FTT/Colic/Poisonings-FCNC unit 3 Flashcards


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1

return of undigested food from the stomach, usually accompanied by burping; it is usually benign, although if it persists it necessitates medical evaluation to rule out gastroesophageal reflux;

Regurgitation

2

dribbling of un-swallowed formula from the infant’s mouth immediately after a feeding

Spitting up

3

Spitting up & Regurgitation

  • Both can be minimized by frequent ___________ during and after ____________, minimal _____________ during and after feeding, and positioning the child on the ____________ side with head slightly ______________ after feeding;
  • apply __&___or _____________ ointment to excoriated areas after _____________ and use _____________ nonplastic-line terry-cloth bibs and ____________ them frequently

burping..feeding

handling..right..elevated

A&D or petrolatum

cleansing..absorbent..change

4
  • Described as cramping that is characterized by loud crying and drawing legs up to the abdomen.

-most often occurs at night (sometimes the crying can persist for all day and night)

Paroxysmal Abdominal Pain (COLIC)

5

Paroxysmal Abdominal Pain (COLIC)

**Despite the behavioral indications of _______, the infant gains _____________ and usually ___________

pain..weight.thrives

6

It is a sign of inadequate growth resulting from inability to obtain and/or use calories required for growth.

Failure to Thrive (FTT)

7

Failure to Thrive (FTT)

  • Common parameters are a ____. (and sometimes ____) that falls below the _____percentile for the child’s age.
  • _____________ measurements alone are not used to diagnose—rather the finding of persistent deviation from established ___________ curve is cause for concern.

wt..ht..5th

Growth..growth

8
  1. result of a physical cause (congenital heart defects, neuro lesions, chronic renal failure, GERD, CF, AIDS, etc.)

Organic Failure to Thrive (OFTT)

9

Organic Failure to Thrive (OFTT)

-if you fix the ___________ cause, then it will fix the FTT as well

physical

10

a definable cause that is unrelated to disease; it is most often the result of psychosocial factor

Nonorganic Failure to Thrive (NFTT

11

unexplained by usual organic and environmental etiologies but may also be classified as NFTT

Idiopathic Failure to Thrive

12

Failure to thrive-----Diagnostic Evaluation

Initially made from evidence of ___________ failure;

wt. <_____ percentile, if FTT is long-standing both ___. and ___. are used indicating chronic malnutrition.

growth

5th...wt...ht

13

Failure to thrive-----Diagnostic Evaluation

Common Diagnostic Procedures

  • Complete ___________ and ____________ history
  • ___________ exam for evidence of organic causes
  • ___________________ assessment
  • _________ assessment
  • To avoid stigma during investigative phase, may health care workers use the term _____________delay (or ______________) until the actual cause can be established

health and dietary

Physical

Developmental

Family

growth..failure

14

Failure to thrive------ Therapeutic Management

  • **Treatment is directed at reversing the _______________. (Goal is to provide sufficient _____________ to support “catch-up” ____________—rate of ____________>expected rate for age)

-the child with FTT is going to have to have ___________ than the normal healthy child bc they need to catch up ____________ developmentally wise

  • Coexisting ____________ problems are treated.
  • Efforts are made to relieve additional _____________on the family by offering referrals to ____________ agencies or supplemental __________ programs.

malnutrition..calories..growth..growth

more..growth

medical

stresses..welfare..food

15

Feeding Children with Failure to Thrive

  • Provide a primary core of ________ to feed the child
  • Provide a _________, _______________ atmosphere
  • Maintain a _________, even ________________ throughout the meal
  • Talk to the child by giving _____________ about eating
  • Be ________________ (_____-_____ min.); remain _________
  • Maintain a ________-to-_________ posture with the child when possible
  • Introduce _________ foods slowly
  • Follow the child’s rhythm of ____________
  • Develop a _____________ routine

staff

quiet, unstimulating

calm..temperament

directions

persistent (10-15)..calm

face-to-face

new

feeding

structured

16
  • Adverse systemic and local GI reaction’s to cow’s milk protein.

Cow’s Milk Allergy

17

Cow’s Milk Allergy

  • Whole milk is not recommended for infants <____mos. of age.
  • Hypersensitivity may be manifested during 1st ___ mos. of life through a variety of signs and symptoms;
  • symptoms may appear within _____ min. of ingestion or after several ______.

12

4

45..days

18

Cow’s Milk Allergy---- Therapeutic Management

_______________ of cow’s milk-based formula

  • Change formula to a ____________ __________________ milk formula (Pregestimil, Nutramigen, Alimentum) in which protein has been broken down “predigested” into its amino acids through hydrolysis
  • _____________milk is not acceptable
  • Eliminate all ____________ and _________ ______ from lactating mother’s diet, and possibly ________ and ________; _____ _____and ___________ supplementation should be considered to prevent deficiency

Maintain infant on the diet for___-____yrs, after which very small quantities of _______ are reintroduced; eggs and fish may be introduced at ____-_____ yrs. of age

Elimination

casein hydrolysate milk formula

Goat’s

peanuts..tree..nuts..eggs..milk

vit. D..calcium

1-2..milk..2-3

19

Cow’s Milk Allergy

Introduce the formula gradually over _____ days using ___ oz. of new formula to ____ oz. of _____ formula, then ___to ____ oz., ___ to ___, and as needed.

few..1..7..old..2..6..3..5

20

Late-onset lactase deficiency (Primary)—most _______________ type; usually manifested around age ___ to ___;

-decrease in intestinal ______________ is not a disease but a normal ___________________ process

common..3 to 7

lactase..physiologic

21

lactose intolerance----Symptoms

  • _______________ pain
  • _____________
  • _______________
  • ____________

*Onset of symptoms occurs within ____ min. to several _____. of lactose consumption.*

abdominal

bloating

flatulence

diarrhea

30..hrs

22

Ways to control Symptoms of Lactose Intolerance

  • Substitute _____-base formula for ______milk formula or ___________milk
  • Limit ________ consumption to _______glass at a time
  • Avoid ___________ creamers; they may contain _____________caseinate, a milk protein
  • Drink ________ with other foods rather than alone
  • Eat hard __________, _____________ cheese, or ___________ instead of drinking milk
  • Use enzyme tablets (___________, ____________, ________ Ease) to predigest the lactose in milk or supplement the body’s own lactase (add tablets to ________ or sprinkle on dairy products such as _____ ___________)
  • ____________ and __________ supplementation may be necessary to prevent deficiency

-___________ is probably the best source to get the extra supps. by that wont be as hard on them

  • _____________ contains inactive lactase enzyme, which is activated by temp. and pH of duodenum (substitutes for lack of indigenous lactase);

-____________yogurt may be tolerated better than ____________yogurt

soy..cow’s..human

milk..one

nondairy..calcium

milk

cheese..cottage..yogurt

Lactaid, Lactase, Dairy Ease..milk..ice cream)

Calcium and Vit. D

yogurt

Yogurt

Fresh..frozen

23
  • Corrosives
    • Drain, toilet, oven cleaners, detergent, batteries, bleach

-best place to keep them is up _______ where the toddler or child cannot reach them

  • Severe ___________ in the ___________, __________, _____________
  • Do not induce _____________

-do not make them __________-____!

high

burning..mouth, throat, stomach

emesis

throw-up

24
  • Hydrocarbons
    • Gasoline, kerosene, paint thinner, lighter fluid
    • ____/____, ____________, _______________, ______________
    • Immediate danger is ______________ and ______________
    • Poisons
    • Inducing __________ is contraindicated

N/V, gagging, choking, coughing

aspiration..pneumonia

emesis

25
  • Acetaminophen
    • ____/____, _____________, _____________, ______________, ______________ abnormalities
    • Most ______________accidental drug poisoning

Treatment:

  • Antidote: ________________
  • N/V, sweating, jaundice, confusion, coagulation abnormalities
  • common
  • Mucomyst
26
  • Aspirin
    • ____/____, _________________, ______________, _______________, _________

Treatment:

  • _____________ ___-for bleeding, ____________________ (for seizures)
  • __________________ ____________-important early in ASA toxicity
    • N/V, dehydration, tinnitus, seizures, coma

Vitamin K..anticonvulsants

activated charcoal

27
  • Antidote
    • ____-____________ (________________ -smells really bad, like old eggs; administered orally, mixed with juice): acetaminophen

-know both names for this

  • _____: carbon monoxide inhalation
  • ______________ (____________): opioid overdose
  • _______________ (_______________): benzodiazepines (Valium, Versed)
  • _______________: poisonous bites

N-acetylcysteine..Mucomyst

O2

Naloxone..Narcan

Flumazenil..Romazicon

Antivenin