R11.12 (Projectile vomiting)
Symptoms and Signs: Vomiting can range from a mild regurgitation to projectile expulsion. The
infant has a distended abdomen, is irritable, and often has a fever. Aspiration of vomitus into the
lungs can result in pneumonia.
Prompt medical intervention is necessary when an attack cannot be resolved by usual and
Prevention: The patient should take all controller medications as prescribed. Use of a daily
controller medication will help to reduce the incidence
Prevention: Prevention is many faceted because of the cause. Good hand washing is important
in preventing microbial infections. Avoiding known allergens, certain medications, and dietary
factors helps. Mechanical and chemical irritations in the diet may b
Patient Screening: Asthmatic patients present an alarming situation. A possible respiratory
compromise requires prompt assessment and intervention.
Etiology: A hereditary factor is strongly associated with the disease. Asthma is the result of
Patient Screening: Children exhibiting behavior that suggests the presence of intestinal worms
require prompt assessment and intervention.
Etiology: E. vermicularis (pinworm) is one of many possible parasitic worms. It is the most
common cause of helminth
Description: Adenoid hyperplasia is an abnormal enlargement of the lymphoid tissue located in
the space above the soft palate of the mouth, causing a partial breathing blockage, especially in
ICD-9-CM Code 474.12 (Requires an
Description: Colic is intermittent distress in the newborn or during early infancy of unclear
ICD-9-CM Code 789.00
ICD-10-CM Code R10.9 (Unspecified abdominal pain)
(R10.0-R10.9 = 29 codes of specificit
Treatment: The medical management is chiefly supportive, with the administration of sedatives
and muscle relaxants to relieve spasms and seizures; a quiet, dark environment promotes rest.
If the patient suffers convulsions, respiratory integrity must be p
Toxoids use an altered form of a bacterial toxin to stimulate antibody production and thereby
impart protection against toxins.
Individuals with autoimmune diseases must not be given vaccines containing live
There is no effective therapy or cure for SSPE. The treatment includes supportive measures,
including drug therapy for seizure control. The duration of this disorder is several years, with
progressive deterioration of the CNS. The patient usually is nonre
Symptoms and Signs: Early symptoms include cough, coryza, conjunctivitis, and photophobia.
The child has a fever, followed in 3 to 7 days by a red blotchy rash. The rash starts behind the
ears, hairline, and forehead and then progresses down the body (Fig
smoke, mold, and mildew.
Prognosis: Because CF is considered a fatal disease, the long-term prognosis is not favorable.
Early diagnosis and compliance with treatment have improved the possibility for these children
to have as near normal a life as possibl
Prognosis: The prognosis is excellent when the infant is placed on a phenylalanine-free diet
soon after birth. Late dietary intervention does not reverse brain damage.
Prevention: No prevention is known
Patient Teaching: Close follow-up with testing for p
Pregnant women should be isolated from individuals infected with rubella to prevent perinatal
infection; in addition, pregnant women must not be given the rubella vaccine. The best
protection against congenital rubella syndrome is universal routine immuni
Patients who are immunocompromised or otherwise at high risk can be given the varicellazoster immune globulin within 4 days of exposure.
Patient Teaching: Reinforce the need for good hand washing along with the use of tissues
during coughing or sneezing e
diseases that formerly caused serious illness and disabling complications, even death.
However, many infections and disease syndromes can interrupt the normal growth and
development of any child. The following section describes the common diseases that af
Patient Screening: Children experiencing signs and symptoms of respiratory distress, including
hoarseness, fever, a harsh, high-pitched cough, and stridor during inspiration, require prompt, if
not immediate, assessment and intervention.
Etiology: Croup i
Diagnosis: A complete postmortem investigation, including autopsy, a review of the child's
medical history, and examination of the scene of death, fails to identify the cause of death.
Treatment: Resuscitation attempts fail. At this time, SIDS is not pred
Diagnosis: Radiographic films of the neck may reveal the enlarged epiglottis. If the obstruction is
not significant, the throat is examined to inspect the epiglottis. Nothing is placed in the child's
mouth until a health care professional with the capabil
Description: Whooping cough is a highly contagious bacterial infection of the respiratory tract.
ICD-9-CM Code 033.9 (Unspecified organism)
ICD-10-CM Code A37.90 (Whooping cough, unspecified species without pneumonia)
(A37.0-A37.91 = 8 codes of specificit
Wilms tumor, or nephroblastoma, is a highly malignant neoplasm of the kidney that affects
children younger than 10 years. It is the most common kidney tumor of childhood and the fourth
most common childhood cancer.
ICD-9-CM Code 18
Ventricular Septal Defect
echocardiogram, and electrocardiogram. Many defects can be detected on a prenatal
ultrasound. The diagnostic investigation determines the presence and severity of any structural
or functional abnormality or defect.
The umbilical vein transports oxygen-rich blood and nutrients to the fetus. The umbilical vein
enters the fetal body by passing through the umbilical ring and then goes on to the liver. Fifty
percent of this blood passes into the liver, and the other 50%
Symptoms and Signs: Cryptorchidism, or failure of the testicles to descend from the abdominal
cavity into the scrotum, is detected at birth or shortly thereafter (Figure 2-26). The condition may
be unilateral or bilateral. During infancy and early childho
Symptoms and Signs
The infant has episodes of projectile vomiting after feedings (Figure 2-28) and fails to gain
weight. Symptoms usually begin at 2 to 3 weeks of age. The infant appears hungry, continues to
feed, and yet fails to gain weight. If left unt
Prevention: There is no known prevention for the congenital form of this disorder. Good prenatal
care along with prudent observation and assistance during labor and delivery help to prevent
damage to the brain. Preventing infections and injury to the head
Etiology: Some sources suggest that fetal position is the cause, and other studies implicate
genetic factors because of an abnormal development of the germ plasma during the embryonic
Diagnosis: The deformity is obvious at birth, with a resistance
Description: Phimosis is stenosis, or narrowing, of the opening of the foreskin in the male that
leads to an inability to retract the foreskin. It is rare for the foreskin to be retractable in the
neonatal period. This is normal and in some cases
Prevention: No prevention for this condition is known.
Patient Teaching: Parents should be taught to care for the skin and the correctional device. In
addition, the need for compliance in the treatment should be stressed. After the condition
appears to ha
Diseases of the Nervous System
Cerebral palsy (CP), the most common crippler of children, is a condition consisting of a group
of disorders possibly involving the brain and nervous system functions that deal with movement,