NRP543 Pediatrics Week 8 DQ response 1 and 2

1. Is there a time that is better or worse to drink alcohol during pregnancy? Explain your rationale in 175 words or more with one peer review scholarly reference in 7th edition APA format.

2. What age group in pediatrics (age birth – 18) is the most challenging to assess and why? Explain your rationale in 175 words or more with one peer-reviewed scholarly reference in 7th edition APA format.

Course Textbook: Burns, C. E., Dunn, A. M., Brady, M. A., Barber Starr, N., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care (6th ed.). Elsevier.

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Week 8 Discussion Question 1

Is there a time that is better or worse to drink alcohol during pregnancy?

There is no better time to drink during pregnancy. Alcohol can cause problems for the fetus throughout the pregnancy, including before a woman becomes aware that she is pregnant.  According to Dejomg et al.(2019), exposure of the fetus to alcohol results in fetal alcohol spectrum disorder (FASD) stillbirth and impaired growth. Alcohol quickly crosses through the placenta with blood alcohol levels in the fetus approaching levels in the mother within two hours after the mother takes alcohol.

Alcohol is teratogenic and can affect the growth and development of the fetus during all phases of the pregnancy.  According to Schuchat (2017) development of the fetus’s brain continues all through pregnancy, and there is no time in which it is safe for a pregnant woman to drink alcohol.  Studies demonstrate that binge drinking and heavy drinking for women (at least four drinking within 2-3 hours) are detrimental to the developing fetus, but present no quantity of alcohol use is regarded safe during pregnancy.

Studies on moderate and light drinking during pregnancy have provided inconsistent results concerning harmful impacts on the fetus. Although heavier alcohol consumption is a strong risk factor for FASD, alcohol metabolism is different from one person to another and may be influenced by genetic factors.  This inconsistency is the reason for current recommendations on abstinence from alcohol use during pregnancy (Schuchat, 2017).

References

Dejong, K., Olyaei, A., & Lo, J. O. (2019). Alcohol Use in Pregnancy. Clinical Obstetrics and Gynecology, 6(1), 142-155. doi: 10.1097/GRF.0000000000000414

Schuchat, A. (2017). The CDC’s Recommendations to Help Prevent Fetal Alcohol Spectrum Disorders.  American Family Physician, 95(1), 6-7.

Week 8 Discussion Question 2

What age group in pediatrics (age birth – 18) is the most challenging to assess

Assessing pediatrics is challenging. Generally, the pediatric being assessed would not have consulted the clinician  Pediatrics aged zero to two years are the most challenging to assess because they are not able to communicate the nature of symptoms or the duration and timing of their problems. According to Dersch-Mills (2018), in pediatrics, patients are usually non-verbal or are not at a stage of development where they can provide descriptions of their symptoms and thus the clinician relies upon the caregiver’s external assessment of the pediatric patient. There is more focus on observation of symptoms and signs when establishing a patient response to medications or need.

While these observations have some level of objectivity, the majority of assessments conducted in this manner might include some subjectivity. As a result, clinicians more frequently rely on other objective measures in younger children.  For example, the objective presence of fever and key lab values results ( for instance, normal blood cell count), can supplement the subjective report of a caregiver of a child acting normal and feeling better when assessing the response of an infection to an antibiotic(Dersch-Mills,  2018).

References

Dersch-Mills, D. (2018). Assessment Considerations in Pediatrics Patients.  Patient Assessment in Clinical Pharmacy, 387-401. doi: 10.1007/978-3-030-11775-7_28