bouncing baby boy 2

bouncing baby boy 2

1. Physical examinations

   • upper body
     • Head • Assess size, shape and symmetry. • Check distribution and character of hair and scalp. • Inspect sutures and fontanelles.
     • Eyes • Inspect for pupillary size, equality, and reaction to light (using an ophthalmoscope). • Assess integrity of iris and test for ‘red reflex’. • Check for symmetry of eye movement’s and ability to fixate and follow. • Identify variations e.g. tearing, subconjunctival haemorrhage, hyper/ hypotelorism; cataract, discharge.
     • Ears • Position o Structure including patency of the external auditory meatus • Well-formed cartilage
     • Nose • Assess size, shape and position. • Check for nasal patency.
     • Spine With baby prone palpate the vertebral column: • Inspect for signs of underlying deformities e.g. myelomeningocele • Inspect sacral area for possible sacral pit. (Noting a coccygeal pit is of no consequence).
     • Arms and hands • Assess length for shortening. • Assess for symmetry and for full range of movement. • Inspect fingers for number, fusion or webbing.
     • Abdomen • Inspect for symmetry and distension. • Palpate for presence of liver or spleen enlargement or masses. • Inspect umbilical cord for signs of separation and/or infection, hernia.
     • Chest • Assess symmetry, shape, rib retraction. • Inspect breasts and nipples.
     • Neck • Assess range of movement. • Palpate neck to identify lumps, swelling or webbing. • Inspect the clavicles for fractures.
     • Mouth and palate • Check for symmetrical movement. • Inspect lips, gums, buccal surface, tongue and uvula. • Check hard and soft palates. • Ascertain suckling and rooting reflexes. • Identify variations e.g. tongue tie, natal teeth.
   • lower body
     • Legs • Inspect legs for length, contour, symmetry, size, full range of movement. • Inspect toes for number, fusion or webbing.
     • Genitalia male • Palpate scrotum for the presence of both testes. • Identify the position of the urethral meatus. • Identify variations e.g. hydrocele. Genitalia female • Inspect vagina for patency and discharge. • Explain female mucoid discharge.

2. Immunization

3. Growth and development schedules

   • Developmental milestones
     • Fine Motor (4-9 months)
     • Gross motor (3-36 months)
     • Personal/social Skills (2-36 months)
     • Language (1-36 months)
   • Growth chart
     • growth parameters
       • length
       • weight
       • Head circumference

4. child care institutions

   • The Baby-Friendly Hospital Initiative
     • a global program that was launched by the WHO, which promotes infant feeding and mother/ child bonding.
   • well-child and well-baby clinic
     • both visits include physical examination to ensure the wellness of the child.

5. Nutrition and weaning

   • methods of weaning
     • One at a time
     • Gradually and slowly
     • Breastfeeding and food simultaneously
   • Nutrition of 2 year old child
     • Important basic meals
       • Meat, fish, chicken
       • Dairy products
       • Fruits and vegetables
       • Carbohydrates
     • 3 healthy meals and 2 snacks per day

6. diseases

   • Signs and symptoms of diarrhea
     • 1- Frequent, loose, watery stools 2- Abdominal cramps 3- Abdominal pain 4- Bloating 5- rectal pain
   • treatment of gastroenteritis
     • 1- Drinking plenty of fluids to avoid dehydration 2- Taking paracetamol for any fever or aches and pains. 3- plenty of rest. 4- anti -vomiting medication (such as metoclopramide) and/or antidiarrhoeal medication (such as loperamide)
   • causes of diarrhea (gastroenteritis )
     • Short-term diarrhoea 1- virus – such as norovirus 2- bacteria – such as salmonella parasites – such as the Giardia 3- food allergy 4- Medicines -- such as antibiotics/ antacid medicines
     • Long-term diarrhoea  1- irritable bowel syndrome (IBS) 2- inflammatory bowel disease  3- coeliac disease 4-  bile acid malabsorption  5- chronic pancreatitis  6- diverticular disease 7-  bowel cancer
   • Dehydration
     • Moderate: 5% loss
     • Severe : 10% loss
     • Mild : 2% loss

7. behavioral aspect

   • hyperactivity
     • sign of ADHD
   • clumsiness
   • Tantrums
     • 1. Reduce stress 2. stay calm 3. Reward good behavior. 4. Be consistent
   • Rubbing Genitalia
     • - Dermal Pathologies
     • - Urinary Tract Infections
     • -Bad Hygiene Habits
     • - Masturbation
     • -Dermal Irritants

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