pediatric-2017

Q-1

🔸a. Define Hydrocephalus. 02 Define hydrocephalus.

• Hydrocephalus is an abnormality of a child’s nervous system.
• In which there is an abnormal collection of fluid in the ventricles inside the child’s brain.
• This fluid is the cerebrospinal fluid, the reason for its filling is either its absorption is not normal or its production is more than normal.

• Thus, due to the imbalance of cerebrospinal fluid, its filling in the ventricles of the brain is known as hydrocephalus. Hydrocephalus is also caused by obstruction of the CSF pathway.

• Due to this condition enlargement of brain ventricle and head is seen. Due to which the circumference of the head increases and the head appears larger than normal.

🔸b. Write the clinical manifestation of hydrocephalus. 04

• Hydrocephalus occurs mainly in two ways. Congenital and acquired.
  The symptoms of hydrocephalus depend on the type and severity of the disease.
• Following are the common clinical manifestations seen in this condition.

• Excessive enlargement of the head is seen in it. This leads to frontanal bulging (upsell). Cranial sutures remain open, which are also difficult to close. Its closure is delayed.
• The veins on the scalp are raised and the head part is shiny due to fluid filling.
• A cracked pot type resonance is observed percussing the child’s head. This sign is also known as Macwan’s sign.

• A child’s eyes are downward-sloping. Most of the sclera is visible on top of the cornea. This type of eye is known as sunset eye.
• In this condition there is an increase in intracranial pressure. Due to which nosia, vomiting, restlessness, irritability and high pitch cry are seen.

• An increase in temperature and blood pressure is also seen in the child.
  More muscle spasticity, ataxia, papilloedema, urinary incontinence and gradual decrease in mental activity are also seen.
• The above clinical manifestations are seen in hydrocephalus. Increase or decrease in symptoms depends on the severity of the disease condition. If the disease condition is more severe, neurological disturbances are more common.

🔸c. Describe the nursing management of patients with hydrocephalus. Write the nursing management of a patient with hydrocephalus. 06

• Write the nursing management of a patient with hydrocephalus.
• A child with the condition of hydrocephalus should be continuously monitored for increased intracranial pressure. If any signs or symptoms of icp increase are seen, treatment should be started immediately and notified.
• Head circumference should be monitored regularly.

• The child’s behavior and cry pattern should be closely monitored. His restlessness level or irritability level should be specially checked.
• During the movement of the child, the head and body part of the child should be supported so that no damage or injury occurs.
• The child’s head should be supported by a sponge while sleeping to prevent head injury and maintain a comfortable position and minimize pressure on the head.

• If the child has undergone an operation, it is necessary to take care of the shunt part and take measures to prevent infection.
• The position of the shunt and its working condition should be continuously monitored.
• The child’s vital signs should be continuously observed.
• The child should be maintained with IV fluid as well as nazo gastric fluid and special monitoring of his input and output chart.

• A plan should be made to ensure that the nutritional needs of the child are met.
• Maintaining the baby’s skin integrity is especially important. Keep changing the position as per the need of the child to prevent bed sore.
• Exercise can also be prescribed to the child as needed.

• The anxiety level of the child can be reduced by informing the child’s parents about each procedure and information.
• Infection can be prevented by maintaining aseptic technique during every procedure with the child.

• To do special monitoring about the general condition of the child and also convince the parents of the child for routine care and regular monitoring. If any symptoms of abnormality appear, immediately inform to contact the hospital or doctor.

🔸OR🔸

🔸a, Define megacolon. 02 Define megacolon.

• This is a type of congenital anomaly of the gastrointestinal system.
• It is also known as Herschprung’s disease.

• When there are no ganglionic nerve cells in the wall of the intestine, the defect causes the part to swell and widen. This disorder is known as mega colon or aganglionic mega colon.

• These nerve cells are absent in the muscular layer and submucosal layer of the intestine.
• This problem can be limited to a part of the intestine or even spread to the whole intestine. Mainly this problem is seen near the part of rectum and sigmoid colon.

🔸b. Enlist the clinical manifestation of megacolon. 04 List the symptoms of megacolon.

• The clinical manifestation of the child depends on which part of the intestine is affected and how many parts are defective.
• The symptoms and sign base of this disease condition are seen differently in neonates and children.

• After birth, a child with this condition usually does not pass stool i.e. meconium or passes very late.
• Vomiting with bile and fecal matter is also seen due to the backflow of the contents of the intestine in the child.

• Abdominal distension and constipation are seen in the child.
• Anorexia and dehydration are seen in the child. So the condition of failure to thrive is also seen due to non-fulfillment of its nutritional needs. In which there is less increase in the growth characteristics of the child according to age.

• Older children do not show immediate symptoms like newborns and the affected part of the colon is smaller or less visible. The symptoms of which..
• Abdominal distention and abdominal discomfort and irritability are especially common in children.

• Chronic constipation is seen in the child.
• Peristalsis movement can be felt in the child’s abdomen and it can be observed that the superficial veins of that part are also dilated.
• Diarrhea and constipation are seen alternately in children. In which the stool is a special ribbon-like, liquid-like stool passed.
• Malnutrition, anemia and failure to thrive are seen in the child.

🔸c. Describe nursing management of patient with megacolon. 06

• Mega colon is a congenital anomaly of the gastrointestinal system seen in children. Which is specially treated surgically. In it, the part of the colon with the distended portion is removed and an end-to-end anastomosis is performed.

• Perioperative nursing management for this condition is as follows.
• Vital signs of the child should be checked regularly, so that its general condition can be assessed.
  Administer antibiotics as per doctor order.
  Maintain the child’s hydration level.

• A daily rectal voce is given with a prescribed solution. The frequency, color and amount of stool returned after washing is noted.
• It is very important to maintain the nutritional level of the child.

• Special post-operative care of the child is necessary to prevent infection at the surgical site. Daily dressing with aseptic technique is essential.
• An opening is made on the abdomen after the baby’s surgery. The opening is called a stoma. This procedure is called colostomy. It is necessary to take special care of the opening part of colostomy i.e. stoma. In which it is necessary to take special care in its dressing, its skin care, its drainage care and not to get an infection in that part.

• Regular checks are necessary for the normal function of the colostomy.
• Explain to apply zinc paste on colostomy site.
• Explain to maintain hygiene and cleanliness.

• After the discharge of the child from the hospital, persuade the mother and father to do all these care related procedures at home. Encourage follow-up care and hospital visits when needed. Daily assessment of the child. Ask to contact the hospital immediately if any complications occur.

👉Q.2.

🔸a. Define nephrotic syndrome. 02

Define nephrotic syndrome.

• This is a disease of the urinary system. Which causes common hospitalization in children.
• Signs and symptoms of more than one condition are seen in this syndrome. The main symptoms of nephrotic syndrome are severe edema (swelling), hypoalbuminemia, albuminuria and hyperlipidemia i.e. hypercholesterolemia.

• Nephrotic syndrome is a kidney disorder. In which the glomerular permeability increases, which filters the proteins in the blood plasma. Due to which the amount of protein in urine increases and the amount of protein in blood decreases.

• Due to the decrease in the amount of protein in the blood, the fluid in the blood is transferred from the capillaries to the surrounding tissues and cells. So edema is seen.
• Thus nephrotic syndrome is a very complex and common pediatric problem in children.

🔸b. Enlist the symptoms of nephrotic syndrome. 04

• In nephrotic syndrome this condition progresses slowly or sometimes it is seen in acute condition. Signs and symptoms are seen according to the severity of the condition.
• Swelling around the child’s eyes is known as peri-orbital puffiness.
• A lot of weight gain is observed in a short period of time in the child’s weight.

• Edema is seen everywhere in the body like legs, scrotum, hands. This generalized edema is known as anasarca.
• When this swollen part is pressed, a pit is formed in it i.e. pitting edema is seen. Stretching of the skin due to this swelling also leads to striae in the skin. There is also a chance of local infection due to skin damage.

• Protein is excreted in the urine, called proteinuria, and a decrease in protein in the blood is called hypoalbuminemia.
• Apart from this, diarrhoea, vomiting and anorexia are seen in the child.
• Urine output is found to be less than normal.
• Symptoms of anemia are seen in the child.

• Liver enlargement and increase in blood pressure are also seen.
  Problems like ascites, pleural effusion, respiratory infection etc. are seen due to hypo albuminemia.
  Muscle wasting is also seen in some cases.
• Conditions of child malnutrition and failure to thrive are also seen.

🔸c. Describe nursing management of patients with nephrotic syndrome. Write the nursing management of a patient with nephrotic syndrome. 06

• In the management of nephrotic syndrome, the child has to be given special bed rest and given a high protein diet.
• It is given minimum fluid intake and special record of input and output is maintained.

• Special care should be taken during hospitalization of the child and his parents should be informed about the disease condition and all its aspects so that his anxiety can be reduced and his cooperation can also be obtained.
• Regular monitoring of the child’s vital signs is essential.

• Dispensing the medicine prescribed by the doctor on time and maintaining its record.
• Pay special attention to the nutritional needs of the child and keep a record of all diet and fluids given to him.

• To provide supplementary vitamins and minerals to the child in his diet.
• To perform all procedures of the child with aseptic technique and to consider the issues of infection prevention in his care.
• Baby’s skin care should be taken specially to prevent skin break down and also to prevent bed sore by changing alternative position.

• Daily assessment should be done for the general condition of the child including its weight, vital sign, alert level etc.. If any kind of abnormality is found then immediate intervention should be taken.

• Child’s hygiene should be taken care of and his finger nails should be kept short to prevent injuries.
• Keeping in mind the child’s play and recreational activities, the child’s mind should be diverted by activities that can be done on different beds.

👉Q.3Write Short Answers (Any Two) Answer in short. (Any two) 2×6=12

🔸a. Describe about under five clinic. Write about Under Five Clinic.

• The concept of Under File Clinic comes from A Well Baby Clinic. The purpose of which is to provide comprehensive health services for children under five years of age.
• Children under the age of five are a high risk group for developing any of the diseases. Morbidity and mortality ratio is high in children of this group due to many reasons.

• Most of these reasons are preventable. So, with the help of preventive services as well as health supervision, treatment and nutritional surveillance through Under Five Clinic, the health of children can be maintained healthy and the rate of mortality and morbidity can be reduced.

• In order to run an under five clinic it should generally be in an area accessible to everyone. It should be administered by a trained health worker. Regular home visits of mother and children should be done by this worker.
• The following services are provided in the Under Five Clinic. Each of the services is arranged in the form of a triangle symbol. These services are as follows.

• Care in Illness…
• Any child should be cared for and treated by a health care person when they are sick. At present, this type of care is mainly given to children at every center. Health care providers are trained and capable of providing all types of health care services.

• This includes timely diagnosis of any type of illness and treating it accordingly. For example, in case of diarrhea, the child is assessed and given ORS therapy. Apart from this, disorders related to growth and development are diagnosed on time and treated accordingly. Referral services are also provided when the child needs it.

Adequate Nutrition…

• Effective nutrition is the mainstay of a child’s growth and development after birth. If the baby gets exclusive breast feeding after birth and gets proper weaning and balance diet then its growth and development is normal.

• During this time, children get nutritional deficiency disorders like protein energy malnourishment, anemia and many nutritional deficiency disorders like blindness, rickets etc. due to lack of proper nutrition. This disorder is identified early through growth monitoring and maintaining a growth chart also provides information about it.

• Apart from this, this nutritional deficiency disorder can also be diagnosed through physical examination and certain laboratory tests. All these problems can be prevented by providing proper nutrition and supplementary feeding.
• Nutritional supplementary feeding programs like ICDS also play an important role in preventing such disorders.

Immunization..

• Immunization at the Under Five Clinic provides protection against six killer diseases. such as tuberculosis, polio, diphtheria, pertussis, tetanus and measles.
• Universal immunization program provides prevention against all these diseases and mortality and morbidity rates can be reduced through immunization in children under five years of age.

Family planning.

• Family planning methods and services provide methods and articles for mothers to keep child spacing. Counseling of the mother is also done in this regard. Family planning services can be used to plan for the birth of a healthy child and maintain its health.

Health Education.

• Under Five Clinic’s core function is health education. In which the mother is given education about the diseases seen in children below five years, its common treatment, symptoms, growth monitoring and nutrition and the mother is made aware. Health education services are promoted to maintain the health of the child by providing education to the mother on special preventive aspects.

🔸b. Role of pediatric health nurse.

• Nowadays, as the demand of medical surgical and sub-specialty is increasing and new challenges are arising in child health care, the role and responsibility of a pediatric nurse also becomes a challenge. Nowadays, it is very important to keep in mind the specific role and responsibility of a specialist pediatric nurse and the use of specialized technology to provide special care according to the needs of the child.

• As a pediatric nurse, it is necessary to work together on both aspects of care and cure. In which care is a continuous process, care is very useful throughout the period whether the child is sick or healthy.
• Cure A is generally used to diagnose and treat a child when he is sick.

• As a pediatric nurse, one has to care and counsel children and their parents in different places like hospital, home, clinic or community. Hence the role and responsibilities of a pediatric nurse are highly specialized as follows.

Care giver..
Her primary role as a nurse is to care for any child when they are sick and hospitalized. The nurse should act as the primary care giver in every aspect of the child’s care like treatment, feeding, hygiene, safety etc.

Child Care Advocate.
Advocacy is basic to comprehensive family centered care of a child or family.
The nurse acts as an advocacy role to ensure that the child receives good treatment from a good treatment unit and receives good quality health services based on scientific principles. For this, the nurse works to get the maximum benefit to the child.

Team leader..
The nurse works well with her team members and takes leadership, maintains good communication between everyone and participates in the care of the child. As a team leader he keeps everyone together and sells equal responsibility among everyone. He also gives equal opportunity to everyone and is always ready to solve any problem.

Educator and Managerial Role..
The nurse provides education to the child and his parents on every aspect during the treatment of the child. They participate in child care by providing health education on issues like nutrition, immunization, medication, personal hygiene etc.
In addition, the nurse manages every activity in the patrick ward and hospital and maintains coordination and management between all.

counselor.
A nurse works with children as a good counselor. The nurse helps the child and his parents to make appropriate decisions and provides counseling for critical condition decisions.

Recreationist..
The nurse provides a variety of activities to the child during his hospitalization. Activities that reduce the child’s anxiety and help him divert his mind and adjust to the hospitalized environment.

Researcher…
In today’s modern times health care facilities are undergoing many changes. As a pediatric nurse, she participates in many research projects. Research provides new concepts for better treatment plans and health care facilities for children. Many technological advancements can also be implemented in health care through research.

🔸c. Recent immunization schedule. Write about current vaccination schedule.

👉Q.4Write Short notes (ANY THREE) 3×4=12
🔸a. Explain about ICDS program.

• This is an important program for the welfare of children at present. Which was started in 1975 by the Government of India.
• ICDS scheme is found in every area, tribal and urban.

• Initially, when starting this program, this program was started only at some selected places. But currently there are more than 5,000 functioning centers.

Objective of ICDS Scheme.

• Improving the nutritional status of zero to six year old children.
• To work for compensatory growth and development of children.

• To reduce mortality, morbidity and mal-nutrition in children
• Also reduce school drop out rate.
• To establish a policy and coordination between different departments working for the promotion of children.

• To increase the health capacity of the mother and supplement her nutritional diet.
• The above objective is delivered to the beneficiaries through the following package services. Following are the services provided to the beneficiaries of icds programme.

• Services provided to children from zero to six years of age.
• Immunization, Health Checkup, Supplementary Nutrition, Referral Services, Non Formal Preschool Education.

• Services provided to adolescent girls.
  Supplementary Nutrition and Health Education.
• Services provided to mother.
  Health Checkup, Immunization, Supplementary Nutrition.

• Dietary services are mainly provided by Anganwadi workers to the above beneficiaries. This Anganwadi worker has a population of 1000. It mainly handles this program at the village level and is involved in providing all types of services related to dietary services, preventive services, antenatal care as well as postnatal care and immunization care.
• There is a supervisor i.e. head sevika for the supervision of these Anganwadi workers. Which is given some special training. who supervises all activities in coordination with the Project Officer of the ICDS programme.

• Due to this program, the amount of mal nutrition is low. Immunization coverage is high. Also there is a reduction in mortality and morbidity rates in children.

🔸b. Nursing responsibilities to prevent child accident. Write the role of nurse in preventing child accidents.

• Health education is very important to prevent accidents among children. Through which information can be given about safety precautions and awareness.
• Parents of children need to be specially persuaded to maintain constant supervision and discipline of children.

• Along with parents, family members, school teachers and the general public also need to be informed about safety precautions.
• It is necessary for the nurse to explain to the parents that along with the increase in age of the child, his mobility and his capabilities also increase so that the chances of accidents also increase. So, with the increase in age, the child needs to be taken care of more.

• To provide a safe environment around the child and to remove harmful things from that environment. By creating this kind of environment at home, school and community and hospital everywhere, the child can be saved from accidents.
• The parents should be convinced that the child does not get injured by the sports equipment and that no part of it gets stuck in the mouth or respiratory track.
• Hospital facilities and emergency and trauma care are also essential for survival. So by improving these services also disability can be prevented.
• General traffic awareness, traffic rules, safety measures, alcohol prohibition, periodic vehicle checking etc. should be brought awareness to the public.
• The laws and the provision of punishment should be explained for strict compliance of the above rules.

🔸c. Describe the nursing management of patients with PEM (Protein Energy Malnutrition.). Write the nursing management of a patient with protein energy malnutrition.

• Preventive, promotive and rehabilitative services by the nursing staff for protein energy mal nutrition is a very important responsibility for the child to get in the hospital and at home.
• A nutritional history of the child with all its dietary aspects should be collected and physical examination and anthropometric assessment should be done to know its nutritional deficiency status.

• Additional investigation should be done if necessary.
• To monitor the growth of the child, it is necessary to maintain regular growth charts. By which children with growth failure can be identified early.
• To participate in crisis management of children with PEM in hospital.
• Implementing a nutritional rehabilitation program.

• To promote the child’s parents to take good care of the child in terms of nutritional and other health aspects.
• Convince the mother and father for regular follow-up of the child.

• Breast feeding, weaning, balance diet, appropriate feeding practice, good health habits etc. Nutritional education and demonstration should be explained to mother and father.

• Explain the preventive measures of PEM to the mother and father.
• Explain the nutritional services available at village level to children from lower socio economic background.

• Monitoring the availability of nutritional services at community and individual level and record reports on nutritional program implementation.
• It is necessary to participate in the nutritional research project and work to bring awareness to the family and community.

🔸d. Describe the management of pre term baby. Write nursing management of pre term baby.

• A baby born before term gestation is called a preterm baby. Such a child is very high risk.
• It is very important to start prevention of preterm baby immediately after its diagnosis.

• After diagnosis, during delivery, the mother should be referred to a center where all types of obstetrical care are available and where skilled specialist doctors are available, the mother should be delivered. So complications can be prevented by providing good treatment to the child at the time of birth by the neonatologist.

• Resuscitation is especially needed at the time of birth of such a child. If the child’s heart rate and respiration are not normal, the process of resuscitation is done immediately to save the child’s life or provide respiratory and cardiac support.

• Preventing the baby from hypothermia after birth is also a very important requirement.
• If the baby does not have any medical emergency at birth, the baby’s cord is cut late so that iron can be stored in the baby and it can be protected from anemia and hyaline membrane disease.

• The baby should be placed in a warmer to maintain body temperature. Apart from this he should be given vitamin K according to his weight.

• After birth, the baby should be transferred to the Neonatal Intensive Care Unit. Here all the care of the baby is taken into consideration and kept till the condition of the baby is stable.

• Respiratory distress is a common problem in preterm babies. So the respiratory status of such a child should be specially monitored. If the child feels the need, the airway can be cleared by suctioning and oxygen therapy is also given as needed.

• A baby is at risk for hypothermia after birth. So it is necessary to maintain its temperature. It is necessary to keep the baby in a continuous warm environment and measure the body temperature of the baby.

• After the baby is stable, giving information about kangaroo mother care by the mother and giving kangaroo mother care till the maximum time mother and baby are comfortable so that the weight of the baby will increase and breast feeding will also get promotion, infection can also be prevented with this technique.

• Satisfying the nutritional needs of the child is very important, therefore giving advice to the mother to give maximum exclusive breast feeding to the child and other methods of feeding can also be used if necessary.

• Every aspect of a child’s care requires special attention to infection prevention, especially during hospital infection prevention practices.
• Monitor the child for any complications and do a complete examination. If any complication is found then immediate management should be done.

• The child is discharged when the child gains a little weight and is physically stable. At this time, every aspect of home care like KMC, feeding, infection prevention, temperature maintenance, etc., needs to be explained in great detail to the mother and father, as well as follow-up care and risk assessment, so that they can properly care for the child. And if there is any problem, the hospital can identify and provide immediate medical care.

• Good antenatal care is also very important for the prevention of preterm baby, for which it is very important to take good care of every aspect of the mother before delivery.

👉Q.5 Write Definition (ANY SIX) Give the definition. (Any six) 6×2=12
🔸a. Growth –

• Physical maturation can be seen through increase in body size and increase in size and shape of organs. It can be measured in inches or centimeters. A key characteristic of physical growth is weight, which can be measured.

• Increase in physical characteristics is seen due to multiplication of cells and increase in intra cellular substance. This is a quantitative change in the body that can be measured in specific centimeters, inches, kilograms or pounds. This is a continuous process.

• Growth means the process of attaining physical maturation in which gradual maturation is seen in the physical characteristics of the child.

🔸b. Cold chain

• Nowadays, many medicines can be preserved with the help of technology to maintain their effectiveness. Especially the vaccine is saved in this regard.

• Cold chain means the system of storing and transporting the vaccine at low temperature from its production to distribution to the beneficiaries to maintain its potency and efficacy (quality).

• If there is any defect in the process of this cold chain, the diseases prevented by this vaccine cannot be prevented and diseases can be seen. It is also a negligence.

• Cold chain equipment, transportation system and training of health care workers to maintain cold chain is very important for successful cold chain maintenance.

• Most vaccines are stored between four and eight degrees Celsius. Polio vaccine is a very heat sensitive vaccine hence it is stored at minus 20 degree temperature.

🔸c. Failure to thrive –

• FTT is especially common in infants and young children. In which the expected growth of the child is not seen.

• FTT is a problem especially seen in children of poor socio-economic groups. After this terminology was mentioned in 1915, it was also known as emotional deprivation.

• FTT is a chronic and progressive disorder of infants and children. In which the child does not have the expected weight for his age and loses weight. His weight is less than normal for his age.

• In Failure to Thrive, there is not much problem in the length or height of the child or in all aspects of its development. Especially his weight is not seen normal according to his age are the main characteristics.

• FTT has many psychological and physiological causes and some external and internal factors are also responsible.

🔸d. Otitis media –

• Otitis media is an infection of the middle ear. In which inflammation is seen in the middle ear.

• This is a common problem in children. Which is especially seen in the infant and early childhood period.

• It is usually associated with infection of the upper restorative track, as the pharyngs become infected, which can easily reach the middle ear through the Eustachian tube.

• A short eustachian tube of the child is also a reason that the infection can easily get into the middle ear. Apart from this, due to the fact that the child is breastfeeding while sleeping, there are also chances of infection in the middle ear.

🔸e. Club foot

• Club foot is a congenital anomaly of the musculoskeletal system. In which a non-traumatic deformity is seen on the leg. It is also called telepus. These words are derived from the Latin words talus meaning ankle and pes meaning foot. This terminology was given in 1839.

• Club foot is a complex foot i.e. foot deformity. In which it is seen due to the deformity of the leg bones, ligaments and muscles.

• A part of this leg is seen twisted from its normal position.
• In this problem, the deviation of the foot is seen in all different directions and it is classified in different ways.

• In this disorder, the main leg is not in the normal anatomical position, it is seen bent in different angles and directions.

🔸g. Juvenile Delinquency –

• Juvenile means childhood or relating to a child and delinquency means anti-social activity or criminal behaviour.

• Thus, juvenile delinquency means criminal activities committed by children, especially when the child is not of adult age.

• These criminal activities include sexual assault, murder, theft, harming others etc. by a child.

• There are many reasons for developing this type of antisocial behavior in a child which include parental causes, social causes, personal causes etc.

🔸f. Hypospediasis –

• This is a type of congenital anomaly of the urinary system in which the opening of the urethra in the child is found on the ventral surface i.e. under the part of the penis instead of the normal place of the penis.

• This urethral opening is found on the underside of the penis. It is a common congenital anomaly of the urinary system seen in males. In which the child has difficulty in passing urine normally.

• This type of problem is also seen in female child. In which the urethral opening opens downward into the vaginal cavity so that urine drips down from the vagina.

🔸h. Thumb sucking

• Thumb sucking or finger sucking is a behavioral disorder seen in children. It is also called habit disorder. In which the child puts his thumb in his mouth and shakes it.
• This type of behavior is seen to reduce the tension and whenever the child has a feeling of insecurity.
• In the early stages of the child’s growth and development, when the child does not get enough oral satisfaction, this habit gradually develops in the child.
• If this habit is observed in the child for more than 3 to 4 years, then due to this problem is seen in the shape of the oral cavity and the structure of the teeth. Other oral cavity related problems are also seen due to thumb sucking.

👉Q.6 A. Fill in the blanks. Vacancy filled. 05

Father of paediatric is _ (Abraham Jacoby)

Oral thrush caused by___________ Oral thrush is caused by__________ organism. (Candida albicans)

Koplik spot is a sign of _ disease. Koplik spot is a sign of ___________disease. (measles)

Mother’s first breast milk is known as _. (Colostrum)

World children’s day is celebrated on________. (November 20)

👉B. Give full form. 05

1.IMNCI

Integrated Management of Newborn and Childhood Illness

2.ENBC –

Essential Newborn Care

3.IPV –

Inactivated poliovirus vaccine

4.IYCF –

Infant and Young Child Feeding Practices

5.CMTC –

Child Malnutrition Treatment Center

👉C. Match the following. 05
‘A’ ‘B’

a. Bleeding gum Bleeding gum i. Myocarditis za myocarditis

b. Xeropthalmia Xerophthalmia ii. Erb’s palsy

c. Blue baby Blue baby iii. Vitamin ‘A’ deficiency Vitamin ‘A’ deficiency

d. Breech Delivery Breech Delivery iv. Congenital cyanotic heart disease

Congenital cyanotic heart disease

e. Diphtheria Diphtheria v. Vitamin ‘C’ deficiency Vitamin ‘C’ deficiency

vi.Vitamin ‘D’ deficiency, Vitamin ‘D’ deficiency

ANSWER

a – v

b – iii

c – iv

d – ii

e – i