Chapter 10
Health Problems From Infancy to Adolescence
Nutritional Disorders
Vitamin Imbalances
o Vitamin D and A: lack of malabsorption issues (CF, short bowel)
Can lead to in respiratory diseases
o B6, B12
Mineral Imbalances
o Zinc, Ca, Phos, Na, K, Chloride
o Iron
Protein- energy malnutrition (PEM) or Severe Acute Malnutrition (SAM)
o Kwashiorkor
Lacking protein, still eating to feel full
Complications:
Oncotic pressure changes
Electrolyte changes
Signs
Big round belly
Peripheral edema (d/t protein/albumin)
Puffy cheeks
Skinny extremities
Comorbidities:
Diarrhea
Resp. Infxn
Skin disorders
Hair loss
Discolored hair
o Marasmus
Total calorie and protein lacking
Signs
Extremely small
Bony Prominences
Tired/fatigue
Severe low BP & HR
» Spikes when standing
o Nursing Management for PEM:
Rehydration
, Antibiotics for comorbities
Replace what is missing
Risks for refeeding syndrome (electrolyte imbalances)
Food Allergy or Food Intolerances
Food Allergies
o IgE meditated immune response
o Most Common
Nuts
Eggs
Wheat
Soy Fish
Cows milk (2.5%)
If infant is breast feeding mom will need to stop drinking milk
o Signs & Symptoms:
Wheezing
SOB
Coughing
Clearing of throat
Swelling/hives
Cyanosis
Runny noses
Vomiting
o Tx:
Epinephrine (WEIGHT BASE DOSING)
0.01mg/kg/dose
Max: 0.3-0.5
» 30-50 kg child will hit max with first dose
» Kids must be >30 kg before use of adult epipen
Food Intolerances
o Non-IgE
Ex. Lactose intolerance
o Want to avoid but not as serious as an IgE meditated allergy
Growth Failure or Failure to Thrive (FTT)
*<5%*
Causes
o Inadequate caloric intake
education
, medical conditions
Breast feeding mom drying out
Education (incorrect formula intake)
Financial resources
o Inadequate absorption
Short gut
CF
o Increased metabolism
Cardiac disorders
Hyperthyroidism
Burn patients
o Defective utilization
Genetic disorders
Lack digestive enzymes
Nursing Management
o First identify the cause
o Correct the cause
o Catch up
In-patient
Daily weight
» Same time in AM
» Same clothes
» Naked if baby
» Before eating food
o Restore
o Educate
How to do the correct ratios
Overcome language barrier
Diaper Dermatitis
Pathophysiology & Manifestations:
o Irritation from urine, feces, detergents, chemicals on skin
Altering wetness, pH and fecal irritants
o Folds or creases in groin are usually unaffected (contact irritation)
Candidiasis (yeast) of diaper area:
o Will appear in the skin folds or creases in the groin area
o Main Identifier: Satellite lesions are apparent
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