NURS342 Ch 5 – Flashcards
Unlock all answers in this set
Unlock answersquestion
How many children died in 2010? Where did half of the deaths occur? Where di a third of the deaths occur?
answer
apox 8 million - sub-Saharan Africa - South Asia
question
Most of the children who die this year will be how old?
answer
in their first five years of life (under-5s)
question
How many deaths occur in neonates? What is a neonate?
answer
they are NBs in their first 28 days after birth and about one third
question
What is an infant? how many die during this stage?
answer
from 29 days to one year old about one third
question
What are the leading causes of under-5 deaths?
answer
- neonatal conditions - diarrheal diseases (highest amount is d/t this) - pneumonia - malaria - other infections (HIV/AIDS, meninigitis, pertussis) - injury - UNDERNUTRITION (contributes to at least 1/3 child deaths) (vast majority are d/t preventable/treatable conditions
question
why do more deaths occur in NBs?
answer
because the babies are born too early or are underdeveloped d/t complications during labor/delivery that may result in asphyxia or birth trauma (complications that are common to women who don't have HC access)
question
how many neonates die each year?
answer
approximately 3.5 million (an additional 3 mil stillbirths occur each year)
question
what is diarrhea?
answer
is an increase in the volume of stool and the frequency of defecation which can cause dehydration and death in young children
question
what electrolytes are lost in diarrhea? What can it lead to?
answer
sodium, potassium, and bicarbonate (can lead to muscle contractions, kidney and heart failure, death)
question
What is diarrhea usually caused by?
answer
usually caused by an infection like rotavirus (which is vaccine preventable) or bacteria e.g. e coli, shigella, campylobacter or salmonella which are passed on by contaminated food or water, physical contact, and by contact with feces
question
What percentage of deaths from diarrhea are attributed to lack of drinking water, adequate water for hygiene and lack of access to sanitation?
answer
90%
question
What is the number of diarrhea cases in under-5 children each year? How many of these children die from it each year?
answer
about 2.5 billion more than 1 million
question
What is oral rehydration therapy? (ORT)
answer
it is the most important method for preventing death. it is a solution of sugar, salt, and clean drinking water that replaces lost fluids and restores the balance of electrolytes in the blood usually come in packets at clinics, but parents can make their own by mixing 8 tsp sugar and one half teaspoon of salt into one L of boiled water Potassium can be added with fruit juice, coconut water, or mashed bananas
question
How much does a dehydrated child need? (ORT)?
answer
THey will need to drink ORT every time they pass watery stool for a total of min. 1 L per day (even more if they are vomiting)
question
What are other things that helps prevent diarrheal deaths?
answer
1. zinc supplementation 2. adequate nutrition (malnutrition increases the risk of death)-- they should be encouraged to eat what they normally consume (or breastfeed) unless vomiting too much to keep it down, and after they recover they should be encouraged to eat even more to regain lost weight/nutrients
question
What is needed in order to increase the use of ORT and continued feeding?
answer
additional health education for parents and communities
question
What is the definition of pneumonia?
answer
occurs when part of the lung fills with fluid causing the alveoli to be unable to effectively exchange O2 and CO2 (people can feel like they are drowning in fluid as fluid fills their lungs and they develop hypoxia)
question
What are the symptoms of acute respiratory illness (ARI)?
answer
cough accompanied by difficult, rapid breathing
question
how many cases of pneumonia occur in children under 5 each year?
answer
150 million cases
question
What are the most common causes of pneumonia?
answer
1. pneumococcus 2. paemophilus influenza type b, HIB (both vaccine preventable) 3. staph aureas 4. klebsiella pneumoniae
question
how many children taken to a HCP worldwide (with pneumonia) are treated with abx?
answer
only about 1/3
question
What is one component of improving child survival from pneumonia?
answer
educating caregivers about the importance of seeking medical care as soon as the symptoms of pneumonia appear so that a course of abx can be started
question
What is malaria?
answer
It is a parasitic infection spread by the bites of infected mosquitoes
question
how does malaria present?
answer
usually presents with a fever and flu-like symptoms, but children with malaria can deteriorate quickly and CAN ENTER A COMA (CEREBRAL MALARIA)
question
How can malaria be treated? how can it be prevented?
answer
effectively and inexpensively with antimalarial tablets, but malaria can cause weeks or even months of illness due to relapses and severe anemia (reinfection is common) One of the most effective prevention techniques is the use of insecticide-treated bednets (ITNs), yet many households don't have them or fail to use them consistently
question
What happens to babies born to women with malaria?
answer
increased risk of low birth weight, birth complications, and stillbirths
question
What is one of the most common causes of vaccine preventable mortality?
answer
measles (although rates of mortality have dropped significantly recently)
question
What is measles?
answer
It is a highly contagious viral infection that is spread from one person to another through the air or by contact with secretions from the nose or throat of people with the infection
question
What are the common symptoms of measles?
answer
- fever - runny nose - cough - sore eyes - followed by a rash that starts on the face and then spreads down the body
question
What are less common symptoms of measles?
answer
may also cause diarrhea, ear infections, pneumonia, and can lead to permanent disabilities especially in children who are undernourished
question
What is the treatment for measles?
answer
There is no treatment for measles so prevention through immunization is essential
question
In addition to deaths directly caused by under-nutrition, what does malnutrition also increase the risk of?
answer
increases the risk of death from infectious diseases
question
What are interventions to prevent malnutrition in NBs?
answer
nutritional interventions including having infants only consume breastmilk during their first six months of life, continuing to provide breastmilk after introducing solid foods into the infant's diet, and providing vitamin A and zinc supplementation when necessary
question
What important elements does breastmilk contain?
answer
Contains all of the nutrients and water babies need, and it also includes digestive enzymes and antibodies and other immune factors that protect against harmful infections and promote health
question
What are specific factors that breastmilk contains?
answer
- bifidus factor=encourages the multiplication of helpful bacteria called lactobacillus bifidus - COLOSTRUM (the milk produced in the first few days after giving birth) contains large quantities off an ANTIBODY called secretory immunoglobulin A (IgA)
question
What does early breastfeeding increase? (breastfeeding within the first hour after birth)
answer
it increases the neonatal survival rate
question
What does exclusive breastfeeding mean? How many children experience this?
answer
That absolutely nothing else is consumed by the baby (recommended for the first 6 months) Only about 1/3 children worldwide which contributes to illness and death from undernutrition and diarrhea
question
When should "complementary foods" be introduced, and what does this mean? how long should breastfeeding continue
answer
They should be introduced after 6 months of exclusive breastfeeding and breastfeeding should still continue for up to two years or more
question
What are some reasons that could prevent a woman from breastfeeding? What should be given as a substitute?
answer
- some don't produce enough milk - some have HIV infection (don't want to pass it on) - work schedules - death of the mother only commercial formula should be given as a substitute
question
What are concerns about using formula?
answer
- lack of access to clean water, difficulty with mixing instructions (illiteracy) and inability to pay for it - providing some samples may cause the woman to stop producing breastmilk, and cause dependence on the formula
question
What is the concerning history that caused reliance on formula?
answer
in the 70s into the 80s maternity wards (developing countries) would give women formula samples, and some companies even hired "milk nurses" to go into communities in nursing uniforms to advertise the formula, implying that it was better than breastmilk
question
Who addressed these problems?
answer
The world health assembly with the adoption of the international code of marketing of breast-milk substitutes which stresses that breastmilk is the best option, and basically that formula shouldn't be marketed like it was
question
How do various cultures discourage breastfeeding?
answer
- rarely do employers supply a private room - in many cultures women aren't free to BF in public - new grandmothers who bottle fed their own babies may discourage their daughters from breastfeeding
question
What does the saying "breast is best" need to be accompanied by?
answer
Conditions that support breastfeeding
question
What can lack of food for children stem from, asides from total lack of food at the household level
answer
some cultures serve food to men first and to children last, meaning that children don't get enough.. promote new serving practices such as giving children their own plate or bowl of food
question
What are multinational efforts that have sought to standardize efforts to improve global child health?
answer
- supported primary HC (system of community based health focuses on BOTH PREVENTION and cures) it is a horizontal approach
question
When did PHC become the focus?
answer
After the alma alta in 78 which developed the goal "health for all by the year 2000" through the reduction of barriers to HC, especially in rural areas
question
What is a hallmark of PHC?
answer
regularly scheduled health clinics for children under 5 years that monitor growth and provide immunizations (weight loss/stagnation can be a serious sign of illness)
question
What is the expanded program on immunization? (EPI)
answer
was started in the mid 70s by the WHO and expanded the number/type of vaccinations typically given to children and successfully increased the percentage of children receiving essential immunizations
question
What is GOBI?
answer
AN initiative started in the 80s by UNICEF and focused on increasing child survival through promo of four simple interventions: 1. Growth monitoring 2. Oral rehydration therapy for diarrhea 3. Breastfeeding 4. Immunization
question
What was later added to GOBI?
answer
later a partnership between UNICEF, WHO and the world bank added three community focused components to the mix: 1. Family planning 2. Food production 3. Female education This created a program called GOBI/FFF
question
What is Integrated Management of Childhood Illnesses?
answer
Its a package of SIMPLE, AFFORDABLE and EFFECTIVE interventions for major childhood illnesses and under nutrition that was first developed in the 90s by UNICEF and WHO - clinicians working under IMCI complete assessments that ID and dx underlying conditions in addition to the primary illness
question
What does "integrated" mean?
answer
one aspect=the interrelatedness of children's health conditions also emphasizes families and communities working together with HC to care for sick children and the outpatient staff knowing when to refer the child for specialty care or the hospital
question
What is the aim of IMCI?
answer
to improve family and community health practices and to improve case management skills of HC staff
question
What does IMCI provide to families with young children?
answer
Home healthcare guidelines for families with young children and evidence based decision charts for clinicians to use when assessing children and treating common illnesses
question
What did the general assembly of the UN adopt in 1989?
answer
It adopted the Convention on the Rights of the Child - articles are related to child health and survival
question
What do the rights of the child include?
answer
- adequate standard of living - freedom from all forms of exploitation - protection from all forms of violence - access to education and appropriate information - the right to be heard - the right to rest, leisure and play
question
What distinction does the international labor organization (ILO) make concerning children working?
answer
between children participating in economic activity (with or without pay) for a few hours, or full time doing activities other than household chores or schooling--and children who are involved in child labor - permissible: 12 y or older doing a few hours a week of light work that is not hazardous - child labor violation: when a child has an excessive workload, unsafe work conditions, or extreme work intensity
question
What impacts may child labor have?
answer
May harm a child's physical health, mental health, or moral development
question
What were the stats for 2008 (child labor?)
answer
the ILO estimates that 300 million children from the ages of 5-17 were engaged in labor in 2008, of whom about 115 million conducted hazardous work
question
What types of abuse are girls especially vulnerable to across the world?
answer
- infanticide - heavy domestic responsibilities at a very early age - female genital mutilation - violence - sexual abuse - discrimination in food allocation - not allowed to attend school - forced into early marriage
question
What is the Beijing declaration that affirms several objectives for promotion the rights of the "girl child"
answer
It includes 1. eliminating educational discrimination 2. the EXPLOITATION of child laborers 3. violence against children Despite some improvements, significant inequalities between boys and girls remain
question
What is really important for children born with disabilities?
answer
For them to receive treatment ASAP - Cleft palate: surgery so they can suck (nutrition) - CP or SB: therapy and braces and crutches - Deafness: U-7 must receive language and communication skills
question
What is UNICEF's mandate? (united nations children's fund)
answer
to advocate for the protection of children's rights to help them achieve their basic needs to expand opportunities for children to reach their full potential
question
How does UNICEF advocate?
answer
-promotes prenatal health care - promotes girls' education - promotes childhood immunizations and nutrition - HIV/AIDS prevention among young people - promotes protective environments free of violence, abuse and exploitation
question
How does UNICEF fund itself?
answer
About two thirds of the UNICEF budget comes from governments, but the rest must be obtained from nongovernmental organizations, partnerships and private donations
