This document provides guidance on taking a complete pediatric history. It outlines the basic components of a pediatric history including history of presenting illness, past medical history, growth and development, medications, allergies, immunizations, family history, and social history. It emphasizes tailoring the history to the child's age, with more focus on prenatal/birth history for infants and developmental/school history for older children. The document also stresses the importance of involving children in age-appropriate ways and taking a confidential "HEADS" history for adolescents.
The pediatric history and physical examination0912783694
The document provides guidelines for obtaining a complete pediatric history, including:
1) Obtaining identifying information, chief complaints, history of present illness, past medical history, family history, social history, and review of systems.
2) Conducting a developmental history to assess growth milestones.
3) Noting important details like prenatal history, birth history, neonatal history, feeding history, and immunization history.
4) Conveying interest in the child to obtain accurate information and addressing concerns in a sympathetic manner.
This document provides guidance on obtaining a complete pediatric history and conducting a thorough pediatric physical examination. It emphasizes the importance of a comprehensive history in arriving at the correct diagnosis for children. Key aspects of the history include the chief complaint, history of present illness, past medical history, family and social history, and systems review. The physical examination section outlines examining the child in a gentle yet expeditious manner, with special consideration for establishing rapport and respecting the child's comfort and modesty. Vital signs, anthropometric measurements, and general appearance should be assessed and documented.
The pediatric history and physical examinationPave Medicine
This document provides guidance on performing a paediatric history and physical examination. It discusses obtaining a complete history from the parent or caretaker, including chief complaint, present illness, past medical history, developmental history, and family/social history. The physical examination should begin by establishing rapport with the child and proceed systematically while respecting modesty. It involves measuring vital signs, anthropometrics, and a full systemic examination from head to toe. Priority is given to assessing emergency signs relating to airway, breathing, circulation, consciousness and dehydration to identify patients needing immediate treatment.
The document discusses strategies for conducting well-child visits in a more effective manner. It notes that simply having clinicians check off pre-selected discussion topics may not be the best use of limited visit time and may not meet families' needs. Alternative approaches discussed include using nurses and other providers for routine screening; providing handouts to cover anticipatory guidance; prioritizing interactive discussions of the most evidence-based topics; and using group well-child care models. The document also emphasizes structuring visits with the goal of promoting adult health outcomes by addressing social determinants of health like poverty, education, environment, and adverse childhood experiences.
HISTORY TAKING AND FAMILY ASSESSMENT IN PEDIATRIC NURSINGRitu Gahlawat
The document discusses history taking, family assessment, and the nurse's role in family assessment. It provides details on collecting a patient's health history, including chief complaints, present illness, past medical history, medications, and more. It describes the purpose of family assessment as understanding a child's needs, risks, and whether the family can meet those needs. The nurse's role involves gathering information on the child's development, parenting abilities, and wider family/environmental factors through interviews, observations, and coordinating with other professionals.
The document provides guidance on taking a pediatric history, including focusing the history on the chief complaint, birth and medical history, developmental milestones, vaccinations, family history, and social factors. It also outlines the approach to performing a physical examination of children, with tips on techniques for different age groups and examining individual body systems in a sensitive manner. The goal is to obtain relevant information to identify health issues while maintaining the comfort, safety and dignity of pediatric patients.
This document discusses issues related to pregnancy among different populations. It begins by providing background on global pregnancy rates and increased risks for certain groups. It then focuses on adolescent pregnancy, describing developmental tasks of adolescence and risks such as peer pressure. The document also discusses elderly pregnancy, outlining higher risks for complications. It notes the importance of nursing management including prenatal assessment, addressing knowledge deficits, and monitoring for complications.
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
The pediatric history and physical examination0912783694
The document provides guidelines for obtaining a complete pediatric history, including:
1) Obtaining identifying information, chief complaints, history of present illness, past medical history, family history, social history, and review of systems.
2) Conducting a developmental history to assess growth milestones.
3) Noting important details like prenatal history, birth history, neonatal history, feeding history, and immunization history.
4) Conveying interest in the child to obtain accurate information and addressing concerns in a sympathetic manner.
This document provides guidance on obtaining a complete pediatric history and conducting a thorough pediatric physical examination. It emphasizes the importance of a comprehensive history in arriving at the correct diagnosis for children. Key aspects of the history include the chief complaint, history of present illness, past medical history, family and social history, and systems review. The physical examination section outlines examining the child in a gentle yet expeditious manner, with special consideration for establishing rapport and respecting the child's comfort and modesty. Vital signs, anthropometric measurements, and general appearance should be assessed and documented.
The pediatric history and physical examinationPave Medicine
This document provides guidance on performing a paediatric history and physical examination. It discusses obtaining a complete history from the parent or caretaker, including chief complaint, present illness, past medical history, developmental history, and family/social history. The physical examination should begin by establishing rapport with the child and proceed systematically while respecting modesty. It involves measuring vital signs, anthropometrics, and a full systemic examination from head to toe. Priority is given to assessing emergency signs relating to airway, breathing, circulation, consciousness and dehydration to identify patients needing immediate treatment.
The document discusses strategies for conducting well-child visits in a more effective manner. It notes that simply having clinicians check off pre-selected discussion topics may not be the best use of limited visit time and may not meet families' needs. Alternative approaches discussed include using nurses and other providers for routine screening; providing handouts to cover anticipatory guidance; prioritizing interactive discussions of the most evidence-based topics; and using group well-child care models. The document also emphasizes structuring visits with the goal of promoting adult health outcomes by addressing social determinants of health like poverty, education, environment, and adverse childhood experiences.
HISTORY TAKING AND FAMILY ASSESSMENT IN PEDIATRIC NURSINGRitu Gahlawat
The document discusses history taking, family assessment, and the nurse's role in family assessment. It provides details on collecting a patient's health history, including chief complaints, present illness, past medical history, medications, and more. It describes the purpose of family assessment as understanding a child's needs, risks, and whether the family can meet those needs. The nurse's role involves gathering information on the child's development, parenting abilities, and wider family/environmental factors through interviews, observations, and coordinating with other professionals.
The document provides guidance on taking a pediatric history, including focusing the history on the chief complaint, birth and medical history, developmental milestones, vaccinations, family history, and social factors. It also outlines the approach to performing a physical examination of children, with tips on techniques for different age groups and examining individual body systems in a sensitive manner. The goal is to obtain relevant information to identify health issues while maintaining the comfort, safety and dignity of pediatric patients.
This document discusses issues related to pregnancy among different populations. It begins by providing background on global pregnancy rates and increased risks for certain groups. It then focuses on adolescent pregnancy, describing developmental tasks of adolescence and risks such as peer pressure. The document also discusses elderly pregnancy, outlining higher risks for complications. It notes the importance of nursing management including prenatal assessment, addressing knowledge deficits, and monitoring for complications.
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
This document provides an overview of objectives and key concepts for a nursing course on pediatric care. It discusses:
- Common causes of mortality/morbidity in children at different developmental stages
- Differences between pediatric and adult assessments
- The importance of family-centered care and minimizing fear in pediatric interactions
- Developmental considerations for assessing and caring for infants, toddlers, and other pediatric age groups
This document provides guidance on evaluating newborn infants and considerations for pediatricians. It outlines components of a comprehensive newborn evaluation including physical examination, medical history assessment, vision/hearing screening, and laboratory tests. Key points discussed are potential risk factors to consider like prematurity, evaluating family history for genetic conditions, discussing gray areas with adoptive families, and ensuring tests are disclosed but not used punitively in adoption processes. The role of the pediatrician is to fully inform families while avoiding guarantees and respecting the child's welfare.
Evaluation of the pediatric surgical patientMohsin Ali
The document provides guidance on evaluating pediatric surgical patients. It emphasizes the importance of thoroughly explaining the child's condition to parents using clear language and diagrams, addressing their questions and concerns, and fostering a good relationship. The physical exam involves a full assessment with modifications for age, ensuring modesty, and explaining steps to reduce anxiety. Exams evaluate major body systems and note any relevant findings for the child's presentation. A trauma evaluation focuses on the history of the injury and signs of abuse or neglect.
Precocious puberty refers to the onset of puberty before age 8 in girls and age 9 in boys. It can be caused by central activation of the hypothalamic-pituitary-gonadal axis or peripheral problems affecting the ovaries, testes or adrenal glands. Treatment typically involves suppressing early hormone production through GnRH analogues to delay puberty and allow for normal adult height. Parents can help children cope by educating them about the changes, monitoring for emotional impacts, and offering praise and support through participation in other activities rather than focusing on appearance.
This document discusses maternal and child health, with a focus on India. Some key points:
- Women and children make up over half of India's population and are the most vulnerable groups. Major causes of death among children under-5 and mothers are preventable.
- The principles of primary health care and treating the mother-child unit as one are important for providing integrated health services. Activities like antenatal care, safe delivery practices, postnatal care, immunizations, and breastfeeding are covered.
- High-risk groups for maternal and child deaths are identified such as teenage mothers, low birth weight babies, and families with poor access to health services. Efforts are needed to reduce preventable
If you’ve recently found out that you’re pregnant, you should learn as much as possible about what it takes to have a healthy pregnancy and how to best care for yourself and your baby during this time of physical and emotional change. Finding a health care professional with whom you’re comfortable to care for you throughout your pregnancy is the first step in a healthy pregnancy.
Ms. Chin Won, age 26, presented for her initial prenatal care visit and was found to have elevated blood pressure, excessive swelling, and a small fetus on sonogram. Early prenatal care could have helped decrease risks of maternal and perinatal mortality by identifying and correcting any problems before they affected the fetus. The nurse should ensure Chin Won's care is family-centered by coaching her and family for care rounds. Cultural assessment would be beneficial in planning care throughout pregnancy and postpartum by considering Chin Won's cultural traditions. The plan of care would vary depending on if Chin Won was single, working, or a teen to address social and personal adjustments needed to cope with her situation.
This document is a magazine from Rocky Mountain Hospital for Children aimed at parents. It provides health and safety tips for common summer activities like biking, swimming, sports, trampolines, and playground play. It encourages balancing fun with precautions like wearing helmets, supervision near water, proper conditioning, and ensuring safe playground surfaces. It also promotes the hospital's online patient portal for accessing care.
This presentation is created by Tara Tayebi and Vahid Shirzad about antepartum care for obstetrics and gynecology at IAUM Iran. the presentation is based on Danforth.
This document summarizes growth patterns in children. It discusses normal growth in four phases: fetal, postnatal/infant, childhood, and pubertal. Growth is influenced by genetics, hormones, nutrition, and other factors. Careful documentation of growth charts can help identify disorders, as deviations from normal growth patterns may indicate underlying issues. The document provides details on measuring and interpreting growth, growth curves, and principles for assessing a child's growth.
Women are three to four times more likely than men to be afflicted with scleroderma, a chronic, autoimmune disease that most often strikes women during middle age. It can cause hardening and thickening of the skin and attack the heart, lungs, kidneys and gastrointestinal tract.
Campus How Does Breast Feeding Compared to Bottle Feeding.pdfbkbk37
The document discusses breastfeeding versus bottle feeding and a case study of an infant experiencing failure to thrive while being exclusively breastfed. The case involves a 6-month-old infant who was breastfed but lost weight and showed signs of failure to thrive. The infant was taken to the hospital and monitored, with initial tests and observations not revealing any organic causes. Supplemental formula feedings were provided while more assessment was conducted.
1. Dating and courtship are important for getting to know a potential lifelong partner's character, background, interests, and compatibility before marriage. It allows a couple to determine if they can get along and build a strong foundation.
2. During pregnancy, expectant mothers should seek regular prenatal care, eat a balanced diet, and avoid unhealthy habits. Common health issues like gestational diabetes and preeclampsia should be monitored.
3. After giving birth, both mother and baby require close observation due to risks of postpartum blues, infections, and other complications. Newborn screening helps detect treatable conditions early.
The document discusses New York state's newborn screening program. It explains that all babies born in NYS have a small blood sample taken to screen for over 45 rare but treatable genetic and metabolic diseases. Early detection before symptoms appear is important so treatment can prevent serious health issues. The screening is done without cost to families and provides important health information to ensure babies get the care they need. Parents are advised to share their baby's screening results and contact information with their baby's doctor.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This document provides an overview of objectives and key concepts for a nursing course on pediatric care. It discusses:
- Common causes of mortality/morbidity in children at different developmental stages
- Differences between pediatric and adult assessments
- The importance of family-centered care and minimizing fear in pediatric interactions
- Developmental considerations for assessing and caring for infants, toddlers, and other pediatric age groups
This document provides guidance on evaluating newborn infants and considerations for pediatricians. It outlines components of a comprehensive newborn evaluation including physical examination, medical history assessment, vision/hearing screening, and laboratory tests. Key points discussed are potential risk factors to consider like prematurity, evaluating family history for genetic conditions, discussing gray areas with adoptive families, and ensuring tests are disclosed but not used punitively in adoption processes. The role of the pediatrician is to fully inform families while avoiding guarantees and respecting the child's welfare.
Evaluation of the pediatric surgical patientMohsin Ali
The document provides guidance on evaluating pediatric surgical patients. It emphasizes the importance of thoroughly explaining the child's condition to parents using clear language and diagrams, addressing their questions and concerns, and fostering a good relationship. The physical exam involves a full assessment with modifications for age, ensuring modesty, and explaining steps to reduce anxiety. Exams evaluate major body systems and note any relevant findings for the child's presentation. A trauma evaluation focuses on the history of the injury and signs of abuse or neglect.
Precocious puberty refers to the onset of puberty before age 8 in girls and age 9 in boys. It can be caused by central activation of the hypothalamic-pituitary-gonadal axis or peripheral problems affecting the ovaries, testes or adrenal glands. Treatment typically involves suppressing early hormone production through GnRH analogues to delay puberty and allow for normal adult height. Parents can help children cope by educating them about the changes, monitoring for emotional impacts, and offering praise and support through participation in other activities rather than focusing on appearance.
This document discusses maternal and child health, with a focus on India. Some key points:
- Women and children make up over half of India's population and are the most vulnerable groups. Major causes of death among children under-5 and mothers are preventable.
- The principles of primary health care and treating the mother-child unit as one are important for providing integrated health services. Activities like antenatal care, safe delivery practices, postnatal care, immunizations, and breastfeeding are covered.
- High-risk groups for maternal and child deaths are identified such as teenage mothers, low birth weight babies, and families with poor access to health services. Efforts are needed to reduce preventable
If you’ve recently found out that you’re pregnant, you should learn as much as possible about what it takes to have a healthy pregnancy and how to best care for yourself and your baby during this time of physical and emotional change. Finding a health care professional with whom you’re comfortable to care for you throughout your pregnancy is the first step in a healthy pregnancy.
Ms. Chin Won, age 26, presented for her initial prenatal care visit and was found to have elevated blood pressure, excessive swelling, and a small fetus on sonogram. Early prenatal care could have helped decrease risks of maternal and perinatal mortality by identifying and correcting any problems before they affected the fetus. The nurse should ensure Chin Won's care is family-centered by coaching her and family for care rounds. Cultural assessment would be beneficial in planning care throughout pregnancy and postpartum by considering Chin Won's cultural traditions. The plan of care would vary depending on if Chin Won was single, working, or a teen to address social and personal adjustments needed to cope with her situation.
This document is a magazine from Rocky Mountain Hospital for Children aimed at parents. It provides health and safety tips for common summer activities like biking, swimming, sports, trampolines, and playground play. It encourages balancing fun with precautions like wearing helmets, supervision near water, proper conditioning, and ensuring safe playground surfaces. It also promotes the hospital's online patient portal for accessing care.
This presentation is created by Tara Tayebi and Vahid Shirzad about antepartum care for obstetrics and gynecology at IAUM Iran. the presentation is based on Danforth.
This document summarizes growth patterns in children. It discusses normal growth in four phases: fetal, postnatal/infant, childhood, and pubertal. Growth is influenced by genetics, hormones, nutrition, and other factors. Careful documentation of growth charts can help identify disorders, as deviations from normal growth patterns may indicate underlying issues. The document provides details on measuring and interpreting growth, growth curves, and principles for assessing a child's growth.
Women are three to four times more likely than men to be afflicted with scleroderma, a chronic, autoimmune disease that most often strikes women during middle age. It can cause hardening and thickening of the skin and attack the heart, lungs, kidneys and gastrointestinal tract.
Campus How Does Breast Feeding Compared to Bottle Feeding.pdfbkbk37
The document discusses breastfeeding versus bottle feeding and a case study of an infant experiencing failure to thrive while being exclusively breastfed. The case involves a 6-month-old infant who was breastfed but lost weight and showed signs of failure to thrive. The infant was taken to the hospital and monitored, with initial tests and observations not revealing any organic causes. Supplemental formula feedings were provided while more assessment was conducted.
1. Dating and courtship are important for getting to know a potential lifelong partner's character, background, interests, and compatibility before marriage. It allows a couple to determine if they can get along and build a strong foundation.
2. During pregnancy, expectant mothers should seek regular prenatal care, eat a balanced diet, and avoid unhealthy habits. Common health issues like gestational diabetes and preeclampsia should be monitored.
3. After giving birth, both mother and baby require close observation due to risks of postpartum blues, infections, and other complications. Newborn screening helps detect treatable conditions early.
The document discusses New York state's newborn screening program. It explains that all babies born in NYS have a small blood sample taken to screen for over 45 rare but treatable genetic and metabolic diseases. Early detection before symptoms appear is important so treatment can prevent serious health issues. The screening is done without cost to families and provides important health information to ensure babies get the care they need. Parents are advised to share their baby's screening results and contact information with their baby's doctor.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
How to Make a Field Mandatory in Odoo 17Celine George
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Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
Pediatric History Taking
Developed by Alanna Chomyn and Dr. Karen Forbes for Pedscases.com.
November 14, 2015
Introduction:
Hello this is Alanna Chomyn and I am a 4th
year medical student at the University of Alberta.
This podcast was created with Dr. Karen Forbes, a pediatrician and medical educator at the
University of Alberta and the Stollery Children’s Hospital.
In this podcast, we will review the components of a complete pediatric history tailored to the
age of the child. By the end of this podcast you should understand the importance of certain
components of the pediatric history at different ages, and have an age-appropriate
approach to pediatric history taking.
We will start off this podcast by reviewing the major elements of a complete pediatric
history, and later will compare and contrast specific elements required when taking a history
for patients at different ages. At the end, we will provide tips and tricks for conducting a
pediatric interview, as offered by a range of experienced pediatricians at the Stollery
Children’s Hospital.
Our discussion will begin with a brief scenario. You are a third year clerk on your pediatrics
rotation at an ambulatory clinic. Your preceptor asks you to see Katie, a 3-month-old girl
presenting with her mother for her well-baby check. What are the important components of
the history for Katie?
The basic components of a pediatric history are as follows: history of presenting illness,
past history including prenatal, birth, and postnatal history, past medical history, surgical
history, growth and developmental, medications, allergies, immunizations, family history,
social history and review of systems. We will now discuss each of these components in
further detail.
History of Presenting Illness:
Similar to history taking in the adult population, the history of presenting illness in a pediatric
history explores the patient’s primary concern or concerns, and must be tailored to the
individual presenting complaint. Generally, you will want to try to characterize the symptoms
of concern and get a sense of the onset, timing, aggravating and alleviating factors,
associated symptoms, and if anything similar has happened to the patient before. In a well-
PedsCases Podcast Scripts
This is a text version of a podcast from Pedscases.com on “Pediatric History Taking.” These podcasts are designed to
give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes or at
www.pedcases.com/podcasts.
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
child visit, the HPI may be focused on concerns the family has had regarding the health and
development of the child and a follow up on previously addressed issues.
Past History:
The past history establishes a complete picture of the child’s health to date, and should
cover events from the prenatal period until the child’s current presentation. The prenatal
history includes inquiring about maternal age, and number of previous pregnancies and the
outcomes of those pregnancies. It may be relevant to ask if the child is a product of natural
conception, or if assistive reproductive technology was required. Ask about whether
prenatal care was accessed, and if there were any abnormal results or concerns identified
on routine screening or ultrasounds. You may inquire into if there were any complications in
the pregnancy such as infections, diabetes, hypertension, or bleeding. Specifically, asking
about group B strep screening in late pregnancy, as well as maternal symptoms of herpes
simplex infection are important for newborns presenting with symptoms that may be
concerning for neonatal sepsis. Asking about prenatal exposures including prescription
medications, substances, and other toxins can be a sensitive topic, but can provide
important insight into possible teratogens the child may have been exposed to, as well as
potential ongoing risks to the child. Start with asking about least threatening exposures
first, and working your way towards more sensitive topics such as alcohol or drug use
during pregnancy. Approaching this topic in a non-judgmental fashion is key in both
obtaining a reliable history and maintaining rapport with the family. Additional exposures
that may be relevant include the mother’s occupation, such as working in a daycare during
pregnancy, pets, and travel.
The next component of past history is the birth history. You will want to ask about whether
onset of labour, was spontaneous or induced, and the gestational age at time of delivery.
Intrapartum risk factors should be asked, including duration of rupture of membranes,
presence of maternal fever or fetal tachycardia, and whether amniotic fluid was mecounium
stained. Asking about mode of delivery will clarify if the infant was delivered by vaginal
delivery, and if any instrumentation such as forceps or suction were required, or if delivery
was by cesarean section. These elements of history provide important information as to
potential issues after birth. Furthermore, ask about any complications that may have
occurred during delivery.
Following the birth history is the postnatal history, which covers details about the wellbeing
of the child immediate postnatal period including APGAR scores if known, birth weight, and
if any resuscitation was required. The APGAR scoring system is an assessment tool used
to assess the wellbeing of an infant in the minutes immediately after birth. It combines an
assessment of the infant’s colour, heart rate grimace or reflex, tone and respiratory effort.
Each of these 5 components of the APGAR score are graded on a scale of 0-2, and the
results are added to provide total score out of 10. Low APGAR scores are an indicator of
poor infant wellbeing in the immediate postnatal period. For further information on the
APGAR scoring system, please refer to our PedsCases podast entitled “APGAR scoring
system”. In asking about the baby’s health in the immediate postnatal period, you may ask if
the baby was born healthy, and if there were any health issues in the prostnatal period such
as respiratory problems or jaundice. One other way to help determine if there were any
concerns in the postnatal period is to ask how long the baby was admitted to hospital
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
following delivery, and if the baby required care in the neonatal intensive care unit.
Typically, healthy infants in Canada can be discharged home within 1-2 days of a vaginal
delivery, or 2-3 days following a cesarean section, as the mother requires a longer stay for
monitoring. If the family reports that the baby was in hospital for longer than you would
expect, it is important to determine if the stay was extended for maternal or infant reasons,
and what the reason for prolonged admission was and how it was managed.
In past medical history, ask the family about any medical conditions the child has had,
including any chronic conditions, past hospitalizations or emergency department visits or
visits to medicentres or other health care providers. For past surgical history, it may be
relevant to include circumcision and/or dental surgeries in an older child.
Growth History:
Growth history is an important part of the pediatric history as prolonged illness or chronic
conditions may impact the child’s growth and result in deviations from an established growth
trajectory. When asking about growth history, the pattern of growth, not just the child’s
measurement at the present is key as alterations in pattern of growth are often early signs
of pathology. Plot the child’s growth on a growth chart, and look at both numbers and
percentiles. It may be helpful to ask regarding growth and size of family members, as
marked deviations in a child’s growth from what is expected from family trends could help in
distinguishing constitutional or familial variants from a pathologic growth pattern. Healthy
children should achieve a minimum growth velocity of 5 cm per year.
Developmental History:
Developmental history consists of the 5 domains of child development: gross motor, fine
motor, speech & language, cognitive, and social/emotional development. One mnemonic
used frequently at our institution to help remember the 5 domains of development is ‘Gotta
Find Strong Coffee Soon’, a memory aid developed by Peter MacPherson, a former medical
student at the University of Alberta. We will not discuss the details of developmental
milestones at this time, however, it will be important to familiarize yourself with these
milestones for various stages of development in order to screen for developmental delay.
There are a variety of developmental tools available that can be used to screen for
developmental concerns.
Medication History:
Medication history includes both prescription and non-prescription medications such as over
the counter medications, vitamins and supplements. One commonly overlooked group of
medications is inhalers, so it might be helpful to ask specifically if the child uses any
inhalers. It is also important to ask specifically about herbal or homeopathic remedies, as
parents may not report this unless directly asked.
Additionally, do not forget to ask about allergies to any drugs, foods or environmental
triggers. If an allergy is endorsed, you should clarify the specific reactions experienced and
whether they required management.
Immunization History:
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
Immunization history is an essential part of the pediatric history. Ask if the child has
received all of his/her routine immunizations, as well as if the child has received any
additional vaccines such as the seasonal influenza vaccine or travel immunizations. It may
be relevant to ask when the child last received a vaccination for various presentations
including febrile seizures or fever. If a parent indicates that a child has not received any or
all of their immunizations, one should explore the reasons for this in a non-judgmental
manner.
Family History:
Next comes family history as it relates to the child’s current presentation. Family history may
begin with clarifying ethnicity when relevant, and then establishing if any medical conditions
have occurred in the family that may relate to the child’s current presentation. It may be
helpful to draw out a pedigree to better understand the health and relationships between
individuals in the family. Again, many items in this component of the pediatric history may
be sensitive, and it is important to approach these topics in an open and non-judgmental
manner. Specify if siblings have both of the same parents as your patient, and approach the
topic of consanguinity for appropriate clinical presentations. There are many sensitive ways
to ask about consanguinity, such as “Is there any way that you and your partner could be
related other than by marriage?” Asking in a straightforward fashion may be a helpful
approach to asking about consanguinity, as it matter-of-fact questioning may help normalize
the inquiry.
Social History:
The social history offers us an opportunity to more fully understand the child within the
context of the family. Like family history, the social history also includes many sensitive
topics such as parental employment status, any financial issues, health coverage and drug
plans, and family composition. This part of the history may lead to discussion about the
impact of the child’s illness on both the child and the family, and can allow the care team to
better support the family.
Review of Systems:
Last in the pediatric history is review of systems. Important general items to ask about in a
pediatric review of systems are feeding and fluids, sleeping, bowel and bladder function,
and vision and hearing. You will want to define the child’s diet, as well as oral intake prior to
your encounter with the child. You should note that a detailed nutrition history may be part
of the HPI for some presentations. Dehydration is common in sick children, and can quickly
become a serious medical concern. Including screening for oral intake as well as bladder
function as part of the review of systems helps to ensure that dehydration, if present, is
identified, and may be further confirmed on physical examination. We are less likely to
complete a “head to toe” review of systems that is often done in adult medicine, as these
questions can be difficult for a parent to accurately answer on behalf of their young children.
We will now move on to discuss pediatric history taking in school-aged children, as
illustrated by the following case:
You are now on Pediatric CTU and are called by your senior to take an admission history
from Oliver, a 6-year-old boy in the Emergency Room, and his father. How will this history
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
differ from Katie’s? What components of this history will you need to emphasize compared
to the infant history? Which history components will be of less importance?
In an infant such as Katie, more important components of the pediatric history tend include
the prenatal, birth, and postnatal history. Events in the prenatal and perinatal period tend to
be more directly relevant to the child’s current health status and presentation in infants and
toddlers than in older children. Of course, exceptions exist and presentations even late in
childhood may relate to events that occurred prenatally or early in development, and these
components of the history should be included in all pediatric histories.
For a school-aged child such as Oliver, both the history taking process and the relevance of
certain elements of the history will differ slightly from the history in younger children,
toddlers, or infants. As the child becomes increasingly verbal, it is important to involve the
child as much as possible in the history taking process. You may be surprised by how much
even young children can contribute to the history! In addition, when given the opportunity,
children may even offer information that the parents are unable to provide.
For Oliver, you will again cover the history of presenting illness, and past history as it relates
to the current presenting complaint including prenatal, birth, and postnatal history. Ask
about past medical history, surgical history, and growth and development. In school-aged
children, school performance may provide further information about the child’s
developmental course. Ask the child and family how the child is doing in school, and if the
school, parents, or the child have identified any issues. It may also be important to ask if the
child has had any problems socially, or if they have a pattern of getting in trouble at school.
Asking about the child’s activities and interests may also provide further information about
his/her development, and contributes to building an overall picture of the child and his/her
context, and how any illness may impact them.
Although the focus of this podcast is on the pediatric history, it is worth mention that there
are valuable elements of the physical examination that can be done concurrent with history
gathering. This time provides an opportunity for observation, which can be valuable
particularly as related to the neurodevelopmental skills of a toddler or young child, and to
corroborate the information gathered on the developmental history.
We will now move on to our final scenario: finally, back in clinic you are asked to see Ivy, a
14-year-old girl presenting for her annual check up. Are there any new components of the
history that will be important to explore in the adolescent population?
As the child grows older, more remote aspects of the past history such as prenatal history,
birth, and postnatal history may or may become less important. As part of the adolescent
review of systems, it is important to include a “HEADS” history. A HEADS history is a
unique component of the adolescent history that explores many sensitive topics that may
arise in adolescence and could potentially have implications for the health and safety of the
child. Because HEADS histories cover many very personal topics, confidentiality must be
respected and this should be discussed with the adolescent prior to asking them to share
this sensitive information. This means that the HEADS history should always begin with a
statement of confidentiality, though important exceptions should be explained including the
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
obligation to report physical or sexual abuse, intent to cause harm to others, or if the patient
intends harm to himself or herself. This needs to be done with the adolescent patient on
their own, gently asking parents or other individuals to leave the room so that you can
speak with the patient in private. Topics that are typically covered in a HEADS history are
home, education and eating, activity and alcohol, drugs, depression, smoking, sexuality,
spirituality, suicide, and safety. For further details on taking an adolescent history, please
refer to the PedsCases podcast “Adolescent Medicine”.
We have now covered all of the components of a pediatric history. However, the art of
history taking involves more than knowing the components of a history, and individuals may
take time to establish their own unique style or approach that allows for a natural flow of the
interview and obtains the required information from the family in an efficient, family centered
manner. Keeping this in mind, we will finish off this Podcast by tapping into the experience
of pediatricians at the Stollery children’s hospital, and have asked 4 pediatricians what tips,
tricks, or advice they have for medical students and residents regarding pediatric history
taking. These pediatricians were Dr. Lois Sim, Dr. Melanie Lewis, Dr. Jessica Foulds, and
Dr. Karen Forbes, and their pearls were as follows:
Dr. Lois Sim suggested that she always tries to obtain her history from her patients, as even
young pediatric patients may have an interesting perspective to offer!
Dr. Melanie Lewis also recommended enlisting the patient as much as possible when taking
a pediatric history. In addition, Dr. Lewis also advised that asking about finances is crucial,
as this provides contextual information that has important implications for patient care. For
example, a family may not mention that they do not have money to purchase a prescribed
medication, and this choice of therapy may therefore be inappropriate in this context.
Therefore, open discussion about finances is important in ensuring the patient receives
appropriate therapy that is feasible for the family. Dr. Lewis reinforced that being patient
centered involves considering what is acceptable and reasonable for the family. Finally, Dr.
Lewis offered that approaching the topic of immunizations in a non-judgmental manner is
crucial, and to be conscious of the magnitude of the Anti-Vax movement and the amount of
scary information available on the Internet.
Dr. Jessica Foulds emphasized the importance of learning and using the names of the
parents and the patient, as this can go a long way to establish rapport. She encouraged
interviewers to ensure that they are at the physical level of the patient when conducting an
interview. This means if the patient is seated, sit. Dr. Foulds recommended we allow the
patient to tell their story, and to clarify once they have a had a chance to be heard. Your
agenda and the patients agenda need not compete for time. She also reminded us as
interviewers not to forget about asking the patient questions appropriate to their level and to
include them and respect the patient as the focus. Finally, Dr. Foulds implored that a
thorough review of systems is essential, and the most often forgotten part of the pediatric
interview!
Dr. Forbes identified that asking about the impact of a child’s illness on the child and family
is essential. If you don’t ask, you won’t find out, and if you don’t find out, you won’t be able
to identify and enlist the supports they may help them navigate their challenges. Regardless
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Developed by Alanna Chomyn & Karen Forbes for PedsCases.com.
November 14, 2015
if the child has an acute or chronic illness or problem, it is always stressful to families.
Keeping a family centered approach in mind is crucial.
That concludes our tips and tricks on pediatric history taking. We would like to thank our
contributors for their pearls!
Thank you for listening to our Podcast on pediatric history taking. We hope you have found
our discussion on Pediatric History taking helpful. We hope you found it useful in
formulating complete, age appropriate histories, and have gained further understanding of
the importance of various components of the pediatric history at different ages.