Common pediatric diseases

COMMON PEDIATRIC DISEASES
UNIVERSITY OF SAINT LA SALLE
BACHELOR OF SCIENCEIN NURSING
MENINGITIS
➢ Is an inflammation of the fluid and
membranes (meninges) surrounding
your brain and spinal cord
➢ 2 Common Types:
• Bacterial meningitis
– Bacteria that enter the
bloodstream and travel to the
brain and spinal cord cause
acute bacterial meningitis. But
it can also occur when bacteria
directly invade the meninges.
This may be caused by an ear or
sinus infection, a skull fracture,
or — rarely — some surgeries.
• Viral Meningitis
– Usually mild and often clears on
its own. Most cases are caused
by a group of viruses known as
enteroviruses, which are most
common in the late summer
and early fall
SEVERAL STRAINS OF BACTERIA CAN CAUSE
ACUTE BACTERIAL MENINGITIS, MOST
COMMONLY:
•
Streptococcus pneumoniae
(pneumococcus)
– This bacterium is the most
common cause of bacterial
meningitis in infants, young
children and adults in the
United States. It more
commonly causes pneumonia
or ear or sinus infections.
•
Neisseria meningitidis
(meningococcus)
– These bacteria commonly cause
an upper respiratory infection
but can cause meningococcal
meningitis when they enter the
bloodstream. This is a highly
contagious infection that
affects mainly teenagers and
young adults.
• Haemophilus influenzae
(haemophilus)
– Haemophilus influenzae type b
(Hib) bacterium was once the
leading cause of bacterial
meningitis in children. But new
Hib vaccines have greatly
reduced the number of cases of
this type of meningitis.
Listeria monocytogenes (listeria)
➢ These bacteria can be
found in unpasteurized
cheeses, hot dogs and
lunchmeats. Pregnant
women, newborns, older
adults and people with
weakened immune systems
are most susceptible.
Listeria can cross the
placental barrier, and
infections in late pregnancy
may be fatal to the baby.
MENINGITIS: Signs and Symptoms
NEWBORNS and INFANTS may show these
signs:
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High fever
Constant crying
Excessive sleepiness or irritability
Difficulty waking from sleep
Inactivity or sluggishness
Not waking to eat
Poor feeding
Vomiting
A bulge in the soft spot on top of a
baby’s head (fontanel)
➢ Stiffness in the body and neck
In anyone OLDER THAN THE AGE OF 2 include:
➢ Sudden high fever
➢ Stiff neck
➢ Severe headache that seems different
from normal
➢ Headache with nausea or vomiting
➢ Confusion or difficulty concentrating
➢ Seizures
➢ Sleepiness or difficulty waking
➢ Sensitivity to light
➢ No appetite or thirst
➢ Skin rash (sometimes, such as in
meningococcal meningitis)
MENINGITIS: management
DIAGNOSTIC TEST
➢ BLOOD CULTURES
• A blood sample is placed in a special
dish to see if it grows
microorganisms, particularly
bacteria. A sample may also be
placed on a slide and stained
(Gram’s stain), then studied under a
microscope to see whether bacteria
are present.
➢ IMAGING
• Computerized tomography (CT)
or magnetic resonance imaging
(MRI) scans of the head may
show swelling or inflammation.
X-rays or CT scans of the chest
or sinuses also may show
infection that may be
associated with meningitis
➢ SPINAL TAP (LUMBAR PUNCTURE)
• For a definitive diagnosis of
meningitis, you’ll need a spinal
tap to collect cerebrospinal
fluid (CSF). In person with
meningitis, the CSF often shows
a low sugar (glucose) level
along with an increased white
blood cell count and increased
protein.
TREATMENT:
➢ Bacterial:
– Intravenous Antibiotics
➢ Viral:
• Bed rest
• Plenty of fluids
• Over-the-counter pain
medications to help reduce
fever and relieve body aches
*Your doctor may prescribe corticosteroids to
reduce swelling in the brain, and an
anticonvulsant medication to control
seizures.*If a herpes virus caused your
meningitis, an antiviral medication is available.
rheumatic fever and rheumatic heart
disease.
COMMON SIGNS AND SYMPTOMS
BRONCHIAL ASTHMA (Reactive airway disease)
➢ Is a condition in which your
airways narrow and swell and
may produce extra mucus
triggered by physical and
chemical irritants such dust
mites, pollens, pets, tobacco
smoke, exercise and stress
COMMON SIGNS AND SYMPTOMS:
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Coughing
Wheezing
Chest tightening
Shortness of breath
MANAGEMENT
➢ Identify and avoid asthma triggers
➢ Avoid excessive activities and sudden
change of temperature.
➢ Always bring your rescue inhalers.
➢ Take medication as prescribed
(bronchodilators, corticosteroid)
➢ Oxygen and Nebulization Therapy.
➢ Fever
➢ Swollen, tender, red and extremely
painful joints-particularly the knees
and ankles
➢ Nodules (lumps under the skin)
➢ Red, raised, lattice-like rash, usually
on the chest, back, and abdomen
➢ Shortness of breath and chest
discomfort.
➢ Uncontrolled movements of arms,
legs, or facial muscles
➢ Weakness
MANAGEMENT
➢ Preventive and prophylactic
therapy (antibiotics) to prevent
further damage to valves.
➢ Blood & Diagnostic Test (ECG,
Echocardiogram, Cardiac MRI etc.)
➢ Anti-inflammatory medications.
➢ Surgery- to repair or replace the
valves that are impacted.
TETRALOGY OF FALLOT
RHEUMATIC HEART DISEASE
➢ Is a condition in which the heart valves
have been permanently damaged by
rheumatic fever.
➢ This type of fever is caused by a group A
streptococcal infection.
➢ Rheumatic fever can occur at any age,
but usually occurs in children ages 5 to
15 years old.
➢ Children who get repeated strep throat
infections are at the most risk for
➢ Is a rare condition caused by a
combination of four heart defects that
are present at birth (congenital), which
affect the structure of the heart, causes
oxygen-poor blood to flow out of the
heart and to the rest of the body.
➢ Infants and children with tetralogy of
Fallot usually have blue-tinged skin
because their blood doesn’t carry
enough oxygen.
COMMON SIGNS AND SYMPTOMS
OVER-RIDING AORTA
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➢ A bluish coloration of the skin
➢ Shortness of breath and rapid
breathing,
➢ Loss of consciousness (fainting)
➢ Clubbing of fingers and toes — an
abnormal, rounded shape of the nail
bed
➢ Poor weight gain
➢ Easily get tired
➢ Irritability
➢ Prolonged crying
➢ A heart murmur
•
where the aorta is shifted
slightly to the right and lies
directly above the ventricular
septal defect.
In this position the aorta
receives blood from both the
right and left ventricles, mixing
the oxygen-poor blood from the
right ventricle with the oxygenrich blood from the left
ventricle.
RIGHT VENTRICULAR HYPERTROPHY
4 ABNORMALITIES THAT MAKE UP TETRALOGY
OF FALLOT:
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PULMONARY VALVE STENOSIS
•
Is a narrowing of the pulmonary
valve —the valve that separates
the lower right chamber of the
heart (right ventricle) from the
main blood vessel leading to
the lungs (pulmonary artery).
VENTRICULAR SEPTAL DEFECT
•
is a hole (defect) in the wall
(septum) that separates the
two lower chambers of the
heart — the left and right
ventricles. The hole allows
deoxygenated blood in the right
ventricle — blood that has
circulated through the body
and is returning to the lungs to
replenish its oxygen supply —
to flow into the left ventricle
and mix with oxygenated blood
fresh from the lungs.
when the heart’s pumping action is
overworked, it causes the muscular wall
of the right ventricle to thicken. Over
time this might cause the heart to
stiffen, become weak and eventually
fail.
MANAGEMENT OF TETRALOGY OF FALLOT
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Diagnostic Test (ECG, Echocardiogram,
Cardiac MRI etc.)
Oxygen Therapy
Medications as prescribed.
Cardiac Catheterization
Surgery is the only effective treatment
for tetralogy of Fallot. Surgical options
include intra-cardiac repair or a
temporary procedure that uses a shunt.
NEPHROTIC SYNDROME
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Kidney disorder that causes your body
to pass too much protein in your urine.
Usually caused by damage to the
clusters of small blood vessels in your
kidneys that filter waste and excess
water from your blood.
SIGNS AND SYMPTOMS:
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Edema
Foamy urine
Weight gain
Fatigue
Anorexia
Feeling very tired
MANAGEMENT
➢ Reduction of salt intake for those with
persistent edema.
➢ Limit oral fluid intake.
➢ Control of Infection
➢ Anticoagulant Therapy
➢ Oliguria
MANAGEMENT
➢ Strict monitoring- fluid intake, urine
output, daily weight, BP
➢ Fluid restriction to control edema and
circulatory overload.
➢ Oxygen Therapy
➢ Medications as prescribed (Antibiotics,
Diuretics)
➢ Dialysis, if no response to diuretics
HIRSCHPRUNG’S DISEASE
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PEDIATRIC ACUTE GLOMERULONEPHRITIS
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Occurs when tiny tubes in kidneys
(glomeruli) become inflamed and
interfere with kidney function.
GLOMERULI
– Are tubes that act as a filter,
cleaning the blood by separating
wastes and extra fluid.
– When the glomeruli do not
function properly, waste products
build up in blood.
– Protein and red blood cells also can
leak into urine.
SIGNS AND SYMPTOMS:
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Headache
Increase BP
Facial/periorbital edema
Malaise
Low grade fever
Weight gain
Proteinuria
Hematuria
•
A condition that affects the large
intestine (colon) and causes problems
with passing stool.
It is present at birth (congenital) as a
result of missing nerve cells in the
muscles of the baby’s colon.
SIGNS AND SYMPTOMS
➢ Most obvious sign is a newborn’s failure
to have a bowel movement within 48
hours after birth
➢ Swollen belly
➢ Vomiting (green or brown substance)
➢ Constipation or gas
➢ Diarrhea
➢ Fatigue
➢ Failure to Thrive
MANAGEMENT
➢ Diagnostic Test
➢ Surgery to bypass or remove the
diseased part of the colon is the
treatment.
➢ Antibiotics
IMPERFORATED ANUS (Anorectal
Malformation)
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Is a defect in which the opening to the
anus is missing or blocked. The anus is
the opening to the rectum through
which stools leave the body. This is
present from birth (congenital).
May occur in several forms:
– The rectum may end in a pouch
that does not connect with the
colon.
– The rectum may have openings to
other structures. These may
include the urethra, bladder, base
of the penis or scrotum in boys, or
vagina in girls.
– There may be narrowing (stenosis)
of the anus or no anus.
SIGNS AND SYMPTOMS
➢ No anal opening
➢ An anal opening in the wrong place,
such as too close to the vagina
➢ No stool in the first 24 to 48 hours of
life
➢ Stool passing through the wrong place
➢ A swollen abdomen
➢ An abnormal connection, or fistula,
between your baby’s rectum and their
reproductive system or urinary tract’
MANAGEMENT
➢ Temporary colostomy
➢ Corrective surgery
2 Types of Acute Leukemia:
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Acute Lymphocytic Leukemia
– starts in cells that become
lymphocytes — white blood cells
that are an important part of your
immune system.
– About 80% of childhood leukemia
cases are this type.
Acute Myelocytic Leukemia
Begins in early myeloid cells These
are cells that become white blood
cells (other than lymphocytes), red
blood cells, or platelet-making
cells. It’s the most common type of
leukemia in older people.
COMMON SIGNS AND SYMPTOMS
➢ The general symptoms of AML and ALL
look very much alike.
➢ Weight loss
➢ Fever
➢ Night sweats
➢ Loss of appetite
➢ Tiredness (AML)
2 STAGES OF TREATMENT
➢ Induction therapy kills most of the
leukemia cells in your blood and bone
marrow and lets your body make
normal cells again.
➢ Consolidation therapy (post-remission
therapy) destroys leukemia cells left
behind in parts of your body like the
brain and spinal cord.
THERAPY METHODS
LEUKEMIA
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is a type of cancer that attacks cells in
the bone marrow that make blood.
➢ Chemotherapy. Doctors use drugs to kill
cancer cells. With ALL or AML, you’ll
probably stay in the hospital while you
get this.
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Targeted therapy. These drugs target
specific flaws in cancer cells that help
them grow.
➢ Bone marrow transplant. Doctors
replace unhealthy bone marrow with
leukemia-free stem cells. This will
regrow healthy bone marrow.
➢ Radiation therapy. This treatment uses
high powered beams to kill cancer cells
➢ CAR T-cell therapy. This is a type of
gene therapy that’s sometimes used to
treat ALL in children and young adults
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