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Paediatrics - Coggle Diagram
Paediatrics
Anthro
Wt under 2 yrs- bare/no nappy (nappy can add 150g), use baby scales, newborns: record to nearest 10g, infants: record to nearest 100g
length - length board with head and food board, 2 people for accurate measure, supine, neck/spine/hips/legs straight, record to last 0.1cm
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wt over 2 yrs - shoes off, sit or stand on scales, record to nearest 100g, wheel chair scales available
ht over 2 yrs - feet flat, slightly apart, record to 0.1cm
ht estimations (knee height) - over 2 yrs, measured left side, used to develop a trend
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skinfold thickness - estimate fat stores, age related standards to monitor trends
faltering growth - slower growth than expected, wt >2 percentiles below ht percentile, wt for ht <5th percentile, growth consistently below 3rd percentile, crossing 2 or more percentile bands (wt for age, ht for age) over 6 months
Growth charts
WHO - >37 weeks, 0-2 yrs, ideal growth, 2nd-98th percentile
CDC - 2-18 yrs, NHMRC, 3rd-97th percentile, BMI z score charts used in malnutrition diagnosis
collect a hx, and monitor trends
fenton growth chart - premature, <37 weeks, corrected gestational age (actual age in weeks - weeks preterm = corrected age)
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BMI over 85th percentile is overweight, over 95th percentile is obese
Malnutrition
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poor growth, impaired cognitive development, decreased immunity, impaired wound healing, increased LOS, increased morbidity and mortality
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MUAC, growth velocity (z scores - 0-2 yrs), % wt loss, vital signs, chronicity, nutrient imbalance
Interventions
breast fed - adequate volumes over 24hrs, lactation consultant, top up with EBM/fortified EBM (expressed breast milk) after feeds
formula fed - check daily volume, check timing of feeds, formula preparation, formula changes, increase formula strength, add CHO or fat
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