Nutritional and GI dysfunction Flashcards
Meconium
thick, sticky, tarry green-black stool shortly after birth
Digestional differences in kids
- immature digestion at birth
- swallow is automatic relex until 6W but can control swallow around 6M
- small stomach
- emptying time of stomach is faster in infants
- less saliva until 2Y
- stomach acid not present until 6M
- more relaxed esophageal sphincter
- stomach pain can be from anxiety/other causes (psychosomatic)
Failure to thrive
inadequate growth from inability to obtain and/or use calories required for growth
- no universal definition but wt/ht is below 5th percentile or wt/ht does not follow growth curve as expected
Common vitamin/mineral deficiencies
Iron (12-36M), Vit A, C, Bs
Organic failure to thrive
From underlying medical condition like cardiac prob, CF
Non-organic failure to thrive
Can’t find anything attributing to them not growing, often psychosocial factors like parents can’t provide
idiopathic failure to thrive
unknown
Clinical features of failure to thrive
- ht/wt below 5th percentile for age
- persistent deviation from an est growth pattern
Clinical features of non-organic FTT
- developmental delays like social, motor, adaptive, lang
- apathy
- inadequate hygiene
- feeding or eating dx
- no stranger anxiety
- avoidance of eye contact
- stiff and unyielding, flaccid and unresponsive
Factors contribute to NFTT
- caregiver frustration and anger at infant poor response to feeding or prob assessing infant’s needs
- poverty
- health beliefs
- inadequate nutritional knowledge
- family stress or crisis
- feeding resistance
- insufficient breast milk
Therapeutic management (NFTT)
- catch up growth
- multidisciplinary team approach to therapy
- correct nutritional deficiencies
- treat underlying cause
- educate parents or caregivers
Nursing interventions for FTT
- feeding is a priority
- give consistent staff
- quiet, calm atmosphere
- calm, even temperament
- talk to child and instruct about eating
- be persistent
- face-to-face posture
- introduce new foods slowly
- follow child’s rhythm of feeding
- follow structured routine
- accurate I&O
- daily weight
- support parents and build confidence
Cleft lip/palate
Abnormal opening in the lip and/or palate that occurs during embyonic development caused by teratogens, maternal smoking, genetics and environmental
Palate examination
Done to all infants at birth
Clinical findings with CL/CP
- difficulty feeding
- mouth breathing causing more air to be swallowed with distended abdomen and pressure on diaphragm, dry mucus membrane, inc risk of infx esp aspiration pneumonia