Child Health Nursing –July/August-2019–SAU UNI RJKT

Child Health Nursing

1.Long essay (any one) 15

💗 A.Explain National Health programmes related to child health and welfare.

India has a range of national health programs designed to improve child health and welfare. These programs aim to address key areas such as child mortality, malnutrition, immunization, maternal health, and overall child welfare. Here’s an overview of the major national health programs related to child health and welfare in India:

1. National Health Mission (NHM)

The National Health Mission encompasses several programs aimed at improving healthcare delivery, particularly in rural and underserved areas. It includes two key sub-missions:

• National Rural Health Mission (NRHM): Focuses on strengthening the rural healthcare infrastructure and improving access to maternal and child health services. Key components include Village Health and Nutrition Days (VHNDs), Accredited Social Health Activists (ASHAs), and Mobile Medical Units (MMUs).
• National Urban Health Mission (NUHM): Targets urban areas to improve healthcare delivery, focusing on urban slums and other underserved areas.

2. Integrated Child Development Services (ICDS)

The ICDS program is one of India’s largest community-based child health and nutrition programs. It aims to improve the health, nutrition, and development of children under six years of age, along with pregnant women and lactating mothers. Key components include:

• Anganwadi Centers: Local centers providing early childhood education, supplementary nutrition, immunization, health check-ups, and referral services.
• Nutrition and Health Education: Targeting pregnant women, lactating mothers, and children, with an emphasis on combating malnutrition and promoting healthy practices.

3. National Immunization Program

The National Immunization Program, also known as the Universal Immunization Program (UIP), aims to protect children from vaccine-preventable diseases. It includes vaccines for diseases such as polio, measles, diphtheria, tetanus, pertussis, hepatitis B, tuberculosis (BCG), Haemophilus influenzae type B (Hib), and rotavirus. The program involves:

• Routine Immunization: A schedule of vaccines for children from birth through adolescence.
• Intensive Immunization Drives: Such as Pulse Polio Campaigns, aimed at eradicating specific diseases.

4. National Programme for Health Care of the Elderly (NPHCE)

Although focused on the elderly, this program indirectly benefits child health by supporting multigenerational families, where grandparents often play a significant role in child-rearing. By promoting the health and well-being of older adults, the program contributes to a supportive family structure, benefiting children’s health and welfare.

5. Rashtriya Bal Swasthya Karyakram (RBSK)

RBSK is a program under the National Health Mission aimed at early detection and management of health conditions in children, including birth defects, developmental delays, and disabilities. The key aspects of RBSK include:

• Screening Camps: Regular health check-ups for children at schools and Anganwadi centers to detect health issues early.
• Referral and Treatment: Ensuring children with identified health problems receive appropriate medical care and treatment.
• Follow-up Services: To monitor the progress of children with health issues and ensure they receive continuous care.

6. Poshan Abhiyaan (National Nutrition Mission)

Poshan Abhiyaan focuses on improving nutritional outcomes for children, pregnant women, and lactating mothers. It aims to reduce malnutrition and stunting in children under five years of age. Key components include:

• Growth Monitoring: Regular monitoring of children’s growth and nutritional status.
• Behavior Change Communication: Campaigns to promote healthy eating practices and reduce malnutrition.
• Intersectoral Coordination: Collaboration between different government sectors to address the multifaceted causes of malnutrition.

7. Janani Suraksha Yojana (JSY)

JSY is a safe motherhood program designed to reduce maternal and neonatal mortality by promoting institutional deliveries. It provides financial incentives to pregnant women for giving birth in hospitals or health centers. By encouraging safe deliveries, the program contributes to reducing neonatal mortality and improving child health outcomes.

Conclusion

These national health programs in India play a crucial role in promoting child health and welfare by focusing on key areas such as immunization, nutrition, early childhood development, maternal health, and early detection of health issues. Through a comprehensive approach that combines healthcare delivery, community engagement, and intersectoral collaboration, India aims to improve child health outcomes and ensure the well-being of its younger population.

💗 B.Describe Essential New borne Care.

Essential Newborn Care (ENC) is a set of practices designed to ensure the health and well-being of newborn babies immediately after birth and during the neonatal period (the first 28 days of life). ENC aims to reduce newborn mortality and morbidity through a series of interventions that focus on providing a safe and supportive environment for the newborn. This comprehensive approach includes a range of practices from delivery through the early days of life. Here’s a detailed explanation of Essential Newborn Care:

Immediate Post-Birth Care

Immediate and Thorough Drying:

• Newborns are quickly and thoroughly dried with a clean, warm cloth immediately after birth to prevent hypothermia.
• This practice also stimulates breathing and helps in clearing the airway of mucus.

Early Skin-to-Skin Contact:

• Newborns are placed on the mother’s bare chest or abdomen to promote bonding, warmth, and initiation of breastfeeding.
• Skin-to-skin contact stabilizes the newborn’s temperature, heart rate, and breathing, and fosters mother-child attachment.

Delayed Cord Clamping:

• The umbilical cord is clamped and cut only after it has stopped pulsating, usually 1-3 minutes after birth.
• Delayed cord clamping allows more blood to transfer from the placenta to the baby, reducing the risk of anemia and promoting better iron stores.

Assessment of the Newborn’s Vital Signs:

• Healthcare providers assess the newborn’s breathing, heart rate, muscle tone, reflexes, and color.
• The Apgar score, taken at 1 and 5 minutes after birth, helps gauge the newborn’s initial health and guides further care.

Early Newborn Care

Breastfeeding within the First Hour:

• The newborn is encouraged to breastfeed within the first hour of life, which provides colostrum (nutrient-rich first milk) and promotes a strong start to breastfeeding.
• Early breastfeeding enhances immunity and helps the uterus contract, reducing postpartum bleeding.

Prophylactic Medications and Immunizations:

• Newborns receive prophylactic medications such as vitamin K to prevent bleeding disorders and antibiotic eye drops to prevent eye infections.
• The first dose of the hepatitis B vaccine is often given within the first 24 hours of life.

Keeping the Newborn Warm:

• The baby is kept warm through skin-to-skin contact, warm clothing, and blankets to prevent hypothermia.
• Care is taken to maintain a warm environment in the delivery room or maternity ward.

Identification and Registration:

• Newborns are identified with an ID band, and birth registration is completed as soon as possible to ensure their legal identity.

Ongoing Newborn Care

Routine Monitoring and Care:

• Healthcare providers monitor the newborn’s vital signs, feeding, weight, and other indicators of health.
• Assessments are made to detect any early signs of health issues, such as jaundice or respiratory distress.

Education for Parents and Caregivers:

• Parents are educated on newborn care, including feeding, hygiene, sleep, and signs of illness.
• Proper guidance is given on breastfeeding, ensuring a good latch, and addressing common breastfeeding challenges.

Support for Mother-Infant Bonding:

• Support is provided to promote bonding between the mother and the newborn, which is crucial for emotional development and attachment.
• Rooming-in, where the newborn stays with the mother in the same room, is encouraged.

Early Screening and Follow-Up:

• Newborns undergo screenings for conditions such as congenital hypothyroidism, hearing impairment, and metabolic disorders.
• Follow-up care is provided to ensure the newborn’s healthy development and to address any issues promptly.

Conclusion

Essential Newborn Care is a holistic approach designed to give newborns the best start in life. It encompasses a range of practices aimed at promoting health, preventing complications, and fostering a strong bond between the newborn and their family. Proper implementation of ENC can significantly reduce neonatal mortality and improve long-term outcomes for children. Healthcare providers, parents, and caregivers all play crucial roles in ensuring that newborns receive the best care from the moment they are born.

2 Write Short notes on following: (any three) 15

💗 A. Low Birth weight Baby

Low birth weight (LBW) babies are infants born weighing less than 2,500 grams (5.5 pounds) regardless of gestational age. Here’s a detailed overview:

1. Definition and Classification:

• LBW is classified into two categories:
  • Very Low Birth Weight (VLBW): Babies weighing less than 1,500 grams (3.3 pounds) at birth.
  • Extremely Low Birth Weight (ELBW): Babies weighing less than 1,000 grams (2.2 pounds) at birth.
• LBW is further categorized based on gestational age:
  • Preterm LBW: Babies born before 37 weeks of gestation but may be appropriate for their gestational age.
  • Small for Gestational Age (SGA): Babies born at or near term but are smaller than expected for their gestational age.

Causes:

• Premature Birth: Babies born prematurely are at risk of LBW because they haven’t had enough time in the womb to grow.
• Intrauterine Growth Restriction (IUGR): Poor fetal growth due to factors such as maternal malnutrition, placental insufficiency, maternal smoking, or medical conditions can result in LBW.
• Maternal Factors: Maternal health conditions (hypertension, diabetes), substance abuse (smoking, alcohol, drugs), and inadequate prenatal care can contribute to LBW.
• Environmental Factors: Exposure to environmental toxins, pollutants, and socioeconomic disparities can impact fetal growth and lead to LBW.
• Genetic Factors: Certain genetic factors may influence fetal growth and contribute to LBW.
• Multiple Pregnancies: Twins, triplets, or higher-order multiples are at increased risk of LBW due to competition for nutrients and space in the womb.

Complications:

• LBW babies are at higher risk of:
  • Respiratory distress syndrome (due to immature lungs).
  • Intraventricular hemorrhage (bleeding in the brain).
  • Necrotizing enterocolitis (intestinal complication).
  • Sepsis (blood infection).
  • Long-term developmental delays and disabilities.
  • Increased risk of chronic health conditions later in life.

Management and Care:

• NICU Care: LBW babies often require specialized care in the Neonatal Intensive Care Unit (NICU) to address medical needs and provide support for growth and development.
• Feeding Support: LBW babies may have difficulty breastfeeding or bottle-feeding due to immature sucking reflexes, so they may require supplementation with expressed breast milk or formula.
• Temperature Regulation: LBW babies have less body fat and may struggle to maintain body temperature, so they may require incubators or radiant warmers.
• Monitoring and Follow-up: LBW babies require close monitoring for growth, development, and potential complications both during their NICU stay and after discharge.

Prevention:

• Adequate prenatal care, including early detection and management of maternal health conditions.
• Proper nutrition and avoidance of harmful substances during pregnancy.
• Avoidance of preterm labor through lifestyle modifications and medical interventions when necessary.

LBW is a complex issue influenced by various factors, and addressing it requires a multifaceted approach involving prenatal care, public health initiatives, and medical interventions.

💗 B. Value of play and selection of Play Material

Importance of Play:

• Play is crucial for cognitive, emotional, and physical development in children.
• It fosters creativity, problem-solving skills, social interaction, and emotional regulation.

Types of Play:

• Physical Play: Running, jumping, climbing, etc., promote physical health and coordination.
• Pretend Play: Role-playing fosters imagination and empathy.
• Constructive Play: Building with blocks or Legos develops problem-solving and spatial skills.
• Sensory Play: Involves exploring textures, sounds, and smells, stimulating the senses.
• Social Play: Interaction with peers teaches cooperation, negotiation, and communication skills.

Selection of Play Material:

• Age-Appropriate: Ensure toys and materials are suitable for the child’s developmental stage.
• Safety: Choose non-toxic, durable materials that meet safety standards to prevent accidents.
• Open-Ended: Opt for toys that allow for multiple uses and interpretations, promoting creativity.
• Educational: Select toys that encourage learning, such as puzzles, books, or art supplies.
• Variety: Offer a range of materials to cater to different interests and abilities.
• Natural Elements: Incorporate natural materials like wood, fabric, or sand for sensory experiences.

Rotation and Accessibility:

• Rotate toys regularly to maintain interest and prevent boredom.
• Ensure toys are easily accessible and organized to promote independent play and exploration.
• Encourage children to clean up after themselves, fostering responsibility and organization skills.

Adult Role:

• Facilitate play by providing guidance, but allow children to lead and explore at their own pace.
• Join in when invited, but also give children space to play independently and use their imagination.
• Use play as an opportunity for bonding and relationship building.

💗 C.Current National immunization Schedule

India’s National Immunization Schedule, also known as the Universal Immunization Programme (UIP), is a government program designed to provide vaccines to infants, children, and pregnant women. It aims to protect against various preventable diseases and is a crucial part of public health strategy to reduce child mortality and morbidity from infectious diseases.

Here’s an overview of the current Indian National Immunization Schedule for infants, children, and pregnant women:

1. Vaccination Schedule for Infants and Children:

• At Birth:
• BCG (Bacillus Calmette-Guérin): Protects against tuberculosis.
• OPV (Oral Polio Vaccine, zero dose): Protects against polio.
• Hepatitis B Vaccine (1st dose): Protects against hepatitis B.
• 6 Weeks:
• OPV (1st dose)
• Pentavalent Vaccine (1st dose): Protects against diphtheria, tetanus, pertussis (whooping cough), hepatitis B, and Haemophilus influenzae type b (Hib).
• Rotavirus Vaccine (1st dose): Protects against rotavirus infection, a common cause of severe diarrhea in infants.
• PCV (Pneumococcal Conjugate Vaccine) (1st dose): Protects against pneumococcal disease.
• 10 Weeks:
• OPV (2nd dose)
• Pentavalent Vaccine (2nd dose)
• Rotavirus Vaccine (2nd dose)
• PCV (2nd dose)
• 14 Weeks:
• OPV (3rd dose)
• Pentavalent Vaccine (3rd dose)
• Rotavirus Vaccine (3rd dose)
• PCV (3rd dose)
• 9 Months:
• MR (Measles-Rubella Vaccine) (1st dose): Protects against measles and rubella.
• JE (Japanese Encephalitis Vaccine) (1st dose): Protects against Japanese encephalitis, applicable in specific states with high risk.
• Typhoid Conjugate Vaccine (TCV) (1st dose): Protects against typhoid fever.
• 16-24 Months:
• MR (2nd dose)
• OPV (Booster dose)
• DPT (Diphtheria, Pertussis, Tetanus) (Booster dose)
• JE (2nd dose)
• PCV Booster
• 5-6 Years:
• DPT (2nd Booster dose)
• 10-16 Years:
• Td (Tetanus and Diphtheria) (Booster dose)

2. Vaccination Schedule for Pregnant Women:

• Early Pregnancy:
• Td (1st dose): Protects against tetanus and diphtheria.
• 1 Month After First Dose:
• Td (2nd dose)

These vaccines are provided free of charge at government health facilities and through various outreach programs to ensure comprehensive coverage across urban and rural regions. The schedule is subject to updates based on emerging public health needs, new vaccines, and changes in epidemiological trends.

It’s important for parents and caregivers to follow the immunization schedule to ensure children and pregnant women receive the protection they need. Vaccination programs play a crucial role in reducing the burden of in

💗 D.Breast feeding and its benefits.

Breastfeeding is the practice of feeding an infant or young child with milk produced by the mammary glands of the mother’s breasts. It is a natural process in which the baby suckles at the breast to consume the breast milk, which provides essential nutrition, antibodies, and other beneficial substances necessary for the baby’s growth and development.

👉Certainly! Breastfeeding offers numerous benefits for both the mother and the infant. Here’s a detailed breakdown of the benefits:

👉Benefits for the Infant:

1. Nutrition: Breast milk provides all the necessary nutrients, including proteins, fats, vitamins, and carbohydrates, in the right proportions for the baby’s growth and development.
2. Immune System Boost: Breast milk contains antibodies and other immune-boosting substances that help protect the baby from infections and diseases, such as respiratory infections, diarrhea, and ear infections.
3. Digestive Health: Breast milk is easily digestible, reducing the risk of digestive issues like constipation or diarrhea in infants.
4. Optimal Growth: Breastfeeding supports optimal growth and development, as breast milk composition adjusts to meet the changing nutritional needs of the growing baby.
5. Cognitive Development: Some research suggests that breastfeeding may contribute to improved cognitive development and intelligence in children.
6. Reduced Risk of Chronic Diseases: Breastfeeding has been linked to a lower risk of chronic conditions later in life, such as obesity, type 2 diabetes, and certain allergies.

👉Benefits for the Mother:

1. Bonding: Breastfeeding promotes bonding between the mother and the baby through skin-to-skin contact and the release of bonding hormones like oxytocin.
2. Postpartum Recovery: Breastfeeding helps the uterus return to its pre-pregnancy size more quickly by stimulating contractions, potentially reducing postpartum bleeding and aiding in weight loss.
3. Reduced Risk of Postpartum Depression: Breastfeeding releases hormones that promote relaxation and reduce stress, potentially lowering the risk of postpartum depression.
4. Contraceptive Effect: Exclusive breastfeeding can suppress ovulation, providing some degree of natural contraception in the first few months after childbirth (though not reliable as a sole method of contraception).
5. Health Benefits: Breastfeeding is associated with a reduced risk of breast and ovarian cancer, osteoporosis, and cardiovascular disease in mothers.

Overall, breastfeeding provides unparalleled nutrition and numerous health benefits for both the baby and the mother, contributing to the well-being and development of both.

3.Briefly Answer the following: (any four) 08

💗 A.List out Different behavioural problems.

1. Aggression: This can include hitting, kicking, biting, or verbal aggression towards others.
2. Defiance: Refusal to follow rules or comply with requests from authority figures.
3. Hyperactivity: Excessive movement, fidgeting, or inability to stay still, often associated with attention deficit hyperactivity disorder (ADHD).
4. Inattention: Difficulty paying attention or staying focused, also associated with ADHD.
5. Oppositional behavior: Constantly arguing, questioning, or defying authority figures.
6. Tantrums: Emotional outbursts characterized by crying, screaming, or physical outbursts.
7. Lying: Deliberately giving false information or withholding the truth.
8. Stealing: Taking items that belong to others without permission.
9. Bullying: Intimidating, threatening, or harming others repeatedly.
10. Withdrawal: Avoiding social interaction, preferring to be alone.
11. Dishonesty: Not telling the truth, even when it is clear they are in the wrong.
12. Substance abuse: Experimenting with drugs or alcohol, which can lead to addiction and other problems.
13. Self-harm: Engaging in behaviors such as cutting or burning oneself as a way to cope with emotional pain.
14. Disruptive behavior: Interrupting others, causing disturbances in class or at home.
15. Social skills deficits: Difficulty making friends or interacting appropriately with peers.

💗 B.Define Thalassemia.

Thalassemia is a genetic blood disorder characterized by abnormal hemoglobin production, leading to anemia. It’s caused by mutations in the genes that control the production of hemoglobin, which is essential for red blood cells to carry oxygen throughout the body. Thalassemia can range from mild to severe forms, depending on the specific genetic mutations involved.

💗 C.Define Malnutrition.

Malnutrition refers to a condition where there’s an imbalance, excess, or deficiency in a person’s intake of nutrients. It can result from inadequate consumption, poor absorption, or excessive loss of nutrients. Malnutrition can lead to a range of health issues, including stunted growth, weakened immune system, and impaired cognitive development.

💗 D.Define Tics and Somnambulism.

Tics are sudden, repetitive, involuntary movements or sounds that occur unexpectedly. They are often seen in conditions like Tourette syndrome but can also occur due to stress, fatigue, or other factors.

Somnambulism, also known as sleepwalking, is a sleep disorder characterized by walking or performing other complex behaviors while still asleep. It typically occurs during the deeper stages of non-REM sleep and can range from simple actions to more complex behaviors.

💗 E.Define orphan and orphanage.

An orphan is a child who has lost one or both parents, typically due to death. An orphanage is an institution or residential facility that provides care, support, and shelter for orphaned children. These establishments aim to meet the physical, emotional, and developmental needs of children who lack parental care.

SECTION – II

Long Essay: (any one)10

💗 A.Explain Tracheo-esophageal fistula and oesophageal atresia.

Tracheoesophageal fistula (TEF) is a congenital condition where there is an abnormal connection between the trachea (windpipe) and the esophagus (food pipe). This connection can occur at various points along the length of the trachea and esophagus and can present with different anatomical configurations. TEF is typically associated with esophageal atresia (EA), where the esophagus does not develop properly and ends in a blind pouch instead of connecting to the stomach.

There are several types of TEF:

1. Type A: Esophageal atresia with distal TEF – The upper esophagus ends in a blind pouch, and a fistula connects the lower esophagus to the trachea.
2. Type B: Isolated TEF without esophageal atresia – The esophagus is intact, but there is a fistula connecting it to the trachea.
3. Type C: Esophageal atresia with proximal and distal TEF – Both the upper and lower esophagus have blind pouches, and there are fistulas connecting the trachea to both pouches.
4. Type D: H-type TEF – This is a rare variant where there is no esophageal atresia, but there is a fistula between the trachea and esophagus.

3. Causes: TEF usually occurs due to abnormal development during fetal growth, but the exact cause is often unknown.
4. Symptoms: Symptoms can vary depending on the type and severity but may include difficulty breathing, coughing, choking, and feeding difficulties.
5. Diagnosis: Diagnosis is typically made shortly after birth through imaging tests such as X-rays, fluoroscopy, or ultrasound.
6. Treatment: Surgical repair is the primary treatment for TEF. It involves closing the abnormal connection between the trachea and esophagus and reconstructing the esophagus if necessary.

Esophageal Atresia:

1. Definition: Esophageal atresia is a congenital condition where the esophagus does not fully develop, resulting in a gap or blockage.
2. Types: There are different types of esophageal atresia:

• Type A: Esophageal atresia without TEF.
• Type B: Esophageal atresia with proximal TEF.
• Type C: Esophageal atresia with distal TEF (most common).

1. Causes: Similar to TEF, the exact cause of esophageal atresia is often unknown but is believed to result from abnormal development during fetal growth.
2. Symptoms: Symptoms may include excessive drooling, difficulty swallowing, choking, and regurgitation of food or saliva.
3. Diagnosis: Like TEF, diagnosis is usually made shortly after birth through imaging tests.
4. Treatment: Surgical repair is also the mainstay of treatment for esophageal atresia. The goal is to reconnect the upper and lower segments of the esophagus to allow for proper swallowing and feeding.

Nursing Management

1. Preoperative Care:
   • Provide emotional support and education to the parents about the diagnosis, treatment options, and expected outcomes.
   • Educate parents on caring for the infant’s feeding tube (if present) and how to suction secretions effectively to prevent aspiration.
2. Preparation for Surgery:
   • Coordinate with the surgical team to prepare the infant for surgical repair of the TEF.
   • Ensure the infant is NPO (nothing by mouth) for a period before surgery to reduce the risk of aspiration.
3. Postoperative Care:
   • Monitor vital signs, respiratory status, and oxygen saturation closely in the immediate postoperative period.
   • Administer prescribed pain medications and assess pain levels regularly.
   • Assess the surgical incision site for signs of infection or complications.
   • Provide emotional support to parents as they adjust to caring for their infant post-surgery.
4. Respiratory Management:
   • Maintain a patent airway by positioning the infant appropriately to prevent airway obstruction.
   • Monitor for signs of respiratory distress, such as increased work of breathing, cyanosis, or stridor.
   • Suction secretions as needed to maintain airway patency.
5. Feeding Management:
   • Coordinate with the healthcare team to establish a safe feeding plan for the infant.
   • Depending on the type and severity of the TEF, feeding may be initiated via a gastrostomy tube (G-tube) or nasogastric tube (NG-tube) to bypass the fistula.
   • Monitor feeding tolerance and assess for signs of aspiration, such as coughing, choking, or respiratory distress.
   • Provide education and support to parents on feeding techniques, tube care, and signs of feeding intolerance.
6. Nutritional Support:
   • Ensure the infant receives adequate nutrition to support growth and development.
   • Collaborate with a dietitian to develop an appropriate feeding plan and monitor growth parameters regularly.
   • Monitor for signs of malnutrition or failure to thrive and intervene as needed.
7. Family Support:
   • Provide emotional support and counseling to parents, including addressing concerns, providing information, and promoting coping strategies.
   • Facilitate communication between the healthcare team and the family, ensuring they understand the infant’s condition, treatment plan, and prognosis.
   • Offer resources and referrals to support groups or community services for families of children with congenital anomalies.
8. Long-Term Follow-up:
   • Coordinate with the multidisciplinary team to schedule regular follow-up appointments to monitor the infant’s growth, development, and surgical outcomes.
   • Provide ongoing education and support to parents as they navigate long-term care for their child with a tracheoesophageal fistula.

💗 B.Define Pneumonia. Explain in detail about Pneumonia.

Definition of pneumonia

✨Pneumonia is a lung infection that inflames the air sacs in one or both lungs, often causing cough with phlegm, fever, chills, and difficulty breathing. It can be caused by bacteria, viruses, or fungi.

👉Causes of pnuemonia

◾Pneumonia can be caused by various infectious agents, including:

1. Bacteria:

◾ The most common bacterial causes include Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Mycoplasma pneumoniae.

◾Bacterial pneumonia often occurs after a viral respiratory infection or in individuals with weakened immune systems.

2. Viruses: ◾Common viral causes include influenza (flu), respiratory syncytial virus (RSV), adenovirus, and coronavirus (including SARS-CoV-2, which causes COVID-19). ◾Viral pneumonia tends to be milder than bacterial pneumonia but can still be serious, especially in young children, older adults, and individuals with weakened immune systems.
3. Fungi:

◾Fungal pneumonia is less common and typically affects people with weakened immune systems or underlying lung conditions.

◾Fungal agents such as Pneumocystis jirovecii (Pneumocystis pneumonia) and Histoplasma capsulatum (histoplasmosis) can cause pneumonia.

4. Parasites:

◾Certain parasites, such as Pneumocystis jirovecii, can cause pneumonia, especially in individuals with weakened immune systems, such as those with HIV/AIDS.

5. Aspiration:

◾Aspiration pneumonia occurs when foreign substances, such as food, liquids, vomit, or saliva, are inhaled into the lungs, leading to inflammation and infection.

◾ This type of pneumonia is more common in people with swallowing difficulties, neurological disorders, or impaired consciousness (e.g., due to intoxication, anesthesia).

◾Other factors that can increase the risk of developing pneumonia include age (very young children and older adults are more susceptible), chronic diseases (e.g., COPD, asthma, diabetes), smoking, weakened immune system (e.g., HIV/AIDS, chemotherapy), and recent surgery or hospitalization. Additionally, environmental factors such as air pollution and exposure to certain chemicals or pollutants can also contribute to pneumonia.

1. Diagnosis: Pneumonia is diagnosed based on clinical symptoms, physical examination findings, and diagnostic tests such as chest X-ray, blood tests (including complete blood count and inflammatory markers), and sometimes sputum culture or other respiratory samples.
2. Medical Treatment:
   • Antibiotics: Antibiotic therapy is the mainstay of treatment for bacterial pneumonia. The choice of antibiotic depends on factors such as the severity of illness, patient age, risk factors for resistant pathogens, and local resistance patterns. Commonly used antibiotics include macrolides, fluoroquinolones, and beta-lactams (e.g., amoxicillin or ceftriaxone).
   • Antiviral Medications: If pneumonia is caused by influenza virus or other viral pathogens, antiviral medications may be prescribed.
   • Supportive Care: Over-the-counter medications such as acetaminophen or ibuprofen can help reduce fever and relieve discomfort. Cough suppressants or expectorants may be recommended to manage cough symptoms.
3. Oxygen Therapy: Patients with severe pneumonia or respiratory distress may require supplemental oxygen therapy to maintain adequate oxygenation.
4. Fluids and Nutrition: Encourage adequate fluid intake and maintain good nutrition to support the immune system and promote recovery. In severe cases, intravenous fluids may be necessary to prevent dehydration.
5. Respiratory Support: In cases of respiratory failure or severe pneumonia, mechanical ventilation or non-invasive ventilation (such as continuous positive airway pressure, CPAP) may be required to support breathing.
6. Monitoring and Follow-up: Monitor the patient’s clinical status, vital signs, oxygen saturation, and response to treatment closely

👉Nursing management

Nursing management of pneumonia involves several key components to ensure effective treatment and support for patients. Here’s an overview:

1. Assessment and Monitoring: ◾Nurses assess the patient’s respiratory status, oxygen saturation levels, temperature, heart rate, blood pressure, and overall clinical condition regularly.

◾They monitor for signs of respiratory distress, such as increased respiratory rate, difficulty breathing, or cyanosis.

2. Oxygen Therapy:

◾Nurses administer supplemental oxygen as prescribed to maintain adequate oxygenation levels.

◾They monitor oxygen saturation levels and adjust oxygen delivery as needed.

3. Medication Administration: ◾Nurses administer antibiotics, antivirals, or antifungal medications as prescribed by the healthcare provider based on the identified cause of pneumonia.

◾They ensure proper dosage, timing, and administration technique.

4. Fluid and Nutrition Management: ◾Nurses monitor fluid intake and output and ensure adequate hydration.

◾ They encourage oral intake if tolerated and administer intravenous fluids if necessary. Nutrition support is provided to meet the patient’s energy and nutritional needs.

5. Respiratory Support: ◾Nurses assist with respiratory treatments such as chest physiotherapy, incentive spirometry, and nebulizer treatments to promote airway clearance and lung expansion.

◾They educate patients on deep breathing and coughing techniques to help clear secretions.

6. Positioning and Mobilization:

◾Nurses assist patients with positioning to optimize ventilation and promote lung expansion.

◾They encourage early mobilization and ambulation to prevent complications such as pneumonia-associated respiratory failure and muscle weakness.

7. Pain Management:

◾Nurses assess and manage pain associated with pneumonia using pharmacological and non-pharmacological interventions.

◾ They ensure timely administration of analgesics and monitor for adverse effects.

8. Patient Education:

◾Nurses provide education to patients and their families about pneumonia, its causes, treatment, and prevention strategies.

◾They emphasize the importance of completing prescribed medications, practicing good hand hygiene, getting vaccinated (e.g., influenza and pneumococcal vaccines), and avoiding smoking and environmental pollutants.

9. Prevention of Complications: ◾Nurses monitor for complications such as respiratory failure, sepsis, and fluid/electrolyte imbalances.

◾They intervene promptly to prevent or manage complications and collaborate with the healthcare team to optimize patient outcomes.

10. Collaboration and Communication: ◾Nurses collaborate with other healthcare team members, including physicians, respiratory therapists, and pharmacists, to develop and implement an individualized care plan for each patient.

◾ Effective communication ensures continuity of care and facilitates timely interventions.

5 Write short notes on following: (any three) 15

💗 A.Prevention of accidents in children

Preventing accidents in children is essential for their safety and well-being. Here are some practical measures to help prevent accidents:

1. Supervision: Always supervise young children, especially around hazards such as water, stairs, and electrical outlets. Be attentive and vigilant when children are playing or engaging in activities.
2. Childproofing: Childproof your home by installing safety gates at the top and bottom of stairs, securing cabinets and drawers with childproof locks, and covering electrical outlets with safety plugs. Keep small objects, choking hazards, and toxic substances out of reach.
3. Safe Sleeping Environment: Ensure infants sleep on their backs in a crib with a firm mattress and no loose bedding or soft objects. Avoid placing cribs near windows, blinds, or cords to prevent strangulation hazards.
4. Road Safety: Teach children road safety rules, such as looking both ways before crossing the street, using crosswalks, and wearing seat belts in cars. Use appropriate car seats and booster seats according to the child’s age, weight, and height.
5. Water Safety: Always supervise children around water, whether it’s a pool, bathtub, or natural body of water. Install fences and barriers around pools, and enroll children in swimming lessons at an early age. Empty buckets, wading pools, and other containers of water when not in use.
6. Fire Safety: Install smoke detectors on every floor of your home and test them regularly. Create and practice a fire escape plan with your family, and teach children how to respond to smoke alarms and safely escape from a fire.
7. Safe Play Areas: Ensure playgrounds and play areas are age-appropriate and free from hazards such as broken equipment, sharp objects, and hard surfaces. Use protective surfaces such as mulch, sand, or rubber mats under play equipment.
8. Sports and Recreational Safety: Provide children with appropriate safety gear, such as helmets, knee pads, and elbow pads, when participating in sports and recreational activities. Teach children how to use equipment properly and follow safety guidelines.
9. Teaching Safety Skills: Educate children about basic first aid skills, such as how to clean and bandage minor cuts and scrapes. Teach them how to recognize and respond to emergencies, including calling 911.
10. Promoting Healthy Habits: Encourage regular physical activity, healthy eating habits, and adequate sleep to support overall health and reduce the risk of accidents. Limit screen time and encourage outdoor play and exploration.
11. Modeling Safe Behavior: Be a role model for safe behavior by wearing seat belts, following traffic laws, and using safety equipment during activities. Teach children by example to prioritize safety in their actions and decisions.
12. Communication: Maintain open communication with children about safety rules, hazards, and how to respond in emergency situations. Encourage them to ask questions, express concerns, and seek help when needed.

By implementing these preventive measures and creating a safe environment for children to grow and explore, caregivers can significantly reduce the risk of accidents and injuries. Regularly review and update safety measures as children grow and develop to ensure continued protection.

💗 B.Concepts (components) of BFHI

BFHI stands for the Baby-Friendly Hospital Initiative. It is a global program launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to promote and support breastfeeding. The initiative aims to ensure that all maternity facilities adhere to the Ten Steps to Successful Breastfeeding, as outlined in the WHO/UNICEF statement for maternity facilities.

The components of the BFHI include:

1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff: Maternity facilities develop and implement a written policy that promotes and supports breastfeeding, including practices such as early initiation of breastfeeding, rooming-in, and breastfeeding on demand.
2. Train all healthcare staff in the skills necessary to implement this policy: Staff members receive training on breastfeeding management, support, and counseling techniques to assist mothers with breastfeeding initiation, positioning, latch, and overcoming common breastfeeding challenges.
3. Inform all pregnant women about the benefits and management of breastfeeding: Maternity facilities provide education and counseling to pregnant women about the importance of breastfeeding, the benefits for both mother and baby, and practical breastfeeding techniques.
4. Help mothers initiate breastfeeding within one hour of birth: Maternity facilities support early initiation of breastfeeding by facilitating skin-to-skin contact between mother and baby immediately after birth and encouraging breastfeeding initiation within the first hour of life.
5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants: Staff members provide guidance and support to mothers on breastfeeding techniques, positioning, and latch. They also encourage frequent and effective breastfeeding, even if the mother and baby are temporarily separated.
6. Give newborn infants no food or drink other than breast milk, unless medically indicated: Maternity facilities adhere to a policy of exclusive breastfeeding, with no supplementation of formula or other fluids unless medically necessary.
7. Practice rooming-in: Maternity facilities promote rooming-in, where mothers and babies stay together 24 hours a day, to facilitate frequent breastfeeding and bonding.
8. Encourage breastfeeding on demand: Maternity facilities support breastfeeding on demand, allowing infants to feed whenever they show hunger cues rather than on a strict schedule.
9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants: Maternity facilities discourage the use of artificial nipples, pacifiers, or bottles, as they can interfere with breastfeeding and nipple confusion.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic: Maternity facilities provide information about community-based breastfeeding support groups and resources to help mothers continue breastfeeding after discharge.

By implementing these Ten Steps to Successful Breastfeeding, maternity facilities can create a supportive environment that promotes and protects breastfeeding and improves maternal and infant health outcomes.

💗 C Rights of children

Children’s rights encompass a set of legal and moral principles aimed at ensuring the well-being, protection, and development of children. These rights are recognized internationally and are designed to safeguard children’s health, education, safety, and overall development. The key document that defines these rights is the United Nations Convention on the Rights of the Child (UNCRC), adopted in 1989, which has been ratified by almost every country in the world.

Here’s a comprehensive list of the main rights of children, based on the UNCRC and other international frameworks:

1. Right to Life, Survival, and Development: Every child has the inherent right to life and the opportunity to survive and develop to their fullest potential.
2. Right to Non-Discrimination: All children have the right to be treated equally, regardless of their race, gender, religion, language, nationality, disability, or any other characteristic.
3. Right to a Name and Nationality: Children have the right to be registered at birth, to have a name, and to acquire a nationality.
4. Right to Family and Care: Every child has the right to grow up in a family environment and to be cared for by their parents or guardians. If the family environment is not possible, children have the right to alternative care.
5. Right to Freedom of Expression: Children have the right to express their views freely and have those views taken into account in matters affecting them.
6. Right to Freedom of Thought, Conscience, and Religion: Children have the right to freedom of thought, belief, and religion, with appropriate guidance from their parents or guardians.
7. Right to Education: Every child has the right to education, which should be free and compulsory at the primary level, promoting the child’s overall development and preparing them for responsible citizenship.
8. Right to Play and Recreation: Children have the right to rest, leisure, play, and recreational activities, appropriate to their age and stage of development.
9. Right to Health and Health Services: Children have the right to the highest attainable standard of health and access to health services, including basic healthcare, nutrition, and clean water.
10. Right to Protection from Abuse and Exploitation: Children have the right to be protected from all forms of abuse, neglect, exploitation, and violence.
11. Right to Protection in Armed Conflict: Children should not be recruited into armed forces or used in armed conflict, and they have the right to special protection during times of war.
12. Right to Protection from Child Labor: Children have the right to be protected from economic exploitation and hazardous labor that could harm their health or education.
13. Right to Privacy: Children have the right to privacy in their personal lives, homes, and correspondence.
14. Right to Participation: Children have the right to participate in cultural life, including access to appropriate information, media, and cultural activities.
15. Right to Social Security and Standard of Living: Children have the right to social security and an adequate standard of living to support their physical, mental, and emotional development.

These rights collectively aim to ensure that every child can grow, learn, and thrive in a safe and supportive environment. The responsibility for upholding these rights lies with parents, guardians, communities, schools, and governments, all of which play a role in creating a safe and nurturing environment for children.

💗 D.Explain Kangaroo Mother Care.

Definition

Kangaroo Mother Care (KMC) is a method of caring for premature or low birth weight infants, especially in resource-limited settings, where access to traditional neonatal intensive care units may be limited. It involves continuous skin-to-skin contact between the infant and the mother (or another caregiver), typically with the baby positioned upright on the parent’s chest, resembling a kangaroo’s pouch.

👉The key components of KMC include:

1. Skin-to-skin contact:

The baby is held against the mother’s bare chest, providing warmth, stability, and emotional bonding.

2. Exclusive breastfeeding or breast milk feeding:

KMC encourages breastfeeding, which provides optimal nutrition and helps in the baby’s growth and development.

3. Early discharge with continued KMC at home:

KMC allows for early discharge from the hospital, promoting family-centered care and reducing the risk of hospital-acquired infections.

4. Support for mother-infant interaction: KMC promotes maternal-infant bonding, which is crucial for the baby’s emotional and cognitive development.
5. Monitoring and follow-up:

Close monitoring of the baby’s health and growth is essential, along with regular follow-up visits to healthcare providers.

👉 This method offers numerous benefits:

1. Thermal regulation:
   The mother’s body heat helps regulate the baby’s body temperature, reducing the risk of hypothermia.
2. Stabilizes vital signs:
   KMC has been shown to stabilize the baby’s heart rate, respiratory rate, and oxygen saturation.
3. Promotes breastfeeding:
   Skin-to-skin contact encourages breastfeeding initiation and increases milk production.
4. Improves bonding:
   KMC fosters emotional bonding between the mother and baby, which is crucial for the infant’s development.
5. Enhances neurodevelopment:
   The closeness and comfort provided by KMC promote healthy brain development in premature infants.
6. Reduces infection risk:
   Skin-to-skin contact helps establish the baby’s microbiome and reduces the risk of hospital-acquired infections.
7. Decreases stress:
   Both the mother and baby experience reduced stress levels through KMC, leading to better overall health outcomes.
8. Supports weight gain:
   Babies in KMC tend to gain weight more quickly, which is essential for their growth and development.

6 Briefly answer the following: (all Compulsory)

💗 A) List out components of IMNCI.

components of IMNCI.

Integrated Management of Neonatal and Childhood Illnesses (IMNCI) is a strategy developed by the World Health Organization (WHO) and UNICEF to improve the management of common childhood illnesses at the primary healthcare level.

👉The components of IMNCI include:

1. Assessment and classification: Healthcare providers assess and classify sick children based on clinical signs and symptoms into categories such as general danger signs, pneumonia, diarrhea, malaria, and severe malnutrition.
2. Treatment: Once classified, children receive appropriate treatment according to their illness classification.
3. Counseling: Caregivers receive counseling on various aspects of child health.
4. Follow-up: Follow-up visits are scheduled to monitor the child’s progress and ensure adherence to treatment and advice.
5. Integration: IMNCI is integrated into existing healthcare services.
6. Training and capacity building: Healthcare providers receive training in IMNCI protocols, clinical assessment, and counseling skills to effectively implement the strategy.
7. Community involvement: Community health workers and volunteers play a crucial role in promoting awareness, identifying sick children, and facilitating referrals to health facilities when necessary.

💗 B.What is APGAR Scoring?

APGAR scoring is a quick assessment of a newborn’s health at one and five minutes after birth. It evaluates Appearance, Pulse, Grimace, Activity, and Respiration, with scores ranging from 0 to 2 for each category. A total score of 7-10 indicates good health, 4-6 may require some medical assistance, and 0-3 indicates immediate medical attention is needed.

💗 C.List out Methods of Heat loss from the Body.

1. Radiation: Transfer of heat energy in the form of electromagnetic waves to cooler surroundings.
2. Conduction: Direct transfer of heat between objects in physical contact.
3. Convection: Transfer of heat through the movement of air or fluid currents.
4. Evaporation: Conversion of liquid sweat on the skin into vapor, carrying away heat energy.

💗 D.Define wilm’s Tumor.

Wilms’ tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. It originates from immature kidney cells and typically occurs in children aged 3 to 4 years old. Symptoms may include abdominal swelling or mass, abdominal pain, fever, nausea, vomiting, and blood in the urine. Treatment often involves surgery, chemotherapy, and sometimes radiation therapy, depending on the stage and severity of the tumor. Early detection and treatment have significantly improved the prognosis for children with Wilms’ tumor.

💗 E.Define Hiccups in children.

Hiccups in children are involuntary contractions of the diaphragm, the muscle that separates the chest from the abdomen, followed by sudden closure of the vocal cords, resulting in a characteristic “hic” sound. They are common in infants and children and usually harmless, often resolving on their own. Hiccups can be caused by various factors such as feeding too quickly, swallowing air, sudden temperature changes, excitement, or irritation of the diaphragm. In most cases, hiccups in children do not require medical attention and will stop spontaneously. However, if hiccups persist for an extended period or are accompanied by other symptoms, it’s advisable to consult a healthcare professional.

💗F.List out Principles of growth and Development.

The principles of growth and development describe the general patterns and rules by which humans develop physically, mentally, and socially. Here is a list of the fundamental principles:

1. Development is Continuous: Growth and development occur throughout the lifespan, from conception to death.
2. Development is Sequential: Development follows a predictable sequence of stages, with each stage building upon the previous one.
3. Development is Multidimensional: It encompasses various domains, including physical, cognitive, emotional, and social development.
4. Development Proceeds in a Directional Pattern: It typically follows a cephalocaudal (head-to-toe) and proximodistal (center-to-extremities) progression.
5. Development is Influenced by Nature and Nurture: Both genetic (inherited) and environmental factors play a role in growth and development.
6. Development Varies Among Individuals: There is variability in the rate and pattern of development among individuals, leading to unique developmental trajectories.
7. Development Involves Integration and Differentiation: As development progresses, different skills and functions become more specialized (differentiation), and they are integrated into a coherent whole.
8. Development is Contextual: It is influenced by the cultural, social, and environmental context in which a person grows.
9. Development is Plastic: There is flexibility and adaptability in development, allowing for changes in response to experiences and environmental factors.
10. Development Follows Critical and Sensitive Periods: Certain periods in life are more crucial or sensitive for specific types of development, such as language acquisition or attachment formation.