Quick Notes
Calculate a formula feeding for a 4 month-old infant of a mother with heart failure including number of feeds daily and amount per feed.
بما أن الأم معها heart failure يعني indication للـ Substitutive feeding.
معروف أن:
Number of feeds in Substitutive feeding is 6 feeding per day.
So:
Number of feed= 6 feeds/ day.
ذلحين نحسب الـ Amount per feed،في طريقتين:
-Age method which is simple,used in healthy infants with appropriate weight for age.
100+(10× age by months)
In above case age is 4 m.
So = 100+(10×4) → 100+40 =140 ml
-Weight method,which is more accurate used in healthy and diseased infants.
As it's known that infant needs 25 ml/kg /feed, and his weight is 6 kg → 25 × 6= 150 ml /feed.
بإختصار:
-Number of feeds =6 feeds /day
-Amount per feed= 150 ml =5 scoops +150ml water.
-Interval of feed: 4hourly interval.
الخمسة هي الملاعق الحليب لكل ١٥٠ مل ماء؛ لأن كل ملعقة ٣٠ مل.
معروف أن:
Number of feeds in Substitutive feeding is 6 feeding per day.
So:
Number of feed= 6 feeds/ day.
ذلحين نحسب الـ Amount per feed،في طريقتين:
-Age method which is simple,used in healthy infants with appropriate weight for age.
100+(10× age by months)
In above case age is 4 m.
So = 100+(10×4) → 100+40 =140 ml
-Weight method,which is more accurate used in healthy and diseased infants.
As it's known that infant needs 25 ml/kg /feed, and his weight is 6 kg → 25 × 6= 150 ml /feed.
بإختصار:
-Number of feeds =6 feeds /day
-Amount per feed= 150 ml =5 scoops +150ml water.
-Interval of feed: 4hourly interval.
الخمسة هي الملاعق الحليب لكل ١٥٠ مل ماء؛ لأن كل ملعقة ٣٠ مل.
المكتبة الطبية الإلكترونية م 5
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Classification of diarrhea according of Duration and etiology .. and 10 kg beby with sever dehydration what is management.
Quick Notes
Classification of diarrhea according of Duration and etiology .. and 10 kg beby with sever dehydration what is management.
It is management in hospital.
1-Addmision
2-Intravenous rehydration: within 24 hrs.
Shock therapy:
-Amount: 20 ml/kg I.V infusion over 10-15 minutes.
20×10= 200ml
-Type of solution: Ringer’s lactate or NS if Ringer’s lactate not available.
Deficit therapy:" over 8 hrs"
-Amount: 80 ml / kg, because we had given shock therapy.
80×10 =800ml /8
-Type of solution: D5% NS 1:1.
-Add KCL 15 % in amount of 1 ml for each 100 ml solution.
Maintenance therapy:
Amount: 100 ml/kg for first 10 kg.
100×10= 1000ml
Type of solution: D5% NS 4:1.
Add KCL 15 % in amount of 1 ml for each 100 ml solution.
Next 24 hrs
If fully hydrated:
Half maintenance given IV
Other half of maintenance given as ORS.
Fully hydrated, but continuous severe diarrhea:
Give maintenance therapy plus ongoing loss.
If Still dehydrated repeat dificit and maintenance.
3-Treatment of complications:
AKI
Sepsis
Metabolic acidosis
.. etc.
1-Addmision
2-Intravenous rehydration: within 24 hrs.
Shock therapy:
-Amount: 20 ml/kg I.V infusion over 10-15 minutes.
20×10= 200ml
-Type of solution: Ringer’s lactate or NS if Ringer’s lactate not available.
Deficit therapy:" over 8 hrs"
-Amount: 80 ml / kg, because we had given shock therapy.
80×10 =800ml /8
-Type of solution: D5% NS 1:1.
-Add KCL 15 % in amount of 1 ml for each 100 ml solution.
Maintenance therapy:
Amount: 100 ml/kg for first 10 kg.
100×10= 1000ml
Type of solution: D5% NS 4:1.
Add KCL 15 % in amount of 1 ml for each 100 ml solution.
Next 24 hrs
If fully hydrated:
Half maintenance given IV
Other half of maintenance given as ORS.
Fully hydrated, but continuous severe diarrhea:
Give maintenance therapy plus ongoing loss.
If Still dehydrated repeat dificit and maintenance.
3-Treatment of complications:
AKI
Sepsis
Metabolic acidosis
.. etc.
How to calculate OL:
Ongoing loss: Number of motion:
Ongoing loss=Wt × number of motion ×10
Example:
4 months old infant, wt is 4kg, presented with vomiting 4 times per day and diarrhea 6 time daily.
Ongoing loss=4×10× 10=400 ml.
#Pediatrics
Ongoing loss: Number of motion:
Ongoing loss=Wt × number of motion ×10
Example:
4 months old infant, wt is 4kg, presented with vomiting 4 times per day and diarrhea 6 time daily.
Ongoing loss=4×10× 10=400 ml.
#Pediatrics
Remember:
-Breastfeeding should be initiated as soon as possible after birth (within ½ to 1 hour after vaginal delivery and 2-4hours after Cesarian Section).
#Pediatrics
-Breastfeeding should be initiated as soon as possible after birth (within ½ to 1 hour after vaginal delivery and 2-4hours after Cesarian Section).
#Pediatrics
Reflexes with Breastfeeding
• Rooting reflex:
-Helps baby to find the nipple and proper attachment to breast.
• Suckling reflex:
-Helps the baby draw out milk from mother’s breast .
It consist of:
1. Drawing in the nipple and areola to form an elongated teat inside the mouth.
2. Pressing the streched nipple and areola with jaw and tongue against the palate.
3. Drawing milk from lactiferous sinuses by wave like peristaltic movement of the tongue.
• Swallowing reflex.
#Pediatrics
• Rooting reflex:
-Helps baby to find the nipple and proper attachment to breast.
• Suckling reflex:
-Helps the baby draw out milk from mother’s breast .
It consist of:
1. Drawing in the nipple and areola to form an elongated teat inside the mouth.
2. Pressing the streched nipple and areola with jaw and tongue against the palate.
3. Drawing milk from lactiferous sinuses by wave like peristaltic movement of the tongue.
• Swallowing reflex.
#Pediatrics
Breastfeeding Jaundice:
-Exclusively breastfed neonates have a tendency to develop higher serum bilirubin levels during first few days of life .
-The cause may be insufficient lactation leading to inadequate feeding, dehydration and hemoconcentration.
-It needs no intervention.
#Pediatrics
-Exclusively breastfed neonates have a tendency to develop higher serum bilirubin levels during first few days of life .
-The cause may be insufficient lactation leading to inadequate feeding, dehydration and hemoconcentration.
-It needs no intervention.
#Pediatrics
Breastmilk Jaundice:
-A small proportion of exclusively breastfed infants also tend to develop persistence of physiologic jaundice or exaggerated jaundice (serum bilirubin touching 18-20 mg/dl in some) in the second week of life as a result of such substances as 3 alpha, 20 beta preganandiol and free fatty acids in mother’s milk which inhibit conjugation of bilirubin.
-It resolves on its own.
-Occasionally, undue anxiety in the parents may warrant temporary withdrawal of breastfeeding just for 2-3 days.
#Pediatrics
-A small proportion of exclusively breastfed infants also tend to develop persistence of physiologic jaundice or exaggerated jaundice (serum bilirubin touching 18-20 mg/dl in some) in the second week of life as a result of such substances as 3 alpha, 20 beta preganandiol and free fatty acids in mother’s milk which inhibit conjugation of bilirubin.
-It resolves on its own.
-Occasionally, undue anxiety in the parents may warrant temporary withdrawal of breastfeeding just for 2-3 days.
#Pediatrics
Remember:
-In nephrotic syndrome, proteinuria exceeds 3.5 g per day (4+ on a urine dipstick) and the urine is often macroscopically frothy.
-In kwashiorkor, some proteinuria may be found but rarely exceeds 1+ on a dipstick test.
#Pediatrics
-In nephrotic syndrome, proteinuria exceeds 3.5 g per day (4+ on a urine dipstick) and the urine is often macroscopically frothy.
-In kwashiorkor, some proteinuria may be found but rarely exceeds 1+ on a dipstick test.
#Pediatrics
Quick Notes
طريقة ثانية، عن طريق الـ calories.
بما أنه في الشهر الرابع وزنه ٦ كيلو
الطفل يحتاج 100kcal =150ml
نضرب 150×6=900ml
نقسمها على ٦ اللي هي الرضعات إللي يحتاجها الطفل السليم اللي معتمد على الحليب الصناعي .
تطلع 150 ml بكل رضعة .
الطفل يحتاج 100kcal =150ml
نضرب 150×6=900ml
نقسمها على ٦ اللي هي الرضعات إللي يحتاجها الطفل السليم اللي معتمد على الحليب الصناعي .
تطلع 150 ml بكل رضعة .
Quick Notes
It is management in hospital. 1-Addmision 2-Intravenous rehydration: within 24 hrs. Shock therapy: -Amount: 20 ml/kg I.V infusion over 10-15 minutes. 20×10= 200ml -Type of solution: Ringer’s lactate or NS if Ringer’s lactate not available. Deficit therapy:"…
Shock: 20 ml/kg
20×10= 200ml
Given within 20 minute
RL is better, because it's diarrhea.
Deficit: 80ml/kg
80×10=800ml
Given within 8 hrs
تكون:
400ml Dextrose
400ml NS
لأنه نسبتهن في الـ Deficit 1:1
Maintenance:
بما أن وزنه 10kg
نضرب في 10 تطلع 1000ml نجيبها في 16 ساعة.
المحلول يكون:
800ml dextrose
200ml NS
لأن نسبتهن 1:4
كمان عنجيب 5ml KCl .
20×10= 200ml
Given within 20 minute
RL is better, because it's diarrhea.
Deficit: 80ml/kg
80×10=800ml
Given within 8 hrs
تكون:
400ml Dextrose
400ml NS
لأنه نسبتهن في الـ Deficit 1:1
Maintenance:
بما أن وزنه 10kg
نضرب في 10 تطلع 1000ml نجيبها في 16 ساعة.
المحلول يكون:
800ml dextrose
200ml NS
لأن نسبتهن 1:4
كمان عنجيب 5ml KCl .