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Gestation
Based on Näegele’s Rule, the estimated date of delivery (EDD) is calculated as follows:
1. Use of Näegele’s rule requires that the person have a regular 28-day menstrual cycle.
2. Subtract 3 months and add 7 days to the first day of the last menstrual period; then add
1 year if appropriate. Alternatively, add 7 days to the first day of the last menstrual period
and count forward 9 months.
1. Parity is the number of births (not the number of fetuses, e.g., twins) carried past 20
weeks of gestation, whether or not the fetus was born alive.
2. A nullipara is a person who has not had a birth at more than 20 weeks of gestation.
3. A primipara is a person who has had one birth that occurred after the 20th week of
gestation.
4. A multipara is a person who has had two or more pregnancies to the stage of fetal
viability.
C. Use of GTPAL: Pregnancy outcomes can be described with the acronym GTPAL
A client is pregnant for the fourth time. Their pregnancy history includes:
Final GTPAL: 4, 1, 1, 1, 2
Parity = 2 (since they carried two pregnancies past 20 weeks, regardless of the outcome).
G is gravidity, the number of pregnancies, including the present one.
1. T is term births, the number born at term (longer than 37 weeks of gestation).
4. L is the number of current living children. This number can be greater than the P if
multiples were delivered, or less than the P if a loss occurred. Note: Multiples count as a
1 for gravidity, as well as a 1 for term, preterm, or abortions, but are recorded as the
actual number for living.
Pregnancy Signs
A. Presumptive signs
1. Amenorrhea
3. Breast tenderness, tingling, feelings of fullness, increased size and pigmentation of the
areola
4. Urinary frequency
5. Quickening: The first perception of fetal movement by the pregnant individual may occur
at the 16th to 20th week of gestation; every pregnancy is unique, and quickening could
happen earlier or later.
6. Fatigue
B. Probable signs
1. Uterine enlargement
2. Hegar’s sign: Compressibility and softening of the lower uterine segment that occurs at
about week 6
3. Goodell’s sign: Softening of the cervix that occurs at the beginning of the second month
4. Chadwick’s sign: Violet coloration of the mucous membranes of the cervix, vagina, and
vulva that occurs at about week 6
Fundal Height
C. At 16 weeks, the fundus can be found approximately halfway between the symphysis pubis
and the umbilicus.
F. Ask the client to void before measurement because a full bladder can displace the uterus,
affecting accuracy.
2. Place the end of the tape measure at the level of the symphysis pubis.
Pregnancy causes various physiological changes in different body systems to support fetal
development and prepare the body for childbirth.
A. Reproductive System
B. Cardiovascular System
C. Respiratory System
D. Gastrointestinal System
E. Urinary System
G. Endocrine System
Pregnancy brings significant emotional and psychological changes as the individual prepares for
parenthood. These changes vary by trimester and can be influenced by personal, social, and
cultural factors.
1. First Trimester
2. Second Trimester
3. Third Trimester
Psychological Adaptation
○ Some embrace the physical changes; others struggle with body image.
Interventions:
Syncope
1. Usually occurs in the first trimester; supine hypotension occurs particularly in the second
and third trimesters.
3. Interventions:
a. Sitting with the feet elevated
b. Risk for falls; teach to change positions slowly
The nurse needs to instruct the pregnant individual to avoid lying in the supine position,
particularly in the second and third trimesters. The supine position places the individual at risk
for supine hypotension, which occurs as a result of pressure of the uterus on the inferior vena
cava.
3. Interventions:
a. Drinking no less than 2000 mL of fluid during the day
b. Limiting fluid intake in the evening
c. Limiting intake of natural diuretics such as coffee, tea, watermelon, lemons
d. Voiding at regular intervals
e. Sleeping side-lying at night
f. Wearing perineal pads, if necessary
g. Performing Kegel exercises
D. Breast Tenderness
3. Interventions:
a. Wearing a supportive bra
b. Avoiding the use of soap on the nipples and areolar area to prevent drying of skin
2. Caused by hypertrophy and thickening of the vaginal mucosa and increased mucus
production.
3. Interventions:
a. Using proper cleansing and hygiene techniques
F. Nasal Stuffiness
3. Interventions:
a. Use a humidifier.
b. Avoid nasal sprays or antihistamines (consult PHCP; normal saline may be
acceptable).
G. Fatigue
3. Interventions:
a. Arrange frequent rest periods.
b. Use proper posture and body mechanics.
c. Engage in regular exercise.
d. Perform muscle relaxation and strengthening exercises.
e. Avoid caffeine and stimulants.
f. Maintain a well-balanced diet to prevent anemia.
H. Heartburn
3. Interventions:
a. Eat small, frequent meals.
b. Sit upright for 30 minutes after eating.
c. Drink milk between meals.
d. Avoid fatty and spicy foods.
e. Avoid bending over or lying flat.
f. Wear loose-fitting clothes.
g. Take deep breaths and sip water.
h. Avoid carbonated drinks, citrus, chocolate, and peppermint if triggering.
i. Consult PHCP before using antacids.
I. Ankle Edema
2. Caused by vasodilation, venous stasis, and increased pressure below the uterus.
3. Interventions:
a. Elevate legs at least twice a day and when resting.
b. Sleep side-lying.
c. Wear support stockings.
d. Avoid prolonged sitting or standing.
e. Drink plenty of fluids.
J. Varicose Veins
4. Interventions:
a. Wear support stockings.
b. Elevate feet when sitting.
c. Lie down with feet and hips elevated.
d. Avoid long periods of standing/sitting.
e. Move around while standing.
f. Avoid crossing legs.
g. Avoid tight clothing (e.g., knee-high stockings).
h. Perform leg exercises.
i. Avoid flying (prolonged sitting).
K. Headaches
1. Common and benign in the first trimester; requires evaluation if persistent in the second
or third trimester.
L. Hemorrhoids
3. Interventions:
a. Take warm sitz baths.
b. Sit on a soft pillow or lie on the side with hips elevated.
c. Eat high-fiber foods and drink enough fluids.
d. Engage in regular exercise (e.g., walking).
e. Apply ointment, suppositories, or compresses as prescribed.
M. Constipation
3. Interventions:
a. Eat high-fiber foods (whole grains, fruits, vegetables).
b. Avoid constipating foods (e.g., cheese).
A. Ultrasound
B. Doppler Flow Studies
C. Alpha-Fetoprotein (AFP) Screening
D. Chorionic Villus Sampling (CVS)
E. Amniocentesis
F. Percutaneous Umbilical Blood Sampling (PUBS)
G. Nonstress Test (NST)
H. Contraction Stress Test (CST)
I. Biophysical Profile (BPP)
J. Kick Counts
Risk Conditions Related to
Pregnancy
Bleeding During Pregnancy
A. Implantation Bleeding – Occurs 10 to 14 days after conception, lasts 1–2 days, lighter than a
period, no treatment needed.
B. Other Causes – Includes abortion, malignancy, polyps, trauma, ectopic pregnancy, infection,
molar pregnancy, subchorionic hemorrhage, cervicitis, placenta previa, abruptio placentae, etc.
C. Low Progesterone – Can cause bleeding; treatable but may lead to miscarriage if untreated.
abortion
A. Description
B. Types
C. Risk Factors
1. Advanced maternal age
8. Low BMI (<18.5), smoking, alcohol, drug use, high caffeine intake
D. Assessment
2. Cramping or contractions
E. Interventions
3. Weigh perineal pads (1g = 1mL blood loss), save expelled tissue
A. Description
● Increased plasma volume and cardiac output may overload the heart.
● Blood volume peaks at 32–34 weeks, then slightly declines by week 40.
C. Assessment
○ Peripheral edema
○ Chest pain
3. Watch for signs of cardiac stress & decompensation (e.g., cough, fatigue, dyspnea,
chest pain, tachycardia).
Chorioamnionitis
A. Description
B. Assessment
2. Elevated temperature
5. Leukocytosis
C. Interventions
A. Description
Definition:
● Develops in the 2nd or 3rd trimester when the pancreas cannot meet increased insulin
demands.
Risk Factors:
Assessment
● Frequent urination
● Blurred vision
Management:
● Blood glucose targets:
Description:
A serious condition where widespread clotting depletes platelets and clotting factors, leading to
excessive bleeding. It is often triggered by obstetric complications such as placental abruption,
preeclampsia, amniotic fluid embolism, or sepsis.
Assessment:
3. Hematuria, GI bleeding
Interventions:
Ectopic Pregnancy
Description:
A pregnancy that implants outside the uterus, most commonly in the fallopian tube. It is a
medical emergency if rupture occurs.
Risk Factors:
● Smoking
Assessment:
Interventions:
1. Monitor vital signs & bleeding
Hepatitis B in Pregnancy
Risks:
● Transmitted via blood, saliva, vaginal secretions, semen, breast milk, and placental
barrier
Interventions:
Vulvar Hematoma
Causes:
● Blood collection in maternal tissue post-delivery
Interventions:
Description:
Assessment:
Interventions:
Hyperemesis Gravidarum
Description:
Assessment:
Interventions:
B. Preeclampsia
● BP ≥140/90 mmHg after 20 weeks + proteinuria (≥300 mg in 24-hour urine) OR evidence of end-
organ dysfunction (even without proteinuria).
C. Eclampsia
● Preeclampsia + seizures (generalized tonic-clonic).
○ Visual disturbances
○ RUQ pain
○ Severe hypertension
D. Chronic Hypertension
2. Risk Factors
● First pregnancy (nulliparity)
● Obesity
● Chronic hypertension or renal disease
● Diabetes mellitus
3. Assessment Findings
Mild Preeclampsia
Severe Preeclampsia
BP ≥160/110 mmHg
Severe proteinuria (>5 g/24 hours)
Persistent headache, blurred vision, photophobia
Severe RUQ pain (hepatic involvement)
Pulmonary edema, dyspnea
Oliguria (<500 mL urine in 24 hours)
Platelet count <100,000/mm³ (risk of DIC)
HELLP Syndrome:
4. Complications
Maternal Complications
Stroke
HELLP syndrome
Placental abruption
Disseminated intravascular coagulation (DIC)
Acute kidney injury
Pulmonary edema
Eclampsia (seizures)
Fetal Complications
● Hydralazine IV (alternative)
Avoid ACE inhibitors & ARBs (teratogenic)
Delivery Planning
● If <37 weeks with severe preeclampsia: Corticosteroids for fetal lung maturity + delivery
if worsening
Eclampsia Management
7. Key Points
Gestational hypertension: BP ≥140/90 mmHg after 20 weeks, no proteinuria.
Preeclampsia: Hypertension + proteinuria or organ dysfunction.
Severe preeclampsia: BP ≥160/110 mmHg, headache, visual changes, liver dysfunction.
Eclampsia: Preeclampsia + seizures.
HELLP Syndrome: Hemolysis, Elevated Liver enzymes, Low Platelets.
Magnesium sulfate prevents seizures; calcium gluconate is the antidote.
Delivery is the only cure for preeclampsia/eclampsia
Multiple Gestation
1. Description
● Results from the fertilization of two ova (fraternal/dizygotic) or splitting of one fertilized
ovum (identical/monozygotic).
● Complications include:
2. Assessment Findings
Placental abnormalities
Placenta Previa
A. Description
1. Improper implantation of the placenta in the lower uterine segment near or over the
internal cervical os.
2. Types:
○ Total (Complete): Placenta fully covers the internal cervical os when cervix is
dilated.
○ Partial: Placenta is within 3 cm of the internal cervical os but does not fully cover
it.
○ Marginal (Low-Lying): Placenta implanted in lower uterus, but its lower border is
more than 3 cm from the os.
B. Assessment Findings
Sudden onset of painless, bright red vaginal bleeding (second half of pregnancy)
Soft, relaxed, non-tender uterus
Fundal height larger than expected for gestational age
Monitor maternal vital signs, fetal heart rate, and fetal activity
Confirm diagnosis via ultrasound (NO vaginal exams!)
Avoid any procedures that may stimulate uterine activity
Maintain bed rest in a side-lying position
Monitor bleeding & treat signs of shock
Administer IV fluids, blood products, or tocolytics as prescribed
Administer Rho(D) immune globulin if indicated
Abruptio Placentae
A. Description
Premature separation of the placenta from the uterine wall after 20 weeks but before
delivery
B. Assessment Findings
Complications
Dental abscess
Broken or missing teeth
Pregnancy gingivitis
Periodontal disease
Pyogenic granuloma
Oral cancer
Risk Factors
Tobacco use
High sugar consumption
Poor oral hygiene
High stress level
Substance use (especially methamphetamine)
Diabetes
HIV infection
Immunosuppression
Low income
Poor nutrition
Medications reducing saliva
Hormonal changes
Genetic predisposition
Poor access to oral health provider
Analgesics
Soft diet
antibiotics
iron-Deficiency Anemia
■ Low dietary intake of iron
■ Adolescence
■ Pregnancy and breast-feeding/chest-feeding
■ Low socioeconomic status
■ African American, Hispanic, Native American, recent immigrant
■ History of anemia before pregnancy
■ Underweight before pregnancy
■ Eating problems
■ Multiparity
treatment
■ Screening during pregnancy: complete blood cell count (CBC) at initial visit, at 24-28 weeks,
and at 36 weeks
■ Iron supplementation in addition to prenatal vitamins as prescribed
■ Teach to take iron supplementation between meals so that absorption of zinc is not affected
■ Advise on foods high in iron
■ Advice on medications inhibiting absorption of iron, such as antacids, proton pump inhibitors
(PPIs), certain antibiotics
■ Referral to dietitian
■ May need blood transfusion or IV iron if severely anemic
■ Short interval between pregnancies
■ Pica
■ Blood loss
■ Menorrhagia before pregnancy
■ Frequent blood donation
■ Chronic infectious process
■ Malabsorptive disorder
■ Strict vegetarian diet
■ Alcohol and substance abuse
■ Tobacco use
Asthma
■ Exposure to allergens, dust mites, animal dander, cockroaches, mold, pollen, grass, flowers,
smoke, tobacco, air fresheners, chemical cleaners, sprays
■ Upper respiratory infections
■ Sinusitis
■ Cold temperatures
■ Physical activity
■ Sulfites in food and drinks
■ Gastroesophageal reflux disease (GERD)
■ Weather changes
Treatment
Zika virus
■ Recent travel or history of residing in an area with local transmission within the past 6 months
Descent
■ Descent is the process that the fetal head undergoes as it begins its journey through the
pelvis.
■ Descent is a continuous process, from before engagement until birth, and is assessed by the
measurement called station.
Flexion
■ Flexion is a process of nodding of the fetal head forward toward the fetal chest.
Internal Rotation
■ Internal rotation of the fetus occurs most commonly from the occipitotransverse position,
assumed at engagement into the pelvis, to the occipitoanterior position while continuously
descending.
Extension
■ Extension enables the head to emerge when the fetus is in a cephalic position.
■ Extension begins after the head crowns.
■ Extension is complete when the head passes under the symphysis pubis and occiput, and
the anterior fontanel, brow, face, and chin pass over the sacrum and coccyx and are over the
perineum.
Restitution
■ Restitution is realignment of the fetal head with the body after the head emerges.
External Rotation
■ The shoulders externally rotate after the head emerges and restitution occurs so that the
shoulders are in the anteroposterior diameter of the pelvis.
Expulsion
■ Expulsion is the birth of the entire body.
Fetal Positions
vertex Presentations
Face Presentations
● RMA: Right mentoanterior
Breech Presentations
Other Presentations
● Brow presentation
● Shoulder presentation
Leopold’s Maneuvers
A. Description: Methods of palpation to determine presentation and position of the fetus and
aid in location of fetal heart sounds
The fetus is back which is smooth ,hard surface,should be felt on one side of the abdomen
Breathing Techniques
First-Stage Breathing
Cleansing Breath
Each contraction begins and ends with a deep inspiration and expiration.
Slow-Paced Breathing
Slow-paced breathing promotes relaxation.
Slow-paced breathing is used for as long as possible during labor.
Pattern-Paced Breathing
Pattern-paced breathing sometimes is referred to as pant-blow.
After a certain number of breaths (modified-paced breathing), the client exhales with a slight
blow and then begins modified-paced breathing again.
Second-Stage Breathing
Several variations of breathing can be used in the pushing stage of labor, and the client may
grunt, groan, sigh, or moan as the client pushes. Prolonged breath holding while pushing with a
closed glottis may result in a decrease in cardiac output. If breath holding while pushing is used,
the open glottis method or limiting breath holding to less than 6 to 8 seconds should be done.
● Begins with the onset of true labor contractions and ends with full cervical dilation (10
cm).
1. Latent Phase (0–3 cm dilation): Mild contractions, lasting 30–45 seconds, every
5–30 minutes.
● Begins with full cervical dilation (10 cm) and ends with the birth of the baby.
● The baby progresses through the birth canal, completing cardinal movements
(engagement, descent, flexion, internal rotation, extension, restitution, external rotation,
expulsion).
● Close monitoring of vital signs, uterine tone, bleeding, and overall maternal condition.
Description
Assessment
Interventions
Description
● The umbilical cord slips between the presenting part and the amnion or protrudes
through the cervix, leading to cord compression and impaired fetal circulation.
Assessment
● Severe fetal hypoxia may cause rapid fetal activity followed by cessation.
Interventions
1. Emergency Response
○ Administer oxygen (8–10 L/min) via face mask to improve fetal oxygenation.
5. Maintain Moisture
6. Emotional Support
○ Keep the client informed and provide reassurance throughout the process.
Description
● A condition where the weight of the uterus compresses the inferior vena cava when the
client lies in a supine position, reducing venous return, cardiac output, and blood
pressure, leading to hypotension.
Assessment
● Nausea.
● Hypotension.
● Tachycardia.
● Fetal distress (detected through fetal heart rate monitoring).
Interventions
○ If the client must remain supine, place a wedge or pillow under one hip to tilt the
uterus.
○ If symptoms persist or fetal distress occurs, administer oxygen (8–10 L/min) via
face mask.
Preterm Labor
Description
● Preterm labor is the onset of regular uterine contractions with cervical changes before 37
weeks of gestation.
Risk Factors
Assessment
● Rupture of membranes
Interventions
Description
Dystocia refers to difficult or prolonged labor due to abnormalities in any of the following:
Assessment
● Signs of fetal distress (e.g., abnormal fetal heart rate, meconium-stained amniotic fluid)
Interventions
Fetal Distress
A. Assessment
6. Late decelerations
B. Interventions
1. Emergency situation
Postpartum Period
physiological Maternal Changes
A. Involution
Postpartum Depression: Persistent sadness, loss of interest, appetite changes, fatigue, guilt,
difficulty concentrating, irritability, lack of energy, withdrawal from infant, and suicidal thoughts.
Postpartum Psychosis: Severe confusion, hallucinations, delusions, panic, and a break from
reality.
Postpartum Complications
1. Hemorrhage
5. Retained Placenta
PAEDIATRIC NURSING
Pediatric Integumentary Disorders
1. Atopic Dermatitis (Eczema)
● Management:
● Management:
● Signs: Red, inflamed skin in diaper area, satellite lesions (if fungal).
● Management:
● Types:
○ Tinea capitis (scalp) → Scaly patches, hair loss.
○ Tinea pedis (athlete’s foot) → Itchy, cracked, peeling skin between toes.
● Management:
● Signs: Intense itching (worse at night), burrow lines on skin (wrists, fingers, axillae).
● Management:
● Signs: Itchy scalp, visible lice/nits behind ears and nape of the neck.
● Management:
7. Burns in Pediatrics
● Assessment:
● Management:
Hematological Problems
● Definition: Sickle cell anemia (SCA) is an inherited blood disorder characterized by the
production of abnormal hemoglobin (HbS), leading to rigid, sickle-shaped red blood cells
(RBCs).
● Cause: Autosomal recessive inheritance (both parents must carry the sickle cell gene).
● Risk Groups: More common in African, Mediterranean, Middle Eastern, and Indian
populations.
2. Pathophysiology
● Sickled RBCs have a shorter lifespan (10–20 days vs. 120 days in normal RBCs),
leading to chronic hemolytic anemia.
● Abnormal RBCs clump together, blocking small blood vessels (vaso-occlusion), causing
pain crises and organ damage.
● Swelling of hands and feet (dactylitis), often the first sign in infants.
Hemolytic Anemia
● Fatigue, pallor, tachycardia.
Stroke Risk
5. Management in Children
Oncological Problems
Diagnosis:
Treatment:
Diagnosis:
Treatment:
3. Neuroblastoma
● Affects sympathetic nervous system (arises from adrenal glands or nerve tissue).
Diagnosis:
● MRI, CT scan.
Treatment:
Diagnosis:
Treatment:
● Nephrectomy (surgical removal).
Treatment:
● Common in adolescents.
Ewing Sarcoma
Treatment:
● Can arise anywhere but often affects head, neck, GU tract, extremities.
Painless mass.
Tumor-specific symptoms (e.g., proptosis if orbital, hematuria if bladder).
Nursing Considerations:
Prevent infections (hand hygiene, avoid crowds).
Monitor for bleeding & anemia.
Provide pain relief (opioids if needed).
Offer emotional support to family & child.
Diagnosis:
● GH stimulation test.
Treatment:
● Acromegaly (after growth plate closure → enlarged hands, feet, facial features).
Diagnosis:
● GH suppression test.
Treatment:
3. Precocious Puberty
● Early activation of hypothalamic-pituitary-gonadal axis.
Treatment:
Diagnosis:
Treatment:
Diagnosis:
Treatment:
● Fluid restriction.
6. Congenital Hypothyroidism
● Thyroid hormone (T3 & T4) deficiency at birth.
Treatment:
Treatment:
Treatment:
Fatigue, weakness.
Weight loss, hypotension.
Hyperpigmentation (bronze skin).
Salt cravings, hyponatremia, hyperkalemia.
Treatment:
Treatment:
GASTROINTESTINAL PROBLEMS
Diagnosis:
Treatment:
● Small, frequent feeds; keep upright after feeding.
Diagnosis:
Treatment:
3. Intussusception
● Telescoping of one bowel segment into another (commonly at ileocecal junction).
Diagnosis:
Treatment:
4. Hirschsprung Disease
● Congenital absence of ganglion cells in the colon → no peristalsis.
Diagnosis:
● Rectal biopsy (gold standard - absent ganglion cells).
Treatment:
Diagnosis:
Treatment:
● Broad-spectrum IV antibiotics.
Diagnosis:
Treatment:
7. Lactose Intolerance
● Deficiency of lactase enzyme → inability to digest lactose.
Diagnosis:
● Lactose hydrogen breath test.
Treatment:
● Lactose-free diet.
8. Appendicitis
● Inflammation of the appendix → risk of rupture.
Diagnosis:
Treatment:
● Appendectomy (surgery).
● IV antibiotics if perforation.
9. Meckel’s Diverticulum
● Remnant of the fetal vitelline duct → painless rectal bleeding.
Diagnosis:
Treatment:
● Surgical resection.
Diagnosis:
Treatment:
● Increases risk of feeding difficulties, speech problems, recurrent ear infections, and
aspiration.
4. Diagnosis
● Prenatal ultrasound (detected by 13-14 weeks of gestation).
B. Surgical Correction
Surgery Timing
●
Multiple surgeries may be needed as the child grows.
D. Long-Term Care
6. Complications
7. Nursing Interventions
Pneumonia
Tuberculosis (TB)
● Treatment:
Apnea of Prematurity
CARDIAC DISORDERS.
● Narrowing of the aortic arch → High BP in upper extremities, low BP in lower extremities
● Pulmonary stenosis
● Overriding aorta
● Treatment: Surgery
● Aorta and pulmonary artery are switched → No oxygenated blood to the body
● Strawberry tongue
● Cervical lymphadenopathy
Treatment:
● IV immunoglobulin (IVIG)
Rheumatic Fever
● Nodules (subcutaneous)
Treatment:
Treatment:
RENAL PROBLEMS
Treatment:
3. Nephrotic Syndrome
Autoimmune kidney disorder → massive protein loss
Patho: Damaged glomeruli allow protein (albumin) loss, causing fluid retention (edema)
Treatment:
● Hypertension
● Swelling (Edema)
● Tea-colored (Hematuria)
● Elevated BP
● Proteinuria (mild)
Diagnosis: ASO (antistreptolysin O) titer, Urinalysis
Treatment:
Treatment:
Treatment:
● Dialysis if severe
● Dietary restrictions (low protein, low phosphorus, controlled fluids & sodium)
● Absent cremasteric reflex (testicle does not retract when inner thigh is stroked)
Treatment: Surgery within 6 hours to save testicle
Hydrocephalus
Excess cerebrospinal fluid (CSF) accumulation in the brain → Increased intracranial pressure (ICP)
Causes:
● Infants:
○ Poor feeding
● Older children:
○ Cognitive delays
Treatment:
Types:
● Spina Bifida Occulta → No visible sac, dimple or tuft of hair at the base of the spine
Treatment:
Types:
● Spastic CP (most common) → Stiff muscles, scissor gait
Treatment:
Types:
Management:
● During seizure: Protect airway, place on side, remove dangerous objects
5. Meningitis
Inflammation of the meninges (brain & spinal cord covering)
Caused by: Bacterial (more severe) or viral infection
● Older children: Nuchal rigidity (stiff neck), photophobia, fever, headache, vomiting
Treatment:
● Loss of reflexes
Treatment:
7. Reye’s Syndrome
Rare, life-threatening disorder causing encephalopathy & liver damage
Triggered by: Aspirin use in children recovering from viral infections (flu, chickenpox)
● Severe vomiting
Treatment:
Treatment:
● Failure to thrive
Treatment:
● IV immunoglobulin (IVIG)
B. HIV/AIDS in Children
Transmission:
● Lymphadenopathy, hepatosplenomegaly
Diagnosis:
Treatment:
● Antiretroviral therapy (ART) ASAP
Complications:
Treatment:
● For pregnant women: Causes congenital rubella syndrome (deafness, heart defects,
cataracts, intellectual disability in newborns)
D. Chickenpox (Varicella)
Treatment:
Prevention: DTaP vaccine (5 doses before age 6, booster in adolescence & pregnancy)
Treatment:
Cause: Coxsackievirus A
Transmission: Fecal-oral, droplet
3. Pediatric Meningitis
Cause:
Diagnosis: Lumbar puncture (bacterial = cloudy CSF, high WBC/protein, low glucose)
Treatment:
● IV antibiotics (bacterial)
● Droplet precautions for first 24 hours