Pediatrics: Screening, Examination, and evaluation (part 1)

a continuous, systematic process of gathering and analyzing information about a child's development, health, and well0being over time; incorporates parental concerns, professional observations, and risk factors to monitor a child's progress

surveillance

what is the purpose of using surveillance?

identify children who may be at risk for developmental delays or health concerns and to determine if further assessment is needed

True or false: screening relays on professional judgement and caregiver input

false - surveillance

What are some surveillance tools?

CDC checklist, growth charts, clinical observation

A focused, standardized process of testing or evaluating a specific aspect of a child's development or health at a single point in time to identify potential concerns

Screening

What is the purpose of a screen?

detect specific conditions or developmental delays early for intervention

True or false: Screening is quantitive

true

what tools are used for screenings?

standardized tests and measures

Cause of Fetal alcohol spectrum disorder

maternal alcohol consumption during pregnancy

With FAS, what deficiencies / impairments might a child have?

growth deficiencies, facial abnormalities, CNS dysfunction

What are some impairments a child could have with Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE)?

behavioral and cognitive impairments

What are the implications of Fetal alcohol spectrum disorders?

cognitive delays, attention deficits, behavioral issues, lifelong developmental challenges

What causes Neonatal Abstinence Syndrome (NAS) ?

prenatal exposure to opioids, barbiturates, other drugs

What are symptoms of neonatal abstinence syndrome (NAS) ?

high pitched crying, tremors, irritability, seizures, feeding difficulties, vomitting, diarrhea

what are the implications of Neonatal Abstinence syndrome (NAS)?

developmental delays, poor growth, increase risk of SIDS

What could cause preterm birth (< 37 weeks gestation) ?

preterm labor, maternal infections, preeclampsia, placental issues, multiple pregnancies

Short term implications for a pre term birth

Respiratory distress syndrome, feeding difficulties, jaundice, hypothermia, infections

long term implications for child who had a pre term birth

chronic lung disease, neurodevelopment delays, vision & hearing issues

What are implications for the mother who had a preterm birth?

psychological stress, potential complications from C-section

high blood pressure doing pregnancy accompanied by protein in the urine, which may progress to seizures

preeclampsia/ eclampsia

What implications does preeclampsia have on a child?

intrauterine growth restriction, preterm birth, placental abruption, low birth weight, stillbirth if untreated

What implications does preeclampsia have on a mother ?

organ damage, stroke, HELLP syndrome

What is HELLP syndrome?

hemolysis, elevated liver enzymes, low platelet count

compromised oxygen supply to the baby, often identified by abnormal fetal HR patterns

fetal distress

What are short term implications for a baby with fetal distress?

hypoxic-ischemic encephalopathy (HIE), meconium aspiration syndrome

What are long term implications for a baby with fetal distress?

cognitive delays, developmental disabilities, physical impairments (depends on the severity of o2 deprivation)

What implications could fetal distress syndrome have on a mom?

emergency interventions (C-section)

Difficulty delivering the baby's shoulders once the head is delivered

Shoulder dystocia

What are short term implications for a baby with shoulder dystocia ?

brachial plexus injury, clavicle fx, asphyxia

What are long term implications for a baby with shoulder dystocia ?

permanent nerve damage leading to Erb's palsy, physical disability

What are implications for a mom whose baby has shoulder dystocia ?

increased risk of perineal tearing, uterine rupture, postpartum hemorrhage

What nerve roots are most likely damaged if a baby has Erbs palsy?

C5-C6

Excessive bleeding (>500 mL after vaginal delivery or >1000 mL after cesarean)

postpartum hemorrhage

What are short term implications for a mother experiencing postpartum hemorrhage ?

severe anemia, hypovolemic shock, need for blood transfusions, emergency surgery

Long term risk for a mother who had postpartum hemorrhage

risk of future pregnancy complications, psychological distress

What are implications for the baby if the mother has a postpartum hemorrhage ?

increased risk of preterm delivery or stillbirth if maternal hemorrhage occurs prior to delivery

What are two types of umbilical cord issues

cord prolapse, nuchal cord

umbilical cord wrapped around the neck of the baby

nuchal cord

umbilical cord slips into the birth canal

cord prolapse

What are short term implications for a baby who has umbilical cord issues?

oxygen deprivation, fetal distress, stillbirth if not timely managed

What are Long term implications for a baby who has umbilical cord issues?

neurological damage due to hypoxia

What are implications for a mom who experiences umbilical cord issues ?

emergency C section or expedited vaginal delivery

premature separation of the placenta from the uterine wall

placental Abruption

What are short term implications for the baby if there was a placental abruption

oxygen deprivation, preterm birth, still birth

Long term implications for baby if there was. placental abruption

neurological damage due to hypoxia

What are the implications for the mother there was a placental abruption ?

severe bleeding, risk of hysterectomy, death if unmanaged

Labor that lasts longer than expected (>20 hours for first-time mothers, >14 for subsequent deliveries )

prolonged labor / Dystocia

prolonged labor implications for the baby

fetal distress, increased risk of infections, birth injuries

Implications for mother with prolonged labor/dystocia

exhaustion, infections, uterine rupture, increased likelihood of cesarean delivery