Paediatric- Failure to thrive (FTT) history taking and physical examination

Paediatric- Failure to thrive (FTT) history taking and physical examinationCreated OnApril 19, 2020Last Updated OnApril 19, 2020byadmin You are here: Main Clinical Examination Paediatric- Failure to thrive (FTT) history taking and physical examination < All Topics Table of Contents History taking: Detailed nutrition history, antenatal and birth histories, past medical history, psychosocial histories and review of systems should be asked during history taking. (Please refer to the history taking addressed in detail under the heading “Approach to malnutrition in children”) Possible positive histories or important questions to elicit during history taking Ask about symptoms suggestive of increased caloric loss – protracted vomiting, diarrhoea and fever Ask about gastrointestinal symptoms – dysphagia, vomiting, abdominal pain, and diarrhoea Ask about symptoms of micronutrient deficiencies Ask about communication between parent and child – parent may have difficulty interpreting child’s signals of hunger and satiety Ask about quality or quantity of food or fluid intake – maybe poor Ask about abnormal feeding/eating behaviour Abnormal mealtime behaviour and routines Parental coercion or excessive control of a child’s food intake Incorrect caregiver beliefs regarding health and nutrition perceived food allergies Poor swallowing (cerebral palsy or neuromuscular disorders) Ask about perinatal complications antenatal infections maternal toxins or drug exposure during pregnancy low Apgar score at birth history pf prematurity Ask about comorbid medical history – congenital heart disease, malignancies, uncontrolled diabetes mellitus, hyperthyroidism, chronic infections such as TB and HIV, recurrent ear infections Ask about recent surgery or burns – prolonged recovery results in increased caloric demand or associated with poor oral intake Ask about social history – poor knowledge regarding nutritional needs of growing children, low socioeconomic status, family stress, parental depression Ask about history of abuse or neglect – a history of ingesting non-food substances suggest neglect Ask about developmental history – maybe delayed or regressed Ask about family history of FTT Physical Examination: The physical examination must be detailed to detect any disease or syndrome that might affect growth and development: Vital signs evaluation – may be normal or revealing hypothermia or fever, hypotension, tachycardia, increased respiratory...

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