6.1 Infant and Children

What are the top 10 causes of injury related deaths in the US (in orders to 1-10)?

Poisoning, motor vehicle traffic, fall, unspecific, drowning, fire/burn, natural/environmental causes, otherwise specified injuries that are classifiable and land transport other than motor vehicles

What is the fourth leading cause of death among infants?

Unintentional injury

What are the 5 leading causes of infant death (in 2022)?

Birth defects (congenital malformations), preterm birth (short gestations and low birth weight), unintentional injuries, pregnancy complications and sudden infant death syndrome (SIDS)

What are the causes of death of children in the first year of life?

Maternal health, medical care quality and access, SES, PH practices, congenital defects, disorders r/t short gestation, maternal complications, SIDS and accidents

What are the interventions that have helped to prevent the causes of deaths in infants?

Improve standard of living, better sanitation, immunization, clean milk supply, increase availability of food, access to maternal health care

What is the gap b/t black/hispanic and white infant mortality rates?

2.2-2.4 times higher in black or hispanic babies

What is the 3rd leading cause of death among babies b/t 1 month - 1 year of age?

SIDS

What is SIDS?

Sudden, unexplained death of an infant younger than 1 year of age that remains unexplained even after a thorough investigation

What is SUID (sudden unexpected infant death)?

Includes other sleep related causes of infant death like accidental suffocation, infections, vehicle collisions, etc.

What are ways to reduce/prevent SIDS?

Baby sleeps on back and keep baby's sleep area (crib) free of objects

What is the leading cause of infant mortality?

Birth defects

What is an example to prevent a risk of certain birth defects?

Getting enough folic acid before and during pregnancy to prevent neural tube defects

What is the 2nd leading cause of infant mortality?

Preterm birth

What are some characteristics that define preterm birth?

Low birth weight, but sometimes full term infants are also born underweight d/t mothers chronic health condition or poor nutrition

What is a way to prevent preterm birth?

Prenatal care

What does a newborn screening do?

Detect certain conditions that are not noticeable at the time of birth, PKU

What are preventative measures before conception for infant mortality?

Screen women for health risks and pre-existing conditions like diabetes, HTN and STDS, education on contraception, education on nutrition, esp folic acid and iron, avoid alcohol, tobacco and illicit drugs, educate on regular exercise

What are the preventative measures during pregnancy for infant mortality?

Early access care throughout pregnancy, labor and delivery, monitor and treat pre-existing conditions, screen for reproductive tract infections (bacterial vaginosis, group B strep infections and HIV), maternal vaccinates, no substance abuse, education on nutrition and exercises and educate on early signs of pregnancy related problems

What are preventative measures during the postpartum period?

Vaccinate newborns at age-appropriate times, provide info about well baby care, benefits of breastfeeding, educate on second hand smoke, place infants on backs while sleeping, educate how to prevent exposure to infectious disease and harmful substances

What are the leading causes of death for children?

Accidents, firearms, motor vehicle traffic accidents, poisoning and cancer

What is the leading cause of death for children?

Firearms

Describe the leading cause of children deaths from accidents.

Leading cause of death for children of all ages

Describe the leading cause of children deaths from firearms.

Leading mechanism of injury death, including accidents, suicides and homicides from ages 5-19

Describe the leading cause of children deaths from motor vehicle traffic accidents.

Leading mechanism of injury and death b/t ages 5-19

Describe the leading cause of children's death from poisoning.

Leading mechanism if injury death b/t ages 20-24

Describe the leading cause of children deaths from cancer.

Leading cause of death for children ages 5-14

What is the leading cause of death from ages 1-19?

Firearms (homicide, suicide, accidental)

What is the leading cause of death from ages 1-4?

Unintentional injuries, particularly drowning

What is the leading cause of death from ages 5-19?

Motor vehicle crashes

What is the leading cause of death for ages 20-24?

Poisonings

What are the environmental causes that can cause child mortality?

Lead, asthma and exposure to cleaning products

What are some safety primary preventions for teaching parents and caregivers?

Prenatal care and immunizations

What are some safety secondary preventions for teaching parents and caregivers?

Pregnancy, neonatal and childhood screenings

What are some safety tertiary preventions for teaching parents and caregivers?

Morbidity of disease and disability

What is the greatest threat to child health?

Poverty

What is the health promotion for children?

Reduce infant mortality and incidence of preventable disease, and increase number of children appropriately immunized against disease

Who founded historic funding for mental health care that included FY23 government funding legislation?

Senator Chris Murphy

What is considered a missed opportunity for immunization by the ACIP?

Any healthcare visit where a person is eligible for a vaccine but does not receive it

What does the ACIP provide?

Advice and guidance regarding the most appropriate selection of vaccines and related agents for effective control of vaccine preventable disease

What is the leading cause of death among adolescents ages 15-19?

Accidents (unintentional injuries), homicide and suicide

What are the leading health issues for adolescent pop.?

Substance use disorder, STIs, injuries (motor vehicle) and obesity

How can parents/caregivers and us reduce those leading causes of injury/death for adolescents?

Identify predictable developmental behaviors, parental/caregiver modeling of safety habits and educate parents and caregivers

What do we educate parents and caregivers about?

Mobility and curiosity can l/t judgement and experience which can cause high risk for unintentional injury

What are some health promotions and protection for adolescents?

Dietary, physical activity and sleep behaviors

What is the role of the nurse for adolescent health?

Actively involve adolescents in making decisions about their own health, use present-oriented, interactive teaching strategies geared to developmental level and interest, and what services can be given to teens w/out parental consent?

What are the barriers to successful transition to adulthood?

difficulty finding stable jobs, lack of support from parents, challenges r/t being different (such as having a disability or being part of the LGBTQ+ community), and not having a consistent, supportive adult esp. for youth who are homeless or incarcerated.

What are the Illinois programs funded by title V?

Teen Pregnancy Prevention Primary (IDPH), Regionalized Perinatal System (IDPH) , School Based Health Centers/School Nurse TA (IDPH), Fetal Infant Mortality Review (IDPH), Family Planning (IDPH), Child Dental Sealant Program (IDPH), Childhood Asthma Initiative (University of Illinois at Chicago, School of Public Health), Family Case Management (IDHS), Better Birth Outcomes (IDHS), Chicago Mini MCH Block Grant (Chicago Department of Public Health), Illinois Perinatal Quality Collaborative (Northwestern University) and Children with Special Healthcare Needs (CSHCN) (University of Illinois, Division of Specialized Care for Children)

What are examples of public and voluntary programs that promote and protect the health of infants, children, and teens?

WIC, APORS, expanded Medicaid through the Affordable Care Act and Child Health Insurance Program, and care at Federally Qualified Health Centers, Other programs include immunization clinics at local health departments, Healthy Families America, Child and Family Connections for early intervention services, and community-based programs like the YMCA, Boys and Girls Clubs of America, schools, libraries, and park districts

What does WIC (Women, Infants and Children) do?

Provide nutrition support or programs

What does APORS (adverse pregnancy outcome reporting system) do?

tracking high-risk pregnancies

What do community-based programs like the YMCA, Boys and Girls Clubs of America, schools, libraries, and park districts do?

offer free or low-cost activities

What are examples of voluntary health organizations?

American cancer society, AHA, american diabetes organization

What are examples of health professional organizations?

American College of OBGYN, american academy of pediatrics, american college of physicians

What are some governmental resources?

USPSTF, community guide, healthfinder.gov and many CDC resources

What is USPSTF?

Used by CMS (center for medicaid and medicare services) to determine reimbursement to PCPs

What is a community guide?

Used by health organizations and policymakers seeking effective pop-level interventions

What are the USPSTF recommendation grades?

A, B, C, D, and I

What is grade A for USPSTF?

Recommended, high certainty that net benefit is substantial

What is grade B for USPSTF?

Recommended, high certainty that net benefit is moderate or moderate certainty that net benefit is moderate to substantial

What is grade C for USPSTF?

Recommendation depends on pt's situation, at least moderate certainty that net benefit is small

What is grade D for USPSTF?

Not recommended, moderate or high certainty there is no net benefit or harms outweigh benefits

What is grade I for USPSTF?

Not enough evidence to make recommendation

What are Adverse Childhood Experiences or ACES?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years)

What are examples of ACEs?

Experiencing violence, abuse or neglect, witnessing violence in home or community and having family member attempt or die by suicide

What are examples of ACEs d/t household environments?

Substance use, mental health, instability d/t parental separation and household members

What are some child and adolescent health care problems?

Poverty, racial and ethnic disparities and health care use

What does the affordable care act do (ACA)?

help ensure affordable preventative services and health care coverage; pre-existing condition coverage; curtained preventative services mandated at no cost (ie vaccines and breast feeding support); teens and young adults under 26

What is CHIPRA?

Illinois' All Kids program offers health care coverage to children or helps in paying premiums of employer or private health insurance plans

Why is Title V important?

support for promoting and improving the health and well-being of the nation's mothers, children, including children with special needs, and their families

What is the eligibility for FMLA (family medical leave absence)?

birth or care of a newborn within one year of birth, for the placement and care of an adopted or foster child within one year, to care for a spouse, child, or parent with a serious health condition, when the employee has a serious health condition that prevents them from working, for qualifying military-related family needs when a spouse, son, daughter, or parent is on covered active duty, or to care for a seriously ill or injured covered servicemember for up to 26 weeks

What nursing diagnoses in children and adolescents are related to injury and death risk factors?

Risk factors include unhealthy lifestyle choices such as poor nutrition, smoking, alcohol use during pregnancy, and lack of prenatal care that can affect fetal development.

What other factors contribute to injury and death risk in children and adolescents?

Lack of knowledge about safety and prevention, including proper child safety seats, breastfeeding benefits, safe sleep practices for infants, and using preventive health care.

What services can be given to teens without parental consent?

STI testing/treatment, birth control, pregnancy testing, prenatal care and counseling for alcohol or drug abuse