| Definitions and health screening | Cause of respiratory distress syndrome and the role of surfactant in the mature lung | Deafness in children | Key developmental milestones up to 5 years | Some h&s :) |
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A newborn child less than 4 weeks old
Define neonate
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NRDS most often occurs when there isn't enough surfactant in the lungs.
When does NRDS occur the most
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Toxic to the ear/affects the ear
Define ototoxic
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8-9 months
When should a child begin crawling?
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Adverse events are defined as incidents in which harm resulted to a person receiving health
care.
What is an adverse effect? (in terms of care)
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Preterm - Babies born alive before 37 weeks of pregnancy are completed
Post-term - Post-term pregnancy is the condition of a baby that has not yet been born after 42 weeks of gestation
Define post-term and preterm
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Surfactant is produced during the last 8 weeks or so (32 weeks onwards) of
pregnancy, by about 35 weeks most babies have enough naturally produced surfactant to keep the alveoli from collapsing
When is surfactant produced?
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Dose - Uncommon for ototoxitity to develop with less than one week of treatment
Potentiating medications - Loop diuretics, other ototoxic drugs (e.g. cisplatin) Genetic susceptibility - Unusual susceptibility to gentamicin or streptomycin ototoxicity related to a mutation of mitochondria
2 factors that affect toxicity of a drug
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18 months
When is the 10 word milestone reached?
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They include infections, falls resulting in injuries, and problems with medication and
medical devices.
Give 3 causes of an adverse reaction in care
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If the mother gave birth in hospital, they may be offered a newborn hearing test for the
baby before they are discharged. In some areas it will be done by a health professional, healthcare assistant, or health visitor within the first few weeks. The test is done in the first four to five weeks, but it can be done at up to three months of age
When is the newborn hearing test offered and when is it done?
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Reduce surface tension
Increase pulmonary compliance (ability of the lungs and thorax to expand) Prevent collapse of the lung at the end of expiration, Facilitate recruitment of collapsed airways.
List 3 purposes of surfactant
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Birth defects that cause changes in the structure of the ear canal or middle ear
Buildup of ear wax Build-up of fluid behind the eardrum Injury to or rupture of the eardrum Objects stuck in the ear canal Scar on the eardrum from many infections
4 problems that may affect the outer or middle ear
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18 months
When should the child be able to identify 4 body parts
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Individual perspective looks for explanations of its causes in people, error can be
traced back to the fault of an individual or individuals that made a wrong decision or were not paying attention
Define individual perspective in terms of system failures
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AOAE is the first screen, earpiece is placed in the outer part of the baby's ear and
soft clicking sounds are played, the cochlea response and this is picked up by the screening equipment.
Define and describe AOAE
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Blue-coloured lips, fingers and toes (cyanosis)
Rapid, shallow breathing Flaring nostrils A grunting sound when breathing
4 signs and symptoms of respiratory distress syndrome
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Exposure to certain toxic chemicals or medicines while in the womb or after birth
Genetic disorders Infections the mother passes to her baby in the womb - Toxoplasmosis, measles, herpes Infections that can damage the brain after birth Meningitis, measles Problems with the structure of the inner ear Tumours
4 problems that may affect the inner ear
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6-8 weeks
When should the child first start smiling responsively?
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System perspective looks for explanations of its causes in the wider system, systems
are often imperfect in many ways but this only comes to light when things have gone wrong, looks at procedures, practices, technology, communication, and the working culture
Define system perspective in terms of system failures
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AABR is used as a second screen, it involves three small sensors on the baby's head
and neck, soft headphones are placed over the baby's ears and soft clicking sounds are played.
Define and explain AABR
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Congenital absence - Problems with proteins in surfactant, don't produce enough
Prematurity Infection Metabolic acidosis Hypothermia Meconium (foetal faeces) aspiration
5 causes of surfactant deficiency
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The most common ototoxic medications include a family of antibiotics callednaminoglycosides Gentamycin, tobramycin, kenamycin, streptomycin.
Irreversibly bind to bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth.
Describe the class of the most common ototoxic medications, give some example and describe how they work on bacteria
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2.5-3 years
When should the child be able to build a tower of 8 bricks or a train of 4 bricks?
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The aim of the NHSP is to find babies who have a hearing loss so that support and advice
can be offered right from the start. Early identification of hearing impairment gives children a better chance of developing speech and language skills, and of making the most of social and emotional interaction from an early age.
What is the aim of the NHSP and why is early identification of hearing impairment in children important?
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