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HLT51015 Diploma Of Paramedical Science

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HLT51015 Diploma Of Paramedical Science Questions: Read Book: Emergency & Trauma Care for Nurses and Paramedics (2nd Edition)  Read Chapter 36, “Paediatric Emergencies”. You are called to attend a 14-month-old child suffering from fever, diarrhoea and vomiting. The mother verbalises that the child has not been feeding properly, has been crying and has not sleep very well for the last 24 hours.  Tasks: 1. When is antipyretic therapy not recommended for children with fever and why? What is the focus of fever management among paediatrics? 2. Name at least five key elements in taking the history for paediatric presentation.  3. What is the most important parameter to be collected for actual and potential fluid and electrolyte imbalance? How would the hospital accurately obtain this data? Answers: 1. Antipyretics are contraindicated if the child’s temperature is below 38.3 Celsius. This is because antipyretics have not been proven to lower body temperature especially if fever is due to an illness. The main focus in managing fever in paediatrics is to avoid development of complication as it is believed high temperatures more than 40.0 Celsius can predispose a paediatric patient to seizures or brain damage. Fever in children is very common as it is usually the main sign of many infections and childhood illnesses. 2. Taking a pediatric history is different from an adult history because of some components. Pregnancy and birth history is very important in taking a pediatric history. This is because some childhood illnesses are related to pregnancy and giving birth. Some congenital anomalies can be due to maternal health during pregnancy such as rubella infection. Maternal nutrition during pregnancy affects the outcome of the unborn baby. During birth, the baby can contract infections especially if aseptic technique is not considered. Infections such as oral thrush can be acquired during birth if he mothers has untreated vaginal candidiasis during delivery. Another component is developmental history. This is the stage at which milestones were achieved such as walking, talking and running. Present school grades are also important especially in diagnosing mental illnesses. The third component is feeding history. This includes the breastfeeding period, solids introduced and reasons for introducing solid food. Children who are exclusively breastfed for more than six months have a lower risk of frequent infections as their immunity is stronger than those on formula. Another component is family and social history. Some illnesses such as diabetes are hereditary. Environmental factors such as pollen grains or dust mites can predispose the already susceptible children to asthma. Immunization history is also important in pediatric history taking. If a child does not receive full immunization according to Kepi schedule, he or she is susceptible to many disease conditions such as tuberculosis, measles and whooping cough. 3. The most appropriate parameter for determining fluid and electrolyte imbalance is urine output. Monitoring fluid intake by the patient and amount of fluids lost through urine, vomiting and diarrhoea can help estimate any potential sign of fluid and electrolyte imbalance. If the patient takes too much fluid and does not excrete proportionally, then he or she is at risk of fluid overload. If the patient is taking too little fluid and losing much, then he or she is at risk of fluid deficit. The hospital can accurately obtain the data through measuring the amount of fluids taken by the patient and measuring the output. Output of urine through catheterization and estimating amount of fluid lost through vomiting and diarrhoea.

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