Case Pres

B. Tooth Decay Tooth decay can cause pain, eating discomfort associated with poor appetite, bad breath and can be a source of infection. Deciduous teeth are lost and permanent teeth erupt during the school-age period. The average child gains 28 teeth between 6 and 12 years of age. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page 913 The average child today can expect to grow up cavity-free. To ensure this happens school age children should visit a dentist at least twice yearly for a checkup, cleaning, and possibly a fluoride treatment to strengthen and harden the enamel. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page 923 School-age children have to be reminded to brush their teeth daily. For effective brushing, the child should use a soft toothbrush, fluoride-based toothpaste, and dental floss to clean between teeth to remove plaque. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page 926 Snacks are best limited to high-protein foods such as chicken and cheese rather than candy. Fruits , vegetables, cereals fortified with minerals and vitamins can all be fun after-school snacks for school age children. If the child does eat candy, a type that is eaten quickly and dissolves quickly. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page 926

C. Impacted Cerumen An impacted cerumen may lead to otitis media, poor hearing and a condition called tinnitus. Cerumen (ear wax) serves the important function of cleansing the external ear canal as it gradually moves out ward, bringing with it shed epithelial cells and any foreign objects. Parents are often concerned that ear wax will lead to loss of hearing (of the view is as dirty) and ask to have it removed. Wax accumulation rarely is extensive enough to interfere with hearing. cerumen serves a protective function and should not be removed routinely. Caution

parents not to

clean the child ears with cotton tip applicators as regular practice, because they may scratch the ear canal, causing an invasion site for secondary infection. This practice may also push accumulated cerumen farther into yhe ear canal, causing a true plugging of wax. Commercial softeners are available if cerumen accumulates to such that extent that hearing is affective. Some physicians, advice a dilute solution of hydrogen peroxide to dissolve cerumen. This may be done once in a while but, again, should not be done regularly because this will keep canal constantly moist, an environment that leads to external otitis. For most children, the basic rule of thumb,never put anything smaller than the elbow in a child ears –is the best rule. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page1601 D. Cough and Colds

It can possibly lead to different kinds of acute respiratory infections like pneumonia and asthma. A cough reflex is initiated by stimulation of the nerves of the respiratory tract mucosa by the presence of dust, chemicals,

mucus, or

inflammation. The sound of coughing is caused by rapid expiratory air movement past the glottis. Coughing is a useful procedure to clear excess mucus or foreigh bodies from the respiratory tract. Although helpful in removing mucus, coughing increases chest pressure and so many decreases venous return to the heart. This lowers cardiac output and can lead to fainting. Paroxysmal coughing may increase the pressure in the central venous circulation to such an extent that bleeding into the CNS. Because young children often vomit after a series of coughs, they may be suspected initially of having a gastric disturbance even though they are coughing. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page1227 E. Skin Lesions Typically skin lesions if not treated and cure can lead to skin infection and irritability. TABLE II RANKING OF COMMON RANKING OF COMMON PROBLEMS AMONG SCHOOL AGE DISEASE

FREQUENCY RANK

Head lice

1

Tooth Decay

2

Common Cough & Colds

3

Impacted Cerumen

4

Skin Lesions

5

Interpretation and Analysis The leading problem among school-age is tooth decay. Out of ___ students, ___ have tooth decay. Meaning to say that at this age it is considered as normal among school-age because development influences both the amount of food they consume and also the foods acceptable to them. Food habits, likes and dislikes begin to be established. The average child gains 28 teeth between 6 and 12 years of age. The average child today can expect to grow up cavity-free. -Maternal and Child Nursing 5th edition by Adele Pilliteri, page 913 and 943