficiency,Inflammatory bowel disease, renal disease, celiac disease

(disorder of the immune system that damages lining of

the small intestine if foods are consumed that contain

gluten)

Small Head CircumferencePremature suture closure, chromosomal abnormalities,

infection, maternal metabolic disorder

Large Head CircumferenceHydrocephalus, subdural hematoma, brain tumor, benign

brain growth

Elevated Blood PressureRenal artery disease, coarctation (stricture) of the aorta,primary hypertension, drugs

High Pulse Rate

(Tachycardia)

Supraventricular tachycardia


5/5

Low Pulse Rate

(Bradycardia)

Hypoxia, intracranial disorders, heart block, drug

ingestion, anorexia

Rapid, Shallow RespirationsCardiac disease, metabolic acidosis, bronchiolitis,pneumonia

Fever Infections, anxiety, dressing the infant too warmly

chapter 19 pediatric diseases and disorders

Documents