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    Infant

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    neuronepal5

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    © All Rights Reserved
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    Infant

    Uploaded by

    neuronepal5
    7 views20 pages

    Copyright

    © © All Rights Reserved

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    PPT, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    7 views20 pages

    Infant

    Uploaded by

    neuronepal5

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 20

    Index case-infant

    1. Name
    2. Age
    3. Sex
    4. Address
    5. Nearest health facility
    6. Presenting complaints
    7. History of present illness
    8. Past history of illness
    9. Family history of illness
    10. Family record/Social history
    a. Type of family
    b. Family size with family tree
    c. Religion and ethnicity
    d. Education of father
    e. Education of mother
    f. Income
    g. Cultural pattern in relation to feeding practices of
    a child / mother

    • vegetarianism is given to a place of honor in


    Hindu society
    • men eat first and women last and poorly
    • Hindu women take food left over by their
    husband
    • some foods are not taken during pregnancy (egg,
    meat, fish, milk, leafy vegetables )
    • children is not put to breast during the first 3
    days of birth
    11. Housing condition

    a. Adequate for members/overcrowding(total


    floor area..)
    b. Cross ventilation
    c. Lighting
    d. Toilet facilities
    e. Source of drinking water
    f. Disposal of waste
    g. Animal/pet
    12. Maternal history

    a.Antenatal care/immunization against


    tetanus/iron and folic acid/complication during
    pregnancy

    b. h/o abortion/stillbirth

    c. delivery- home/institution/complication
    13. Baby
    a.Birth weight
    b.Colostrums/exclusive breastfeeding
    c.weaning practices
    d. Immunization
    e. Developmental milestones- with respect to
    movement and posture, vision and manipulation,
    hearing and speech, social behavior
    14. Nutritional history of mother and child
    a. Habit: Vegetarian/non vegeterian and for a child-
    breast fed/ otherwise in detail
    b. Assessment of dietary intake
    (mother and child)
    -retrospective inquiries about the nature and quantity of
    foods eaten during the previous 24 or 48 hours
    -calculation of intake (grams)of food in terms of cereals,
    pulses, vegetables, fruits, milk, meat,eggs,etc
    c. Diet survey findings-present
    i.Daily calorie intake
    ii. Daily protein intake
    (compare with reference level and remark as poor
    or adequate or high)

    Expression of deficit:
    %deficit= (deficit/requirement) x 100
    15.Family planning

    a. Know the possibilities to prevent pregnancy


    (husband and wife)
    b. Awareness of any methods (husband and
    wife)
    c. Willing to practice(husband and wife)
    d. Practicing any method (husband and/or wife)
    16. Physical examination/observation

    1. General appearance- normal built/thin


    built/sickly
    2. Personal cleanliness- Nails/ dress
    3. Body measurement (physical growth)
    a. Weight
    b. Length-measured in lying down
    position preferably on special
    measuring board
    Classification of PEM according to IAP
    1. Wt > 80% of expected for age- Normal
    2. Wt :71-80% of expected for age-Grade I
    3. Wt:61-70% of expected for age- Grade II
    4. Wt:51-60% of expected for age-GradeIII
    5. Wt: Less than or equal to 50% of expected for age-
    Grade IV
    (alphabet K is postfixed in presence of edema.)
    Criteria for hospital treatment( admission):
    I. Weighing less than 60% for age with a. edema, b.severe
    dehydration, c. severe diarrhea, d. hypothermia, e. systemic
    infection, f. jaundice, g. bleeding, h. age less than 1 yr or h.
    persistent loss of appetite
    II. With severe wasting or edematous undernutrition
    c. Head circumference

    - under 2years age; should be measured


    -occipitofrontal circumference

    -birth(35cm),3month(40cm), 1yr(45cm),2
    yrs(48cms)

    -hydrocephalus is suspected when the rate


    of growth of the head is greater than
    normal for the sex, age and size of infant
    d. Chest circumference
    -measured at the level of nipples, midway between
    inspiration and expiration
    -at birth;3cm less than head circumference
    -1yr; equal to head circumference and exceeds
    thereafter
    e. Arm circumference
    -ages 1 –5years
    -estimates the body’s muscle mass
    -more than 13.5cm (satisfactory nutritional status)
    -12.5 to 13.5cm (mild-moderate malnutrition)
    -below 12.5cm ( severe malnutrition)
    4.Body temperature
    5. Hair- normal/lack of
    luster/dispigmentation/thin or sparse
    6.Face- Diffuse pigmentation/moon face
    7.Eyes- conjunctiva (normal, dry, pale, icterus)
    -cornea ( hazy or opaque)
    -cataract
    8.Lips- normal, angular stomatitis, hare lips, cleft
    palate
    9. Tongue- normal, pale, fissured
    10. Gums-normal, bleeding
    11. Teeth
    -eruption of teeth in the upper jaw and lower jaw
    -caries and other dental abnormalities

    12. Glands-
    thyroid enlargement/parotid enlargement

    13. Oedema
    14. Rachitic changes-bow legs, beading of the
    ribs
    15. Respiratory system
    -thoracic cage retraction in respiration
    -Respiratory rate
    -Added breath sound
    16. Cardiovascular system
    -location of apex beat
    -cardiac murmur
    -arterial pulse
    17. G.I. System
    -distension, abnormal masses, enlarged
    liver/spleen
    18. Ears- hearing, discharge, accessory auricle
    19. External genitalia
    -any abnormalities
    -male; hypospadius, undescended testes, hydrocele
    -female; fused labia, enlarged clitoris
    20. Limbs and joints- any deformities
    21. Neuro-behavioural activities
    -neck retraction
    -hyperextension/hyperreflexion of limbs
    -Tendon reflexes
    -cry
    -movements
    22. Provisional diagnosis

    -Medical

    -Environment ( food, housing, water,


    sanitation)

    -socio- economic;education,poverty,family
    size
    23. Investigation to be done:

    Blood glucose, blood smear and


    microscopy, hemoglobin, urine
    examination and culture, stool(ova and
    parasites), serum albumin, HIV test,
    electrolyte,etc.
    24. Management

    a. Clinical management according to


    presenting illness.
    b. Involving environmental
    improvement; Health education,
    nutritional education
    c. Involving socio-economic condition;
    promotion of education and literacy,
    income generation activities

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