Past Medical History

As with the adult, the past medical history should include details of any hospitalizations, injuries, and surgeries, as well as any medications taken on a regular basis. Ask, ''Does your child have any chronic health problems?'' Common chronic health problems in children include asthma, seizure disorders, eczema, recurrent ear infections or urinary tract infections, sickle cell disease, cystic fibrosis, diabetes, gastroesophageal reflux disease, and cerebral palsy. If the child was born before term, ask about late effects of preterm birth, such as chronic lung disease, nutritional problems, developmental difficulties, and sensory deficits.

It is important to identify allergies to medication (including penicillin), foods, or other substances. The most common problem associated with medications is the development of a rash. Rashes, however, are common in children and may have occurred coincidentally at the time a medication was prescribed. Therefore, try to determine whether the medication was the

*In 2007, fewer than 5% of births in the United States involved the use of forceps or a ''vacuum extractor'' to assist in vaginal delivery of a baby. In previous decades, use of such tools was much more common, and cesarean delivery was less common; see (accessed June 26, 2008). {A rapid determination of the child's cardiopulmonary status at birth. This is discussed later in the chapter.

states collect a small amount of blood from the newborn to screen for a variety of inborn errors of metabolism (up to 40 different disorders, most of them quite rare). In addition, most states screen newborns for hearing loss by using special equipment.

cause of the rash. Certain viral states "sensitize" a patient to a medication. The medication may be given at other times without any problems. Whenever a parent describes a ''medication allergy,'' ask the following questions:

''What was the rash like?'' A hivelike or urticarial rash is likely to be a true allergy. ' 'Did the child have any problems other than the rash?'' ''How long after the child started the medication* did the rash appear?'' ''After the medication was stopped, how long did the rash last?'' ''Has the child ever taken the medication again with recurrence of the rash?''

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