‫تمريض اطفال‬

The Newborn characteristic ( Neonntal )

1) Length ( 47.- 53.75 ) cm
2 ) Weight ( 2700 – 3850 ) gm
* During the first few days loss 10 percent of his birth weight
Temperature : - Rise to normal about 8 hours , hand and feet
cold .
Pulse ( 120-150 ) perminitue .
Respiration . irregular in depth & rhythm ( 35 – 50 )
perminitue
Blood pressure : low it is difficult to determine .
The skin : soft red or dark pink ,
Lanugo : distribution of hair over body .
Vernix caseosa : is a cheese like , greasy , yellowish white
substance
• Milia : is condition in which tiny white papillae occur on
nose & chin
The head : - head circumference : ( 33-37 ) cm
The Fontanels – are openings
Anterior Fontanels ( 2-3 ) cm in width close ( 12-18 )
months .
Posterior fontanels ( close ( 2- 4 months
Chest:- is bell shaped.( 33-30.5 ) and equal with hend 3،5-3،7
The bone :- soft,
The legs :- small, short
The arms . small and short.
Muscles:- smooth and small.
• The movement are random and uncoordinated.

Senses:-
1) Touch:- is highly developed of the other senses:
- Failure to grasp the nipple.
-Respond to touch.
2) Sight:-
blue or gray att birth.
Eye only half open.
3) Hearing:-
Because of the presence of fluld in the external auditory
canal the new Born cannot hear until after his first cry

4) Taste :- Is move than sight and hearing he accepts sweet

& resist to acid.
5) Smell:- Smell breast milk and reach the nipple.
Reflexes:- are absolutely essential to the infants life.
* In "Blinking reflex which aroused which aroused when the
infant is subjed o brfght light.
* Coughing & sncezing
*Yawn reflex :- Sense protective
 * Rooting reflect cause the infant to turn his head te ward
any thing
*Sucking reflex t,
* swallowing reflex.
* Gagging reflex
*Grasp reffex In hand & feet
*Dancing reflex.
*More reflex.

"Tonic neck reflex

(disappear in maturity),
Growth & Development
Growth:-Increase in physićal size of the whole or any of its
part and can be Mensured in inches or centimeters, kg,
pound.
Development:- progressive increase in skill and capacity of
function.

Stages of growth and development

1-Fetal or embryonic. From conception to birth.
2- new born ( neonate) Birth to 2 –4 wecks
3- Infancy. 2-4 wecks to one year.
4- Toddler. 1-3 years
5- preschool. 4-6 years
 6- school. 6- 12 years
7-Adolescene Puberty beginning ef adult life

Facter effecting Growth & development :-

1- Heredity & constitutional make-up,
2- Racial &Nationel characteristic ndia ,
3- Sex male infant longer & havier than.. Female

4- Environment. Prenatal. ( utro)

Postnatal
. External environment,
(socio econemicy),

5- Nutrition (quantitative & qualitative)

6-Climate arid season
Gain in weight low in spring & early summer
7- Exercis
8-Ordenal position.

Internal environment
* Intelligence.
*Hormonal balance,
*Emotion.

Types of growth and Development

1- physical growth
* Change in general body growth
* head circumference 35 cm.
*Thoracic Diameter
* Abdominal and pelvie measurement.
* Height
*Develópment of muscular control.
2- Mental development ,
Intelligence: The ability to adjust to new situations.
L .Q
LQ 90. =109 normal
L .Q of 140 or over giffed.
L.Q less the average retardation.

3- Emotional Development
Infancy. 0-1 sense of trust
Toddler. 1-3 sense of autonomy.
Preschool. 3 -6 sense of initiative
School. 6-12 industry.
& adolescence. 12..Identity,

4- Social Development.
* Spcialization training achild in the culture of group.
*Premature infant :- is infant who weight less than 2500 gm
*xatermination of pregnancy in the period from
approximately the 28- 37 week of gestation.

Characteristic of premature infants

1- He is small and limp
2- His skin is thin & wrinkling and red
3- Excess of lanugo
4- Nổ vernix caseosa.
5- his head is large.
6- The thorax is less firm that the full term infant.
7- The abdomen protrudes
8- The genitalia are small
9- The extrenitics are thin, muscle small
10- The finger nails ind toenails are abnormally soft and
shor
11- The subcutaneus tissue is deficient.
12-Engorgement of breast.
13-The normal sucking, swallowing and gag – reflex are
absent
14-Slow gain in weight.

, Causes of Premanture
1-Multiple birth.
2- Use of contraceptive.
3-Toxemia of pregnaney
4- Antepartum hemorrhage.
5- Premature separation of membrance,
6- Premature rupture of the membrance.
7- Cardic disease.
8- Diabetes mellitus.
9- Kidney disease.
10- Tuber cullosis.
11- Malnutrition
12- Fetal abnormality.
13- Injury to mother or fetus.
14- Old age of mother & father.
15- Drugs poisoning or alcohol)
16- Syphilis.

Care Immediately after Birth

1- Warmth
* The infant is placed in a warm incubator provide with
increasing environmental oxygen & lumidity

2-Initiation of respiration
• Air way should cleara
• Mucus may bay be removed from nose & throat.
• Oxygen administration,
3-Prevent infection
• Prevent any person from interring of his room but mother
& nurse.
• Hand washing
• wear mask
 4- Nutrition
Small after 12 hours. glouse
Large alter 24 hours.
In first day,,
Another by breast or artificial or droping.

Care in the nursery

1- Environmenta
* Nursery should isolated from all other unit
* no. nurse enter except those assigned to,
* Observe respiration, colour , sucking, activity, cry; change
in his condition.
2- Minimal handling
* Remove him few times from his incubator.
* Prevent infection,
3- Mantance of body temperature
[( 35. 5-36.5)c]
4- Mainteance of respiration:
Rapid – shallow, irregular.
* Section
*Vaporize
 5-Nutition:
Difficult sucking & swallowing.
A. gavge
. Premature must feed care fully,
Seldon giyen 18-24 hours and oral feeding.
The initial feedịng may be, as little 2- 4 cc and 5 percent
sugar solution & slowly increased.
B. Feeding with melicine Dropper,,
Who good swallow & cant suck

6-Medication:
Vitamin Irom
Prevention of Infection
1- Gastrointestinal infection: by contuminated feeding
equipment.

2- Skin infection : From trauma- contact. Bathing the infant

3- Respiratory infection:
By personal who care him.
Wear gowns
Wear cup
Mask

Needs During the First Year

1- Need for feeding.
2- Need for sucking pleasure
3-Need for warmth of & comfort
4-Need for love & security.

1Month
*Weight 8 pounds.
*Can turn his head to side
*Can push with feet.
2Month
Posterior fontanel closed,
Tonic nick & Moro reffexes are fading
*Can follow light.
3Month
*Weight 12-13 pounds.
*Plays with hands.
*Gasping reflexes weaked,
*Turn eyes to any object.
4Month
*Weight 13-14 pound.
*Sit with support.
5Month
Weight 15-16 pound.
6 Month
Weight double -twice, birih
7Month
*Sit with out support
8Month
*Attempted to stand
*Know his name
9Month
Walking with helping.
15Month
*Stand with out help.

Weight:
2500-4kg. at birth
6 Month. Double,
1year. Treble.
2Years. 4X birtlh weight.

height:
50 cm at birth
4 Years Double birth height.
14 years Treble birth height.
Needs of Toddler
1- Love & security.
2- Graded independence.
3-Fulfillment of needs.
4-Control of body function.
Bowel control 18 monthses
Bladder Day-2year
Night-3-4 yeárs
5- Learning langyage 15 months.

Care of Toddler
1- Physical care.
2- Sleep.
3- Safety.
4- Nutrition.

Problem of Toddler
1- Negativism
2-Ritualistic belhavior.
3- Slowness in carry out request,
4-Temper tantrum

Needs of preschool age

1-Learning language.
2- Sexual information.
 3- Religious education.

Problem of preschool age:-

1- Thumb sucking.
2- Food like and dislike.
3- Enuresis.
4- Encopresis.
5- Selfishness.
6- Bad language.
7- Hurting others.
8- Destructiveness.
9- Masturbation.

(deciduous) dentition
1) The teeth of child Fruption in age of ( 6 month ).
(Temporary teeth)
2) Permanent teeth began at 6 years.

Causes of delayed of teeth :-

1) Dišease of child during dentition.
2) Decrease Ca in food
3) Mental retardation.
4) Thirord gland disease.

Cause of deformity of teethes :

1) Mouth breathing.
2) Thump sucking.
3) Tongue sucking.
4) Accident.

Child Nutrition .
The child need milk after ( 4- 12) hours affer delivery.

Advantage of breast feeding to child:

1) Is more easily digested.
2) Is available at all time odtiv
3) Have grater immunity,
4) Less likély to have gastro intestinal disorders.
5) Less likely to suffer from colds & severe respiratory
infection.
6) Çlose contact with mother.
7) Lešs prone to anemia.

Advantages to mother
1) Return of uterus to normal after delivery. 2) Emotional
satisfaction.
3) Saves, ready .
4) Economic.

Contraindication of breast feeding

 1)Disease of mother.. Tubercylosis.Syphlis. 2)Mental disease.
3)Disease of Nipple (local lesion ).(inverted nipple).
4)Taking some drúgs (Morphine), (Codeine ). 5)Infant
condition … Cleft fip, cleft plate.

Artificial Feeding
aalipha Requirements for artificial feeding :- 1) Low Bacterial
count of milk.
2) Economy and availability of milk
* The child néed added. Nutrition to feeding at of ( 4 Month)

Weaning:
The best time for weaning in the second half of the first year

Method of Weaning The infant should be weaned gradually.

Not onset Kwashiorkor
( protein malnutrition) is a form of malnutrition due A
deficiency of protein.

S& S:-
1) lack adequafe growth.
2) Loss of muscle tone.
3) Lack of energy
4) odema
5) Hair is thin (red cofour)
6 ) Albumin level lowered
7)Anemia
8) Enlargement of cardic & liver

Treatment & Nsg care

1) Give milk free from oil
2) Noso Gastric tube, slid
3) Treat infection
4) Blood transfusion Anemia.
5) Check wejght, vital signs Urine
6) Psychological support.

Malnutrition ( Marasmus)
Cause :-
1) The infant not receive a dequate diet.
2) Bad Balance diet .
3) Foor leeding habit (cleft lip, cleft, palate).
4) Cardiac abnormalities.
5) Chronic disease…….. cystic fibroses
6) Infection
7) Vomiting Diarrhea
8) Psychological problem

Malnutrition ( Marasmus)
S&Symp
1) Loss of weight
2) The eyes are sunken ,
3) The face takes on aged look.
4) Tissue yargor is lost
5) The subcutancous fat disappenrs.
6) Muscles rélaxed
7)Cry weak.
8) Anemia ( his colour gray .
9( Appetite poor,
10) Slow in growth.
11) Low temp.
12) Bleeding under skin

Nsg care and treatment:;

1) Give fluid and Nutritoion.
2) Bed rest.
3) Prevent infection.
4) Check vital signs.
5) Skin care.
6) check weight.
7) check fuid intake & out put.
8) Blood , feces, Utine test.
Rickets:- Is a deficiency disease of growing children
due to a lack of fat soluble vitamjn D.
, - vit. D in crease absorption of Ca, p, from intestinal
tract.

Etiology-
1) Heredity.
2) Age 3 month-3 years
3) Artifieial feeding.
4) Prematurity .
5) Lack of sun shine
6) Season… late winter & early spring.

S&S
1)Head appears enlarged & square when viewed from
above.
2) The anterior fontanel is late in closing
3) The cranial bones are soft.
4) Dorsal Kyphosis when sit-up
5) Scoliosis with deformities of pelvis.
6) Deformities of extremities
7) Enlargement of wrists & ankle.
8) Nutritional anemia & low resistance
9) Delay of growih & development.
Treatment & Nsg. Care:-
1) Oral administration of vit D.
2) Splint of legs.
3) Ostcotomy
4) To prevent deformities püt on good bed reat &
change his position.
5) Not the child stand or sit- down on long time.
6) Exposure the child to sunlight.
7) Prevent infection. Tetany (vitamin D deficiency)

Cause:-
1) Decrease Vit .D. in food.
2) Decrease absorption of Vit .D.in the body
3) Decrease Ca in blood & bone.
4) Decrease the active of parathyroid.

S&S
1) Increase neuromuscular irritability.
2)Laryngo spasm .cyanosis.
3)The arms & legs may be adducted and flexed.
4)Convulsion.

Treatment & Nsg care :-

1)Ca in mouth or iv – im.
2)Vitamin intake
 3) O2. & section
4)Tracheotomy.
5) artificial breathing
6) the nurse should have padded tongue blades to
prevent child from pitng his tongue

Scurvy: is due to lack of water – soluble vit C

Vit C :- destroyed by heat

S & S:-
1)The child become & irritable & apprehensive.
2)Fears to be touched because of pain.
3)Anorexia.
4)Subperiosted hemorrhage
5)Bluish – purple
6)Swollen & bleeding gums.
7)Blood in vomits & stool.
8)Hemorrhage in soft tissue &a round eyes .
9)Petechiae in skin
10)Anemia.
11)Deformities in bones.
12)Fever.

Tretment & Nsg care:-

1)Large dose Vit. C.
2)Provide food easy digestion.
3)Avoid excessive movement.
4)Prevent infection.
5)Change position.
6)good bed rest.
7)Mouth care.
8)Observe S &S.

Acute Nasopharngitis ( Common cold ):

Is most common respiratory infection infant and Let Gamin
children… Rhinitis. Nasophary

Causes
1)Virus. Inflammatioin of upper respiratory.
2)Bacteria . Peneumococci, hemolytic streptococci or
staphylococci

Contributing factors :-
a) Age
b) nutritional
c) fatigue
d) emotional

S&S
1) Irritable & restless.
2) Sneezing & nasal discharge
3) Difficult respiration.
4) Throat is sore,
5) Swollen of lymph nodes.
6)Gastric intestinal disturbance (Vomiting, Diarrhea).
7) Fever.
8) Anorexia.
9) Cough.
10) General malaise.

Treatment &Nsg care

1) Isolated & rest
2) Increase fluid intake,
3) Nose drops. ( Nasal drainage).
4) Humidity of room ( 80- 90 ) percentage.
5) Prevention of Excoriation of the lip.
6) Change position
7( Use of medical aseptic technique.
8) Use sedative drugs.

Complication :-
* Sinusitis.
* Oitis media. ,
*Bronchitis.
*Trachectis. Empid
*Pneumonia.

Tonsilitis
Causes : group A Beta hemolytic streptococcus.

S & S:-
1) enlargement of tonsils & redness.
2) Difficult swallowing.
3) Difficult breathing.
4) Fever.
5) Headache.
6) Weakness.
7) Join pain.
8) Coughing.
9) Sound change.

Treatment & Nsg :-

1) Drugs.
2) Check vital signs.
3) Ice to prevent bleeding
4) Rest .
5) Nutrition fluid
 Acute Broncholitis and interstitial Pneumonitis,

Causes Virus

S&S-
1) Dry persistent cough
2) Dyspnea
3) The mucosa swells.
4) Paller face & cyanosis.
5) Sound with respiration.
6) Difficult swallowing.
.7( Irritable and anxious.
8) The respiration rapid & shallow,
9) Chest sound ( wheezing).

Complication :-
1) Bronchopneumonia .
2) Otitis media
3) Cardiac failure
4) Pulmonary atelectasis with abscess.

Nsg & Treatment :-

1) Oxygen therapy administration.
2) High humidity in room
3) The infant head & chest should elevated.
4) Increase fluid intake.

Pneumonia :- Is responsible for approximately 10 percent of

neonatal death.

Cause :-
1-) Virus.
2) Bacteria

S&S:-
1) Fever.
2)Fatigue
3) Pallor.
4) Cyanosis.
5) Dry respiration.
6) Increase pulse.
7) Anorexia.
8) Abdominal distennon

Treatment & Nsg/care :-

1) Bed rest.
2) Move of child in bed. To provent bed sore.
3) Cleaning
4) Good Nutrition
5)Check vital signs.
6) Check intake & output.
7) Suction
8) Oxygen tent.

Lipoid pneumonia:
The condition is caused by aspiration of oils or lipoid Material
cleft palate. Difficult swallowing, Give, Feeding when child lying
on back.

S& S
1) Non- productive cough.
2) Rapid respiration.
3) Dyspnea.
4) Fever.

Treatment & Nsg care:-

1) Change position.
2) Isolated child to prevent his contracting secondary infection
3) Oxygen therapy as needed.

Vomiting :- Metabolic alkalosis associated with the loss of a

strong acid from the body.
Cause :-
1) Improper way in child feeding.
2) Improper Nutrition.
3) Food allergy.
4) Sore throat – laryngitis – Pharynx.
5) Increase intracranial pressure :
- Intracranial hemorrhage.
– Hydrocephalus.
– Meningitis.
6) Obstruction of the gastrointestinal.
7) Emotional cause.

Type of vomiting:-
1) Rumination ( persistent ).
2) Regurgitation.
3) Projective.

Nsg care & treatment :-

* 1)Good position of child feeding.
2) Clean of artificial feeding.
• 3) Clean the Pt.
• 4) Check vital signs.
• 5) Check intake & out put.
• 6) Check weight daily.
• 7) Check vomit time, colour, amount,bleed.
• 8) Give fluid by month small amount.

• Diarrhea :- Metabolic acidosis with again of non – volative

acid or loss of bicarbonate.

Etiology :- .‫اسباب‬
• 1) Improper preparation of infant formula.
• 2) Over feeding .
• 3]Unbalanced diet.
• 4) Spoiled food.
• 5) Socioeconomic cause.
• 6) Allergy
• 7Jantibiotic therapy.
8) Emotional causes.
• 9) Respiratory treat infection.
Quiz1- what are the causes of diarrhea ?:

Type of Diarrhea :-
1) Mild .( 2-10 ) in a day.
2) Moderate.
3) Sever Diarrhea – 10 & over.

S & S:-
1) Low fever.
2) Iritability & disturbed sleep.
3) Change in nature & number.
4) Dehydration.
5) Weight loss.
6) Thirst.
7) Decrease urine.
8) Pulse & resp .
9) Dry skin .( loss turgor ).
10) Abdominal cramps.
11) Sunken eye .

N sg care :-
• 1) Oral fluid & Iv. Fluid ( oral rehydration ) (ORS ).
• 2) Rest ( 3) clean.
• 3) Prevent respiratory infection.
• 4) Check weight.
• 5) Check intake & output.
• 6) Check vital signs.

• Quiz2 – what are the nursing care of patient with diarrhea

Constipation :-
Causes :-
1) Decrease active & movement .
2) Irregular food time & sleep & defecation .
3) Improper Nutrition.
4) Decrease fluid intake.
5)Fear of child.

Nsg care & treatment :-

1) Give vegetable & fluid intake .
2) Psychological support .
3) Arrange of food time .
4) Exercise

Congenital deformities
Cleft lip: is one of the most frequently occurring congenital
anomalies occur among boys

Causes:
1) Hereditey
2) disease of mother with communicable disease
during first month of gestation.
3) some drugs.
4) x- ray.

Treatment:
 1.surgical
Nsg care
1.prevent movement of hand.
2.dressing.
3. I. V fluid.
4. Sucur.
5.Give water after feeding.
Quiz1- what are th e nursing care of patient with Cleft
lip:

• Cleft palate
Is congenital anomalies occur among girl causes same cleft lip.

Treatment:
Surgical

Imperforated Anus
Is a congenital anomalies occur to child.

• causes
1.heriedity.
2.drugs.
3.fail in complete of fetus.
S&S
• No meconium
No opening of anus.
Abdominal distention.
Child crying because of pain.

Surgical ( colostomy).

Nsg care.
1. I .v fluid
2.cleaning
3.change cyst
4.Antipiotic
Quiz2- what are the causes of Imperforated Anus

Nursing care of urinary tract disease

Acute glomerulo nephritis
Is an antigen anti body reaction following an infection in some
part of body usually group A beta hemolytic streptococcal
infection

S&S
1.headache
2.malaise
3.fever
4.hypertention
5.oligurea
6.Anuria
7.hematuria
8.Odema ( eye, Ankle )
9.Diplopia
10.slow pulse
11.cardiac failure

•Nsg care
• 1. Bed rest
• 2.fluid decrease salt and protein
• 3.check weight
• 4.cheek viltal signs
• 5.cheek urination
• 6.decrease potassium in food

Renal failure (uremia)

Cause :
• 1.original because acute kidney infection, urinary tract
infection
• 2. Functional, Because decrease of blood to kidney and loss of
fluid.
• S&S
• 1.nausea &vomiting
• 2.odema
• 3.hyperteution
• 4.fast respiration
• 5.decrease urination & anuria
• Quiz1 – what are the nursing care of patient with Acute
qlomerulo nephritis

NSG CARE
1.I.V fluid
2.Rest
3.check urination a mount
4.Decrease protein & fat in food
5.Decrease salt in food
6.high sugar & vitamin
7.clean.

Nephrosis ( Nephrotic Syndrome )

Is a term used for a symptom complex having Various
pathologic findings

Causes : unknown
Signs and symptoms :-
1. Insidious at onset
2. Edema around eye and ankle.
3. Gain in weight
4. Decrease urine
5. Paller
6. Decrease albumin in blood
7. Increase cholesterol in blood
8. Increase protin uria
9. Inguinal hernia or umbilical
10. Irritability
11. Low resistance to disease
12. In severe cases, fever, pain.

•Nursing care
• 1-prevent infection
2- High proteins in food
• 3- Diuretics
• 4- rest
• 5- Skin care & eyes
• 6- check weight daily
• 7- check intake and out put
8-check vita signs
• 9- paracenteses
10-check protein in urine
Quiz2 – what are nursing care of patient with nephrosis ?

Pyelonephritis (pyelitis ) Is infection of renal pelvis and renal

parenchyma plus.
• most common in renal disease
• occur in (2 month age – 2 years)
girl more than boys

Causes :-
• staphylococci
• hemolytic
streptococci

Signs and symptoms

:- Fever
Pallor
Anorexia
Vomiting
Dehydration
Pyuria
 Hematuria
Change in renal pelvis bladder

• Nursing care :-
1. Rest
2. Antibiotic
3. Increase fluid in take.
4. Decrease oil and salt in food
5. Clean
6. Urine test

Nursing care of heart and blood disease

Anemia :- Is a deficit of erythrocytes or hemoglobin.

• Causes:-
• 1) In adequate production of hemoglobin or red blood
because of lack ( Fe – Cu-Vit.C-B12 – folic acid ).
• 2) Blood disease -leukemia , plastic anemia.
3) Bleeding.
4) Thalasemia disease & sickle cell anemia.

• S&S :-
1) Fatigue
2) Pallor.
3) Tachycardia.
4) Resp
5) Low weight.
6) Vomiting
7( Low resistance
8) Splenomegly.
9) Heart failure.

• Treatment & Nsg. Care:-

1) Bed rest.
2) Good Nutrition
3) Prevent bedsore
4) Splenoctomy
5) Blood transfusion
6) Cleaning

Quiz1 – what are the nursing care of patient with anemia

Thalassemia ( Cooley's anemia ): Is a chronic congenital

hemolytic anemia. In which the chief seems to be in ability to
produce cells.

Type :
1) Minor.
• 2) Major.

• Minor :-
• 1) Mild anemia .
• 2) RBCS. Cells are unequal size & irregular in shape.
• 3) Spleen enlarged.

• Major
• S&S:
• 1) Sever anemia.
• 2) Easy diagnosis.
• 3) Jaundice.
• 4) Pallor, muddy bronze color.
• 5) Spleen enlarged.
• 6Jabdominal distention.
• 7) Cardiac enlargement.
• 8) Skeletal change.
• 9) Mongoloid face.
• 10) Protrusion teeth.

• treatment :
-No treatment of Thalassemia minor.
• Major:-
• 1) blood transfusion.

Leukemia :- Is a malignant neoplasm involving all blood

forming organs production of any one of the type of W.B.C s.
/N = 5000 – 10000per.

• Type:
• - Acute.
•-Chronic.

S & S:
Pale & anorexia Vomiting weight loss, Weakness fatigue,
Temp. ,palpitation.of heart & Dyspnea Abdominal pain ,
enlarged
• Lymph rode ,anemia become severe sever ,liver & spieen
enlarged ، Joint pain

. • R\ & Nsg .care :

1) blood transfusion & antibiotic.
2) Corticosteroid.
3) Methotrexate.
4) Vincristine.
5) Cyclophosphamide.
6) Daunorubicin.
– Radiation.
– Chemical drugs.

• Nsg. Care:-
1) protection from infection.
2) Prevent Nausea. Small amount.
3) Intravenous therapy.
4) Oral hygiene.
5) Prevent bleeding gums, teeth.
6) Observe side effect of drugs.
7) Emotional support.

Hemophilia :- It is syndrome disease represents in born

errors of metabolism.
* There are defects in any one of several factors in blood
plasma needed for thromboplastic activity.
1) hemophilia A is due to deficiency of factor VII, anti
hemophilic globulin AHG.
2) Hemophilia B is due to deficiency of factor IX, ( Christmas
disease, plasma thromboplastin companent ) (Ptc ).
3) Hemophilia C is duo to deficiency of factor XI. PTA . (
plasma thromboplastin antecedent).
A)
– Inherited.
– Appears in male.

S & S: - Bleeding.

Nsg Care :-
- Blood transfusion.
– Prevent infection & fall.
• -Clean.
• Hemolytic disease due to RH incompatibility RH-ve.
Women & child RH+ ve.

S & S:
1) Vernix caseosa is yellowish.
2) Sever Odem.
3) Jaundice appears on first days.
4) Anemia because hemolysis .
5) Enlargement of liver & spleen.

• Treatment :-
1) Blood transfusion RH – ve.
2) Antibiotic.
Congestive heart failure
• S & S:-
1) Fatigue.
2) Weak crying.
3) Cyanosis & pallor.
4) Edema.
5) Liver & cardiac enlargement.

Nsg Care :-
1) Cheek Vail signer.
2) Highballs & diuretics.
3) Rest.
4) Small meals & recurrent.
5) Check intake & output.
6) Check weight clearly.

Nursing care of nervous system diseases

Spin Bifida :- _Is a malformation of the spine in which the
posterior portion of the laminae vertebra fail to close.

Type :-
1) Spinal bifida occult a :- The defect in vertebra.
2) Meningocele in which the ménages protrude through the
opening in the spinal canal.
3) Meningomyelocle : Both the spinal cord & meninges
protrude thorough the defect in the bony ring of spinal.

S & S:- No sensation legs.

RX
1) No treatment.
2) Surgical after few days of labor.

Nsg Care :-
1) Prevent & pressure & trauma to protrude. 2) Prevent
cold.
3) Check feeding.
4) Prevent feces & urine on protrude

Hydrocephalus :- Is due to in adequate absorption of

cerebrospinal fluid

Causes :-
1) Obstruction in the flow of cerebrospinal fluid due to.
A) congenital mal development of the ventricular formation.
b) Neoplasm.
C) Fibrous of meningitis .
e) Hemorrhage.
F) Meningitis.
g) Spinal bifida.

S & S:-
1) Intra cranial pressure.
2) Enlargement of head.

R\ & Nsg. Care :-

1) Shunt surgery .
2) 02therapy .
3) Check vital signs.
4) Check head circumference.
5) Cleaning.
6) Change position.
7) I.V. fluid.
8) Check intake & output .
quiz 2- what are the nursing care of patient with
hydrocephalus

Meningitis :- Is infection of the meninges.

Causes:-
1) Viral.
2) Bacterial.
3) Tuberculosis .
4) Fungi.
5) Protozoa.

Transmission :-
1) Nose & Lung .- section.
2) Direct contact & indirect.
3) Incubation period : 2- 10 days.

S & S:-
1) Fever.
2) Headache.
3) Restless.
4) Vomiting.
5) Back pain .
6) Convolution.
7)Pulge of fontanel.
8) Bleeding under skin.
9) Hardness in external.
10) Stiff neck.

R\:-
1) Isolation.
2) Good ventilation.
3) Vaccine.

Nursing care of communicable diseases

T.B
Causes acid – fast bacillus, mycobacterium tubercular,

S&S:
1.Symptomless
2.Cough
3.Expectoration
4.Heamoptesis
5.Fever
6.Wheezing
7.Chest pain
8.Dyspnea

Treatment & Nsg Care

1. Antibiotic – for (9 month)
2. Isolation
3. Prevention
4. Drugs
 INH
Streptomycine
Refadine
quiz1- what are the nursing care of T.B?

Measles (( rubeola))
• Incubation 10-12 days

Cause : Virus

• Method of Spread •
1.Direct contact and air borne droplets 2.Contaminated dust
• Communicability : 4 days to 5 days after rash appears

S&S
1.conjunctivitis
2.Coryza
3.Photophobia
4.Koplic spots in mouth
5.High fever
6.Rash brown or pink behind ear, or fore head
Cheeks extremities last 5 days

Treatment :
1.Bed rest
2.Light should be dimmed
3.Cleaning
4.high fluid
5.Cold compress
6.Check vital signs
7.Increase humidity in room

• Complication
1.Otitis media
2.Pnemonia
3.Tracheobronchits

Germen measles
• incubation period 14-21 days
• cause virus

S&S
Slight fever, mild coryza , Rash -swelling of lymph nodes NO
koplic spots & photophobia
• T& Nsg Care : bed rest &isolation..

Mumps
– Incubation period : 14 – 12 days. • - Communicipality period :
1-6 days before first symptmus
– Causative of agent : Virus
• - Method of spread ; Direct & indirect.

S & S:
1.- Swelling & pain in gland.
2.- Difficult swallowing , headache.
3.- Fever.
4.- Malaise.

Nsg Care :
1) Heat & cold application.
2) Liquid or soft food.
3) Bed rest.
4) Decrease acid in food ..
quiz 2—what are the nursing care of patient with mumps?

Nursing care of diphtheria pertusis, tetanus

• Diphtheria Incubation period : 2-6 days
• Communicable period : Several hours before onset of disease

• Causes : Coryne bacterium diphtheria (bacillus) Method of

spread : Droplets == respiratory tract infection

• S&S: Membrane over tissue in nose or throat at site of

bacterial invasion. Hoarse brassy cough Pallor Malaise Fever

• Nsg. Care
1. .Bed rest
2. .Liquid & soft diet
3. .Gavage
4. .Observe respiratory obstruction
5. .Cleaning
6. .Check vital sings
. Quiz1- mention the nursing care of patient with Diphtheria?

•Whooping Cough (Pertusis )

• Incubation period 5-21 days
• Communicability Period : 4-6 weeks
• Causative agent : Bordetella pertusis
• Method of spread : Direct contact

• S&S :
1.Dry cough, rise night
2.Rapid inspiration ,Dyspnea & Fever
3.Vomiting after coughing

• Treatment
• Bed rest
• Increase humidity in room
• O2 therapy
• Vitamin in food
• Good ventilation

Complication
Bronchitis , Pneumonia , atelectasis , encephalitis

• Quiz2—what are the complication of pertusis

•Luck Jaw (tetanus )

• Incubation period : 3-21 days
• Communicability period : No Causes : Clostridium tetani
bacillus
• Method of spread
• Organism found in soil & enter body through wound -Deep
puncture

• S&S :
1.Muscle spasm
2.Convlsion
3.Headache
4.Fever
5.Inability to open mouth
6.Pallor
7.Retained of urine

• Treatment :
1) Clean Wound.
2)Anti toxin.
3)Trachoostomy.
4) Bed rest.
5)I.V fluid , Gavage.
6) Catheterization.

Nursing care ofpoliomyelitis, chicken pox

Poliomyelitis
Incubation period : 5-14 days
Communicable period : during period infection Method of
spread : oral contamination by phartngeal & intestinal
excretion
S&S:
1.Symptoms of respiratory tract infection 2.Headache
3.Fever
4.Vomiting
5.Nusea ,paralysis ,back pain

Nsg .Care :
1.Bed rest
2.Change position
3.Good nutrion salt & vitamin .
4.Check in take & out put
5.Physiotherapy
6 .Fluid in take
7.Drainage
8.Gavage
9.Cleaning & prevent food & air ambulation 10.Immunization

Complication:
1.Meningitis
2.Paralysis larynx
Quiz1—mention the nursing care of patient with Poliomyelitis
?

small pox
• Incubation period 12 days. –
• - Communicable period : one – 2days before symptom.
• - Method of spread : Direct or indirect contact.
•S & S:-
1) vomiting.
2) Headache.
3) Skin eruption.
4) Convulsion..
5)Crop on mucous meuloranes of mouth & eyes.
6) Itching.

• Complication :-
1)laryngitis .
2)Pneumonia.
3) Meningitis

Nsg Care :-
1) Isolation .
2) Sterilization.
3) Checking.
4) Good Nutrition .
5) Prevent Hand from itching.
Chicken pox:
1 ) Macules .
2) Papules .
3) Vesicles

Infection hepatitis and typhoid fever

Infections hepatitis :
1) Virus : A. oral, Food & drink infected
2) Virus :B. syringe , blood infected

Incubation period. A (24-30) days

B ( 9-12) days
Communicable period Few days 30 days 60 days upper of
disease

• S & S:
1.nausea .
2.vomiting .
3.pain in upper abdomen .
4.jaundice
5.madly feces.
6.yellow urine
7.itching -Enlargement of liver
8.itching in skin
9.spleenomagly

Nsg. Care
1.lsolation
2.Sterile of equipment
3.Rest
4. I .V. fluid
5.Check vital sign
6.Prevent respiratory infective
• Quiz1—mention the nursing care of patient with Infections
hepatitis ?

• Typhoid Fever :- Is one of communicable disease caused by

salmonella Typhoid

. • Transmission :-
1) Drinking & food infections.
2) Dust, Insect- sand.

DX: Widal test.

•S & S:-
1) Fever. Night. Day
2) Headache.
3) Delray.
4) Weakness.
5) Dry mouth & Tongue .
6) Splenomegely
7) Enlargement of lymph node
8) WBC. Decrease.
9) Skin rash.

. Nsg. Care :
1.Rest.
2.Isolation
3.Fluid
4.Cold compress
5.Cleaning
6.Health education
• Quiz2 – what are the nursing care of patient with typhoid
fever?

The contaminated environment

Cholera
• Acute disease caused by fibro cholera
Infection :
1- Contaminated water.
2- Contaminated food.
3- fly .

Prevention :
1- Use Cl in water & boiling.
2- Waste drainage.
3- Boiling of milk.
4- Vegetable sterile
5- Health education.
6- Immunization.
Quiz1- how to prevent cholera?

Brucellosis
Acute disease transfer from animals to human .

S&S:|
1. Fever
2. Headache
3. Pain in any part of body
4. Join pain
5. Weakness

Transmission :
1- Infected milk.
2) Direct from animals.
3) Milk & product.

Causes : Brocella

Prevention :
1) Milk pasteurization.
2) Milk & its product.
3) Treat the animals.
4) Infected meet.
Quiz2 ---how to prevent Malta fever?

The endemic disease

Malaria
• 1) Plasmodium.
• 2) Pivivax .
3) P. ovale .
4) P. falciparum .

S &S:
• Fever
• Anorexia
• Vomiting
• Diarrhea
• Convulsion
• Enlargement of liver
• Anemia Treatment
• Chloroquine amodiaquine Quinine
• Quiz1-what are the type of malaria?

Schistosomiasis ( Bilharziasis) )
Causes:
1. Schistosoma mansoni.
2. Schistosoma Japonicum .
3. Schistosoma haematobium.

S&S:
1- fever
2- headache
3- allergy skin
4- Hematuria

RX – praziquantil
Quiz2- what are the s&s of Bilharziasis