Download Document

Lesson 1
• Department of propedeutical
pedaitrics
• Subject: propedeutical
pediatrics
Propedeutical
pediatrics
• Module 1: Children development
• Module 2: Children clinical
investigation
• Module 3: Children nutrition
What do you need?
•
•
•
•
•
•
•
Wrightg book
Pen, pencil
Phonendo-stetoscope
Tape-line (centimetr)
White coat
Comfortable shoes
Mask
Lecture
Practical classes
???????????
Off-class job
Topic 1
-The age periods in childhood, and adolescent,
their characteristic.
-The peculiarities and principles of patients case
history collection.
-The methods of clinical investigation healthy
and sick children.
-The whole inspection of healthy and sick child.
-The criteria of estimation of whole health state
in sick children.
Periods of childhood
Prenatal
Germinative
Embrional
Fetal
Postnata
l
Neonatal
Infancy
Toddlerhood
Preschool
Schoolage
Subjective data
• interrogation
• Complaints
• Anamnesis morbi (present history)
• Anamnesis vitae (past history)
Subjective data
• Complaints:
• Specific
• Non-specific
Subjective data
• Present history:
•
•
•
•
•
•
Why
When
What’s happened
What did he do
What’s medicines
All other…
Examiner asks:
• 1. Do you have a cough? And…
•
•
•
•
When did it start?
Was it gradual or sudden?
How long have you had it?
How often do you cough?
Examiner asks:
• 1. Do you have a cough? And…
• Do you cough at any special time of day or
just on arising?
• Does the cough wake you up at night?
• Do you bring up any phlegm or cough up
any sputum? How much? What colour?
Examiner asks:
• 1. Do you have a cough? And…
• Do you cough up any blood?
• Does this look like streaks or frank blood?
• Does the sputum have a foul odor?
Examiner asks:
• 1. Do you have a cough? And…
• How would you describe your cough:
hacking, dry, barking, hoarse, congested,
bubbling?
• Does the cough seem to come with
anything: activity, position, fever,
congestion, talking, anxiety?
Examiner asks:
• 1. Do you have a cough? And…
• Does activity make it better or worse?
• What treatment have you tried?
Prescription or over-the-counter
medications, vaporizer, rest, position
change?
• Does the cough bring on anything: chest
pain, ear pain? Is it tiring? Are you
concerned about it?
Another complaints:
• Ever had any shortness of breath, or
hard breathing spells? What brings on
it? How severe is it? How long does it
last?
• Do you have any chest pain with
breathing? Please point to the exact
location.
Another complaints:
• Any past history of breathing trouble, or
lung diseases like bronchitis,
emphysema, asthma, pneumonia?
• Are there any environmental conditions
that may affect your breathing?
Additional questions:
• Has the child had any frequent or very
severe colds?
• Is there any history of allergy in the
family? At what age were new foods
introdused? Was the child breat-fed or
bottle-fed?
Additional questions:
• Does the child have a cough? Does the
child seem congested? Does the child
have noisy breathing or wheezing?
• What measures have you taken to childproof your home? Yard? Is there any
possibility of the child inhaling or
swallowing toxic substances?
Subjective data
• Past history:
•
•
•
•
•
•
•
•
Pregnancy and Delivery
Neonatal period
Infancy period
Growth and development
Family history
Social history
Epidemic history
Alergological history
• Inspection
• The method of observation is used
during physical examinations.
Inspection, or "looking at the
patient," is the first step in
examining a patient or a body part.
• Palpation
• The method of "feeling" with the hands
is used during physical examinations.
The examiner touches and feels the
patient's body part with his hands to
examine the size, consistency, texture,
location, and tenderness of an organ or
body part.
• Percussion
• A method of "tapping" of the body parts during
physical examination with fingers, hands, or small
instruments to evaluate the size, consistency, borders
and presence or absence of fluid in body organs.
Percussion of a body part produces a sound (like
playing a drum) that indicates the type of tissue within
the organ. Lungs "sound" hollow on percussion
because they are filled with air. Bones and Joints
"sound" solid. The abdomen "sounds" like a hollow
organ filled with air, fluid, or solids.
• Auscultation
• This method used to "listen" to the sounds of
the body during a physical examination can
be performed by listening with the ear but is
usually done by listening through a
stethoscope. Health care providers routinely
auscultate a patients lungs, heart, and
intestines to evaluate the frequency, intensity,
duration, number, and quality of sounds.
Health care providers also use auscultation to
listen to the heart sounds of unborn infants.