By John W Graef; Nancy Catherine Andrews; Children's Hospital Boston. Dept. of Medicine.; et al
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Sexuality. See Chap. 14, p. 425; Chap. 22, p. 556. 4 Fluid and Electrolytes Top John T. Herrin I. General principles A. Renal function. Renal function. The glomerular filtration rate (GFR) is low in infants and reaches an adult value at age 1 to 2 years. Other functions are similarly depressed (Table 4-1Table 4-1). B. Fluid and volume physiology. Fluid and volume physiology. At birth, total body water (TBW) constitutes 75 to 80% of the infant's weight and falls to 60% in childhood (see p. 64). There is rapid diuresis of 7% of TBW over the first few days of life.
Screening. Because parents often notice abnormalities before they become evident to the pediatrician, the best screening test is a good history. a. Simple testing includes visual and hearing acuity and tuberculosis skin tests. b. Simple laboratory tests include screens for anemia, lead poisoning, and pyuria. Guidelines for appropriate times for these screens are suggested by the AAP (see Table 3-4 Table 3-4 ). 3. Physical examination. Physical examination serves to verify normalcy for the parent's benefit, and to pick up abnormalities that may not have been previously noted.
Yearly preparations of influenza vaccine should be administered to all children and adolescents who have cardiac or pulmonary disorders, who are immunosuppressed, or have debilitating chronic diseases. n. Hepatitis A vaccine. An effective hepatitis A vaccine has recently been licensed for individuals 2 years of age and older. Three doses are required for children from 2 to 18 years of age. The second dose is given 1 month after the first, and the third dose 6 to 12 months later. Though universal immunization of children may be recommended in the future, current CDC recommendations are for immunization of travelers to endemic areas and members of high risk groups (Alaskan natives, Native Americans, homosexual men, IV drug users, day care center employees, and military personnel).
Manual of pediatric therapeutics by John W Graef; Nancy Catherine Andrews; Children's Hospital Boston. Dept. of Medicine.; et al