PEDS NR 328 Exam one- Chamberlain 2023

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