Unit 2-Health Problems of Infants

nutritional disorders

-vitamin imbalances-Vit D is most common

-mineral imbalances-Iron most common

-food allergies-cows milk allergy

failure to thrive

describes inadequate growth resulting from inability to obtain or use calories requires for growth

failure to thrive s/s

-growth failure

-developmental delays

-undernutrition

-apathy

-withdrawn behavior

-feeding/eating disorders

-no fear of strangers

-avoidance of eye contact

-wide eye gaze & cont. scan of the environment

-stiff & unyielding or flaccid & unresponsive

0minimal smiling

failure to thrive dx

-based on growth parameters

-decrease more than 2 percentiles from baseline

-persistently below 3 or 5 percentiles

-rule out organic problems

failure to thrive tx

reversing the cause

-the goal is to provide sufficient calories to support "catch up" growth

failure to thrive nursing care

quiet, unstimulating environment

-avoid distractions

-keep record of intake

-structured feeding routine

-be persistent through child refusal

-new foods slowly

positional plagiocephaly

an oblique or asymmetric head that occurs as a result of the cranial molding during infancy, as a result of laying in the supine position

positional plagiocephaly s/s

-bald spot over area

-misshapen skull

-mild facial asymmetry may develop

positional plagiocephaly dx

-identify the side of flattening

-identify which ear is anteriorly positioned

-check forehead position in correspondence w/ ear position

positional plagiocephaly tx

-change head position often

-don't leave them on their backs for an extended period of time

-maximize tummy time

-minimize time in bouncers, swings & car seats

-cranial orthotic helmet

positional plagiocephaly nursing care

-encourage parents to position baby supine sleep position

-assist in proper use of orthotic helmet

SIDs

sudden, unexplained death of a previously healthy infant under 1 year

-exact cause is unknown

SIDs s/s

N/A, unexplained

SIDs Dx

rule out w/ autopsy

SIDs risk factors

-0-6 months in age

-preterm, low birth weight

-co-sleeping, soft bedding

-sibling death

-nicotine exposure

-socioeconomic status

-lack of prenatal care

-maternal smoking

SIDs protective factors

- breastfeeding

- pacifier use

- room sharing

- immunizations

SIDs nursing care

-no indication of wrong doing or neglect towards family

-ask few factual questions

-make sensitive judgements about resuscitation efforts

-comfort family

-allow family to say goodbye

-provide services to cope

apparent life threatening event

Sudden event where the infant exhibits apnea, change in color, change in muscle tone, and choking

colic

abdominal pain/ cramping

colic s/s

-loud crying & drawing up legs to abdomen for more than 3 hours/ day for more than 3 days/wk for more than 3 wks

-increase in late afternoon/evening

colic dx

organic causes, CMA

-intussusception-part of intestine telescopes into itself

-feeding too rapidly

-over feeding

-swallowing excessive air

-improper feed technique

-emotional stress between parent & infant

colic tx

-massage abdomen

-respond immediately to crying

-lay infant on heated towel/hot water bottle

-small frequent feedings, avoid milk products

-carry infant prone over forearm

colic nursing care

-detailed hx of daily events

otitis media

inflammation of the middle ear

-often begins w/ virus, allergy, or upper respiratory infection

otitis media s/s

-ear pain

-drainage from ear

-pulling/tugging at ear

-trouble breathing

-fussiness

-loss of appetite

-fever

-headache

-vomiting/diarrhea

-rolling of the head side to side

otitis media dx

-otoscope to look at ear drum for redness, swelling, bubbles, rupture, blood & drainage

-tympanometry to measure pressure in ear drum

-reflectometry detects fluid by sound

otitis media tx

-warm moist wash cloth over ear

-OTC pain relievers (Tylenol or Motrin drops)

-ABX

-referral to ENT if persistent for more than 2 months, frequent episodes, hearing impaired or speech delays

-possible surgery for ear tubes or adenoid removal

otitis media prevention

-breastfeeding

-d/c bottle feeding as soon as possible

-feed infant in upright position

-refraining from giving bottle in bed

-no smoking