Refugee Health 101 with focus on Syrian Refugees
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The document outlines recommendations for providing healthcare to refugees. It discusses screening refugees for chronic diseases like diabetes and iron deficiency anemia. It recommends catching children up on vaccinations if records are absent and giving adult refugees doses of MMR, tetanus, diphtheria, and polio vaccines. Infectious disease screening should include hepatitis B, hepatitis C, varicella, and strongyloides serology. Women's health considerations include rubella and varicella screening, discussing contraception, and preconception counseling. Mental health screening involves remaining alert for PTSD but not routinely screening for trauma history.
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This document discusses HIV in pediatrics. It describes the two types of HIV, HIV-1 being most common worldwide. It outlines the WHO clinical staging of HIV in adolescents and children from Stage 1 (asymptomatic) to Stage 4 (severe manifestations). It discusses diagnosis of HIV infection in infants and children, including early infant diagnosis using viral RNA or antigen detection. It covers ART goals, considerations before initiation, groups and classes of drugs used, monitoring after initiation and management of treatment failure in children living with HIV. Key counseling issues for child clients and their parents/caregivers are also summarized.
Antenatal-Care-1.ppt
This document provides information on antenatal care. It discusses the aims of antenatal care including promoting health, detecting complications, providing education and support. It describes the components of antenatal care visits including medical history, examinations, investigations, and advice provided at each visit. The document outlines the schedule of typical antenatal visits and care provided, including monitoring of vital signs, testing, and growth assessments. Complications are also addressed through specialized antenatal clinics.
PediatricsStudyGuide.pdf
The document provides an overview of pediatric nursing including foundations of care from infancy through adolescence. It discusses health supervision visits, developmental screening, immunizations, and interventions for various pediatric health issues. The later sections cover common pediatric respiratory, cardiovascular, gastrointestinal, genitourinary, neurological, musculoskeletal, and integumentary disorders.
Prenatal care
Prenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. The nurse plays an important role in prenatal care by registering pregnant women, providing clinical assessments and testing, educating mothers on nutrition, rest, hygiene and warning signs, and making referrals for high-risk mothers. The goals of prenatal care are to ensure a healthy pregnancy and delivery for both mother and baby.
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Care of Pediatric Down Syndrome
Down Syndrome is the most common chromosomal abnormality affecting children today. It occurs in approximately 1 in 800 to 1,000 births and is caused by the presence of an extra copy of chromosome 21. Individuals with Down Syndrome often have intellectual disabilities and are at increased risk for certain medical conditions such as congenital heart disease, gastrointestinal abnormalities, hearing loss, thyroid disorders, and periodontal disease. Proper screening, monitoring, and management of associated health issues can help improve quality of life for those with Down Syndrome.
PEDIATRIC HISTORY.ppt
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.
Antenatal & Postnatal Care
A 23-year-old pregnant woman, who is on her third pregnancy with two previous home births and a history of 7 months without menstruation, presents to the casualty department with complaints of breathlessness, palpitations and easy fatigability. On examination, she had severe pallor. This is her first visit to a hospital for antenatal care.
History
This document outlines principles and components for taking a thorough paediatric history. It emphasizes using good communication skills to encourage an open account from the informant. Specific questions should then clarify and amplify the description. Components include identification, chief complaints, history of present illness, review of systems, previous history, family history, and social history. Guidance is provided on questioning techniques for common symptoms like vomiting, abdominal pain, cough, and convulsions. Thorough history taking allows for a comprehensive understanding of the child's health issues.
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Bowie State Nursing Care Plan.pdf
Mrs. L.M. is a 24-year-old African American woman who was admitted for a fall and delivered her baby via cesarean section due to being HIV positive. She has a medical history of bipolar disorder, anxiety, and HIV. A nursing assessment found the patient to have acute pain from her c-section incision and anxiety. Lab results showed she was immune to rubella and negative for syphilis, GBS, hepatitis, chlamydia, and gonorrhea. The newborn is doing well and received medication to prevent HIV.
The principles of antenatal care
The document outlines the principles of antenatal care, which include predicting and preventing problems in pregnancy through medical history screening, physical exams, and education. It then describes the current approach to antenatal care, which involves prepregnancy counseling, booking and routine visits, and education classes. Finally, it provides details on the processes involved in antenatal visits, including tests, exams, screenings and monitoring the growth and health of the fetus over the course of pregnancy.
Pitfalls in pediatrics
1. Failing to keep up with changing medical knowledge and concepts, relying too heavily on tests and reports, and not thoroughly examining patients can lead to missed diagnoses or improper treatment.
2. It is important to consider common conditions first, get additional opinions if the patient is not improving, and refer to specialists in a timely manner when needed.
3. Pediatricians must thoroughly assess patients' medical histories and symptoms, as underestimating any complaint can be a pitfall.
antinatalcare-181015071715.pdf
Antenatal care (ANC) coverage is an indicator of access and use of health care during pregnancy. The antenatal period presents opportunities for reaching pregnant women with interventions that may be vital to their health and wellbeing and that of their infants.
Approach to abdominal pain
This document discusses the diagnosis and management of abdominal pain in pediatric patients through a series of case studies and discussions. It begins with an introduction on abdominal pain in children and objectives. It then presents 5 case studies of children presenting with abdominal pain and asks the reader to make a diagnosis. Following this, it discusses the causes, history, examination, investigations and management of abdominal pain in children at different ages. It provides details on recognizing red flag signs, systemic causes, and approaching the diagnosis of acute abdominal pain.
Adoption - Is my baby fine doc
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.
Zero Trimester
Every woman should be thinking about her health whether or not she is planning pregnancy. One reason is that about half of all pregnancies are not planned. Unplanned pregnancies are at greater risk of preterm birth and low birth weight babies. Another reason is that, despite important advances in medicine and prenatal care, about 1 in 8 babies is born too early. Researchers are trying to find out why and how to prevent preterm birth. But experts agree that women need to be healthier before becoming pregnant. By taking action on health issues and risks before pregnancy, you can prevent problems that might affect you or your baby later.
Preventive pediatrics
Prevention of disease.
Promotion of physical, mental and social well-being of children so that each child may achieve the full genetic potential with which he/she is born.
Primary Prevention
Secondary Prevention
Tertiary Prevention
4 Prenatal Care.pdf
Prenatal care involves planned examinations and monitoring of the woman from conception to birth. The goals are to reduce maternal and infant mortality and morbidity through early detection and treatment of any complications. Prenatal visits include assessment of medical history, symptoms, vital signs, weight, fetal growth and position. Screening tests are performed to check for conditions like anemia and gestational diabetes. Regular visits allow monitoring of the pregnancy and risks are assessed based on factors like maternal age, pre-existing conditions, and family history. Genetic screening options are offered depending on risk level. Prenatal care aims to promote the health of the mother and baby and prepare for delivery.
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Refugee Health 101 with focus on Syrian Refugees
- 1. January 27, 2016 Dr. Bhooma Bhayana Dr. Natalie Lovesey Joanne Veldhorst, NP REFUGEE HEALTH 101
- 2. Mission Statement Chronic Diseases Infectious Diseases Women’s Health Mental Health CCIRH Preventative Care Forms PRESENTATION OVERVIEW
- 3. MISSION STATEMENT Transition/ welcome “altruism” the caring of “the other” Global health, our boundaries are beyond “sea to sea” Early detection Evidence based- informed by evidence and not xenophobia Not an immigration medical exam
- 4. CHRONIC DISEASE IN SYRIAN NEWCOMERS Diabetes Iron Deficiency Anemia Dental Health Vision Health
- 5. Varicella – most adolescents and young adults will be immune CHILDREN: Catch-up childhood vaccine if absent or uncertain vaccination records. Offer varicella vaccine to children <13 yo. ADULTS: If no records, give 1 dose of MMR and a primary series of tetanus, diphtheria and polio, with 1st dose being Tdap. Varicella serology & vaccinate if susceptible. INFECTIOUS DISEASES
- 6. Do not offer testing for latent TB Screen all children and adults for chronic Hep B infection and vaccinate if susceptible Consider screening for Hepatitis C Shoulder consider Strongyloides serology, but should not collect stool samples unless the patient has abdominal symptoms. INFECTIOUS DISEASES RECOMMENDATIONS
- 7. Hep B sAg, sAb, cAb Hep C serology Varicella serology (esp women of childbearing age) Rubella serology (women of childbearing age) Strongyloides serology Stool O&P only if GI symptoms ID SUMMARY – WHAT TO ORDER
- 8. Childbearing years - Rubella and varicella serology Anemia Confirming or ruling out pregnancy Discussing contraception needs Preconception considerations (folic acid) Follow up visit – gyne exam/Pap smear, STI screening, screening for IPV Adjustment stress/social isolation WOMEN’S HEALTH
- 9. Immunization catch-up Growth and development (WHO growth charts) Anemia Resource: www.kidsnewtocanada.ca PEDIATRICS
- 10. CCIRH: Remain alert for possible PTSD but do not routinely screen for history of trauma CCIRH: Screen for depression (as usual for primary care) MENTAL HEALTH
- 15. Paper/e-Package of Resources Caring for Kids New to Canada (CPS) – kidsnewtocanada.ca Sick Kids – aboutkidshealth.ca – multilingual patient handouts CCIRH: www.ccihrken.ca Online London Refugee Health Network List RESOURCES
Editor's Notes
- IME includes CXR in those >11 yo to rule out active TB, and syphilis & HIV tests in those 15 yo and over. Europe has received ~600 000 Syrian refugees in the past year and no serious public health concerns have been noted In crowded enviro’ts – scabies and head lice Vaccine coverage was >90% in Syria prior to the war WHO & UNICEF estimate that only ~40-50% of Syrian children have received the primary series of Tdp and polio vaccines. Studies have shown most adolescents 83-97% are immune to varicella. Varicella vax is not part of the routine imm schedule in Syria. Give vaccines without prior serologic testing (with possible exception of varicella). More research may change this.
- TB – WHO 2014 – incidence in Syria was low, 17 in 100 000. Active cases of TB in Turkey and Lebanon – low in 2014 - <20/100 000. Syrian refugees in Jordan in 2015 – 12 per 100 000. (CCIRH g/l advise screening when incidence is >30 per 100 000. Rate of chronic Hep B infection 5.6% Hep C: – prevalence in Syrian refugees is uncertain; war may have increased the prevalence Strongy – relatively low prevalence (<5%) in limited community based studies, but the prevalence appears highest in refugee populations. Potential increased exposure to it in unsanitary conditions in refugee camps– potential high benefit of preventing fatal disseminated strongy//low risk of therapy. *More research could change this recommendation. Recommend AGAINST stool stamples for O&P if asymptomatic.