Paediatric Feeding and Swallowing (foundation) Flashcards
What is oesophageal injury and how can it be caused?
- Irritation of the oesophageal mucosa by orally ingested drugs
- Can occur from: lack of fluid to wash the drug down, larger tablets, taking drug lying down, taking before sleep
- Risk reduction - give liquid forms if safe, have child sit down for a period after, give with fluids to help wash it down if safe
What are Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (TEN)
- Severe mucocutaneous reactions
- Feeding and swallowing difficulties associated:
- poor mouth opening and lip seal
-poor bolus control
-laryngeal penetration or aspiration
-Impaired oral clearance
-Topical anaesthesia can help before oral intake or modifications of food
What is Oral and oesophageal thrush?
-Some drugs can disturb the natural balance of microorganisms in the body and increase the risk of oral thrush
-Symptoms:
*creamy white lesions on the tongue, inner cheeks, palate, gums or tonsils
*redness, burning or soreness that may be severe enough to cause *difficulty eating or swallowing
*slight bleeding if the lesions are rubbed or scraped
*cracking and redness at the corners of the mouth
*loss of taste
What is oral mucositis?
-An inflammation of the oral mucosa and is a side effect of cancer treatment (incidence in children with cancer is 52-81%)
-Clinical features: erythema, oedema and sensitivity, painful ulceration and mucosal bleeding.
-Children with severe OM are unable to eat, speak or swallow due to pain
- Management: liquid diets, pain medication, antifungal and antiviral therapy, total parenteral nutrition
What are extrapyramidal side effects?
Side effects pf some drugs can cause extrapyramidal side effects: hypersomnia, headache, nausea/vomiting, gastrointestinal disturbances, dizziness, dry mouth…
effect of Neuromuscular blocking drugs
sometime difficulty swallowing is reported
how much more likely are patients with dysphagia to experience medication administration errors?
3 times as likely
What is the difference between food allergies and intolerances
A true food allergy causes an immune system reaction that affects numerous organs in the body. It is caused by antibodies causing the release of irritant chemicals resulting in inflammation. Symptoms include: swelling, hives, difficulty breathing/talking, cough/wheeze, loss of consciousness, pale and floppy (for young children). Influences on severity include: amount, form (liquid can sometime be absorbed faster), whether it was mixed with other foods, presence of asthma. Allergies are treated with various drugs/medications
A food intolerance causes symptoms less serious and are often limited to digestive problems, there is no immune system component involved. Symptoms include: stomach/bowel upset, bloating, headaches, runny nose, hives. There are no evidence based specific assessments for identifying food intolerances but an elimination diet can be used.
what are the common signs and symptoms presenting in infants and children with food allergies/intolerances and indicators for referral
Explain the potential impact of food allergy/intolerance on feeding skills development
Possible behavioural presentations in children with food allergy/intolerance
How does allergy/intolerance effect the development of assessment/therapy sessions including preparation of the environment
What is the purpose of a oral motor assessment?
observe the anatomical structures involved in feeding and swallowing and their function.
