Behavioural disease in children are written by deepak shrimali and all the sign & symptoms are explain in detail about child health nursing.

1. Behavioural Disorders
Deepak Shrimali

2. Otitis media
• Otitis media is a an inflamtion of the middle ear .

4. Types
Acute Otitis media
Chronic Otitis media

5. Incidence
• 20 % children between 6 month to three year and
between 4 years to 6 years of age.
Etiology
Pneumococci, hemophilia influenza, streptococci etc.
Disfunction of the eustachian tube.

7. Pathophysiology
• Obstruction of eustachian tube by infection
• Functional defect and mechanical defect
• Blockage of drainage from ear(middle )
• Retention of normal secretions
• Organism reach to middle ear
• Otitis media

8. Clinical manifestation
• Pain during chewing
• Pain in ear
• Irritability due to discomfort
• Pyrexia
• Vomiting
• Ear dischage
• Headache

9. Management
• Provide antibiotics as prescribed by dr.
• Give analgesics to relieve pain.
• Give antipyrectic to treat fever.
• Surgical maryngotomy and drainage of the ear is
successful.
• Provide soft and liquid diet to prevent pain or chewing.

10. Parental Advice
• Advice parents and children to avoid putting anything in
the ear.
• parents should be explained the importance of medical &
surgical treatment and care of ears.

11. Child Abused
• The Battered child syndrome refers to the non accidental
injuries and other forms of child abuse caused when
parents or other adult,strike out their help and harm infant
when the child is suffering from physical injury,sexual
abuse or psychological harm due to full negligence of the
parents.

13. Etiology
• Violence by a husband towards a pregnant wife.
• Irresponsible or mentally sick parents.
• Gripping and shaking the infant may produce finger tip
bruising on his chest and arms.
• Forcing till mouth open to give food may cause similar
bruises on the cheeks.
• Slapping and hitting the infant.

15. • Drug addiction
• Unwanted child
• Alcholic parents
• Affected child may also show
scratches,bitemarks,cigarette burn or scalds.

16. Sign & Symptoms
• Sign & symptoms consist primarily of
bruises,scretches,burns,hematomas,and fractures of
long bones,ribs or skull as well as discomfort and pain.
• poor skin hygiene and some degree of malnutrition are
usually also evident in bettered children.

17. Management
• Complete history of family and relatives.
• physical examination of child.
• when the abused child is admitted to the hospital,the
nurse must help to establish a tone of treatment for the
child and parents rather than a tone of punishment.
• Counselling the parents appropriately.
• take the help from NON PROFITE agencies.
• also can inform 24 hours child helpline number.
•

19. Breath Holding spells
• Breath Holding spell is a common situational disorder.
• it is also known as infantile syncope.in this child holds
breath for some moment which is very anxious for the
parents of child.
• almost 18 month of child are more incidence for this.

21. Etiology
• Breath Holding spells occure as a result from frustration.
• A disciplinary conflict between parents and the child is the
basic underlying cause.
• The child used the attack or its threat to assert him self
and express his anger.

23. Types
• Two main types
• 1) Pallid type :-The pallid type is supposed to be
secondary to cardiac asystole,similar to a vasovagal
attack. it can be induced by occular compression.
• 2) The cyanotic type:-it results from a rise in infrathoracic
pressure when breath is hel in expiration.it leading to
decrease in cerebral circulation.

24. Clinical manifestation
• In the pallid :- The child develops characteristics pallor
rather than cynosis.
• In cynotic type :- The heart rate become slow.
• spasm of laryngeal muscles.
• The frequency of one to three attacks a day.
the child cries , hyperventilates and hold his breath.

25. Management
• Reduce the parental anxiety by explaining them cause
and it's management.
• Assure the parents about its harmfull effect.
• Advice the parents to do not over protect the child.
• Do not give excessive punishment.
• Do the childs physical examination properly and
investigate if needed.
• use proper psychotherapy if needed.
• proper treatment for iron deficiency anemia.

26. FINGER SUCKING (Thumb sucking)
• sucking is the infants chief pleasure they get
love,affection and satisfaction.
• According to psycholoanalytic theory an infant do thumb
sucking.if it lacks sufficiant oral satisfaction through
sucking to obtain food.

28. Incidence
• The majority of children give up thumb and finger sucking
by the time they are 2 years old. other relinguish it during
the preschool years.
• if finger sucking persist beyond 4 years of age, the nurse
should recommend evaluation by a dentist.

29. Causes
• It is more common in infants who are deprived of sucking
or unsatisfied by breast feeding or bottle feeding.
• thumb sucking may be the manifestation of feeling of
insecurity.
• It is sign of an emotional problem between the parents &
the child.
• it is sign of maladjustment in the child.
• it may be due to isolation and lack of love and stimulation.
• it may be sign of stress.

30. managemnt
• The parents should consider it as an instinctual behavior
pattern and as normal.
• The parents should not show excessive anxiety about
thumb sucking untill at least the child is 4 years old.They
shold ignor the symptoms.
• The parents shold know that thumb sucking is a natural
tendency in infants. most of the childrens give up the habit
by the time they go to school.
• Thumb sucking does not have any harmfull effects on the
teeth of the child.

32. • provide additional support by the family members will
result in a decrease of the habit.
• if it persist in school child of 6 to 8 years it may be an
indication of personality disturbance requiring
investigation by a clinical psychologist.
• Always encourage the child to give up in thumb sucking.
• Mother should fullfill the need for sucking during infancy
by allowing the child to suck the breast and never abrupt
while sucking.

33. • Thankyou