Republic of Philippines

Mindanao State University

College of Health Sciences
Marawi City

COMMON HEALTH PROBLEMS

THAT DEVELOP DURING INFANCY

In partial fulfillment of the requirement for the course

NSG124 – Care of Mother and Child with Problems (Acute and Chronic) LEC

Submitted to:
Prof. Donabelle L. Abdullah

Submitted by:
MACA-ALANG, Logina B.
MACAALIN, Asliah P.
MACAPAAR, Lailanie B.

April 2023
 COMMON HEALTH • IVF
PROBLEMS THAT DEVELOP • Prescription of pain medication
• Therapeutic enema
DURING INFANCY
• Surgical reduction
• Laparoscopy
INTUSSUSCEPTION Nursing Management
Etiology • Administer IVF as ordered
• A nasogastric tube is inserted to
• enlarged lymph nodes, a tumor, or
decompress the bowel.
a blood vessel problem in the
• Monitor v/s frequently
intestines.
• If surgery is required, provide
• Infections preoperative teaching to the SO
Risk factors • Monitor I&O
• Education
• Age. Children – especially young
children – are much more likely to Surgical Management
develop intussusception than adults
• Laparoscopic surgery
are.
• Bowel resection
• Sex. Intussusception more often
• Appendectomy
affects boys.
• Irregular intestinal formation at Drug of Choice
birth.
• Intravenous morphine
• Certain conditions include: cystic
• Analgesic
fibrosis, IgA vasculitis, Crohn’s
• Acetaminophen
disease, celiac disease.
• Cefoxitin
Signs and Symptoms: • Penicillins and cephalosporins
• Sudden loud crying caused by belly Nursing Diagnosis
pain.
• Acute pain related to bowel
• Stool mixed with blood and mucus
invagination.
• Vomiting A lump in the belly. • Deficient fluid volume related to
• Weakness or lack of energy. vomiting, nausea, fever, and
• Diarrhea diaphoresis.
• Dehydration • Ineffective breathing pattern related
• sweating to abdominal distention and
Diagnostic procedure rigidity.

• Ultrasound
• Abdominal X-ray
FAILURE TO THRIVE
• Barium enema and air contrast
• Rectal examination Etiology
• Palpation
• Congenital abnormalities
• Radiographs
• Inadequate nutrition
• CT scanning
Risk factors
Medical management
 • Not enough calories provided.
• Eats too little
• Health problem involving the
digestive system.
• Food intolerance
• Infections
• Metabolic disorders
Signs and symptoms
• Poor sucking
• Hard to feed
• Vomiting or diarrhea
• Sleeps too much or not enough
• Fussiness Weak cry
• Loses weight or does not gain
enough weight
• Stiff or floppy muscles
• Slow in growth and development
• Does not move around much
Diagnostic Procedure
• CBC and differential
• Urinalysis, urine culture
• Serum electrolytes
• Stool tests
• Diet history
• Weight monitoring
Medical Management
• Observation of feeding
• Feeding techniques
• Increase protein
• Consider vitamin and mineral
supplements especially zinc and
iron
Nursing Management
• Maintain adequate nutrition and
fluid intake
• Post-feeding instruction
• Document the intake
• Monitor elimination pattern
• Providing family teaching
Surgical management
• Gastrostomy feeding tube
Nursing Diagnosis
• Imbalanced Nutrition: Less than
body requirements related to low
calorie intake of the infant
• Risk for impaired skin integrity
related to poor nutrition
• Deficient fluid volume related to
inadequate oral intake of the infant
SUDDEN INFANT DEATH
SYNDROME
Risk factors
• Sex
• Age
• Race
• Family history
• Secondhand smoke/maternal
smoking
• Being premature
• Sleeping position and bedtime
environment
Clinical manifestations
• Cyanosis
• Breathing difficulties
• Abnormal limb movements
Diagnostic procedure
• Laboratory studies
• Radiography and computed
tomography scans
• Histology
Medical management
• Emergency Care
• Management of apnea
Nursing diagnosis
• Dysfunctional grieving related to
sudden, unpredictable death of the
infant
• Interrupted family processes related
to grieving

TRISOMY 21
Etiology:
It is also known as “Down Syndrome”. The
term “trisomy” means having an extra copy of a
chromosome. Trisomy 21 occurs when a
developing fetus has three copies of chromosome
21 in every cell instead of the typical two copies.
Risk Factors:
• Women who become pregnant at an older
age, particularly those over the age of 35.
• Family history of Down Syndrome.
• Having previously given birth to a baby
with Down syndrome.
Signs and symptoms:
• Flattened face, especially the bridge of the
nose
• Almond-shaped eyes that slant up
• Short neck
• Small ears
• A tongue that tends to stick out of the mouth
• Tiny white spots on the iris of the eye
• Small hands and feet
• Small pink fingers that sometimes curve
toward the thumb
• Poor muscle tone or loose joints
• Shorter in heights as children and adults
Diagnostic Test:
• Amniocentesis: This test involves taking a
small sample of the amniotic fluid and
analyzing it for chromosomal
abnormalities. It is typically performed
between 15-20 weeks of pregnancy.
• Chorionic villus sampling (CVS): This
test involves removing a tiny piece of tissue
from the placenta analysis. It can be
performed as early as 10-12 weeks of
pregnancy.
Medical Intervention:
Treatment options could include:
• Physical therapy.
• Speech therapy.
• Participating in special education programs
in schools.
• Treating underlying medical conditions.
• Wearing glasses for vision problems or
assisted hearing devices for hearing loss.
In addition, specific manifestations of the
syndrome and associated conditions must be
addressed, as follows:
• Thyroid hormone. To prevent intellectual
deterioration and to improve the
individual’s overall function, academic
achievement, ad vocational abilities.
• Digitalis and diuretics. Such as
Furosemide and Digoxin for cardiac
management.
• Vaccines. Consider Pneumococcal and
Influenza vaccination for children with
chronic cardiac and respiratory disease;
consider prophylactic palivizumab, since
infants with Down syndrome are at high
risk for hospitalization with a respiratory
syncytial virus.
Nursing Management:
• Provide a safe and supportive environment.
• Provide adequate nutrition.
• Frequent consultation is a must.
• Assess understanding of Down Syndrome.
• Promote safe sleep practices, such as
placing the infant on their back to sleep.
• Provide age-appropriate stimulation, such
as visual and auditory toys and activities, to
promote development.
• Assess the infant’s physical and
developmental status regularly.
• Identify any medical or developmental
concerns early.
3 Nursing Diagnosis:
• Risk for delayed development related to
genetic disorder.
• Risk for impaired social interaction related
to cognitive development.
• Risk for altered body image related to
physical characteristics.
 • Improving gut motility.
COLIC • Strengthening the gut barrier.
Etiology: 3) Dietary changes: This can be effective way to
• Refers to excessive and prolonged crying or manage symptoms of colic in pediatric patients.
fussiness in an otherwise healthy infant for • Avoiding trigger foods such as dairy, soy,
at least three hours a day, three days a week, gluten, and certain fruits and vegetables.
for at least three weeks.
• Increasing fiber intake such as whole
• The exact cause of colic is unknown, but it grains, fruits, and vegetables.
is thought to be related to gastrointestinal,
• Staying hydrated by drinking plenty of
neurological, or behavioral factors.
water and other fluids.
Sign and symptoms: • Limiting gas-producing foods such as
beans. Onions, and lentils.
• Excessive crying or fussiness.
• Crying for no apparent reasons. 4) Referral to a specialist to help diagnose and
• Predictable timing with episodes often treat underlying conditions.
occurring in the evening. Drug of Choice:
• Facial discoloring, such as skin flushed or
blushing. • Simethicone drops are often used as a first-
• Body tension, such as pulled up or stiffened line medication for colic in infants.
legs, stiffened arms, clenched fists, arched Nursing Management:
back, or tense abdomen.
• Assess pain and relieve or reduce pain.
Diagnostic Procedures:
• Educate caregivers on the disease.
• It is based on the characteristics symptoms • Improve parenting skills.
and ruling out other potential causes of • Provide rest periods to promote relief,
crying and fussiness, such as ear infections sleep, and relaxation.
or reflux. • Place infant on a position of comfort to
reduce pain.
Medical Management:
1) Medications:
3 Nursing Diagnosis:
• Anti-gas agent or anti-foaming agent:
• Impaired parenting related to lack of
Used to relieve symptoms of excessive gas,
knowledge and confidence in parenting.
bloating, and discomfort in the
Deficient knowledge related to lack of
gastrointestinal tract by breaking down gas
exposure and unfamiliarity with
bubbles, making them easier to pass.
information resources.
• Anti-spasmodic drugs: To help relieve
• Risk for injury related to exhaustion and
muscle spasms and cramping in the
frustration of caregivers.
intestines.
• Antacids: To neutralize stomach acid and
can provide relief for children with acid
reflux or indigestion.
• Prokinetics: To help speed up movement
of food through the digestive tract.
2) Probiotics: This can treat colic in pediatric
patients by improving gut health and reducing
inflammation.
• Balancing gut bacteria.
• Reducing inflammation.

FETAL ALCOHOL
SYNDROME (FAS)
Etiology:
• It is a disorder that can occur in infants who
are exposed to alcohol in the womb. It is a
leading cause of preventable birth defects
and developmental disabilities.
• FAS is caused by alcohol exposure during
pregnancy. The alcohol can damage the
developing brain and other organs of the
fetus. The severity of the symptoms
depends on the amount and timing of
alcohol exposure.
Signs and symptoms:
• Physical symptoms may include a small
head, low birth weight, and fetal
abnormalities such as thin upper lip and
small eye openings.
• Behavioral symptoms may include
hyperactivity, impulsivity, and difficulties
with social skills.
• Cognitive symptoms may include learning
disabilities, intellectual disabilities, and
memory problems.
Diagnostic Procedures:
• It is diagnosed based on the physical
examination, medical history, and
assessment of cognitive and behavioral
symptoms. A diagnosis may also involve
laboratory tests and imaging studies to
evaluate organ damage.
Medical Management:
• Early intervention services such as
occupational therapy, speech therapy, and
physical therapy.
• Medications:
a) Stimulant medication such as
methylphenidate (Ritalin) or
amphetamines to manage
hyperactivity and impulsivity.
b) Antidepressant such as fluoxetine
(Prozac) or sertraline (Zoloft) to
manage depression or anxiety.
c) Antipsychotic such risperidone
(Risperdal) or olanzapine (Zyprexa)
to manage violent behavior.
• There is NO cure or specific treatment for
FAS. The physical defects and mental
deficiencies typically persist for a longtime.
Nursing Management:
• Assess for fetal exposure to illicit drug
substance.
• Review ultrasound results to determine
fetal growth and gestational age.
• Assess fetal heart rate regularly.
• Assess for symptoms of alcohol
withdrawal.
• Increase the mother’s awareness of the
detrimental effects of alcohol.
• Decrease environmental stimuli and plan
care activities carefully.
• Wrap or swaddle the infant snugly.
• Provide adequate nutrition to support
weight gain.
• Encourage mother to interact with the
newborn.
• Administer opioid replacement therapy to
mother.
• Instruct the mother to avoid breastfeeding if
using street drugs.
3 Nursing diagnosis:
• Risk for impaired social interaction related
to behavioral and cognitive deficits.
• Ineffective coping related to stress and
challenges associated with caring for a
child with FAS.
• Risk for injury related to hyperactivity and
impulsivity.
Cleft Lip and Palate
➢ cleft lip: failure of the maxillary and
median nasal processes to fuse normally
➢ cleft palate: an opening of the palate
Etiology
✔ Polygenic inheritance
✔ Environmental influences
3 Nursing Diagnosis
• Risk for imbalanced nutrition, less than
body requirements, related to feeding
problem caused by cleft lip or palate
• Risk for ineffective airway clearance
related to oral surgery
• Risk for infection related to surgical
incision

Risk Factors: Imperforate Anus

• Vitamin Deficiency (Folic Acid)
• Obesity
• Smoking or Tobacco use during pregnancy
• Substance Abuse
• Birth disorders like DiGeorge syndrome
Or Pierre Robin syndrome
• Exposure to Viruses or Chemicals while
fetus develops in the uterus
Signs and Symptoms
• Crooked, poorly shaped or missing teeth
• Misalignment of teeth and jaw
• Deformities of the upper jaw (maxilla)
• Speech problems
• Unrepaired oronasal fistulae, which is a
hole between
• Alveolar celfts, which are defects in the
bone that supports the teeth
Diagnostic Procedures
• Prenatal Ultrasound
• Physical Examination of mouth, nose and
palate after child’s birth
➢ stricture of the anus, resulting in inability
to pass stool.
Etiology
✔ No known cause
Risk Factors:
• Not clear what factors raise the risk for
this condition
Signs and Symptoms
• No anal opening
• An anal opening in the wrong place such
as too close to the vagina
• No stool in the first 24 to 48 hrs of life or
not having bowel movements
• Stool passing through the wrong place,
such as the urethra, vagina, scrotum, or the
base of the penis
• Swollen abdomen
• An abnormal connection, Fistula, between
your baby’s rectum and their reproductive
system or urinary tract

Medical Management Diagnostic Procedures

• Surgery • Prenatal sonogram
• Dental Speech Appliance • X-rays
• Renal Ultrasound
Nursing Management • Spinal Ultrasound
• Maintain adequate nutrition. • Spinal Ultrasound
• Positioning • Echocardiogram
• Tools for feeding. Lamb’s nipples
• Promote family coping Medical Management
• Reduce family anxiety • Nothing per orem
• Provide family teaching • Neonatal colostomy
• Primary neonatal pull-through without
Surgical Management colostomy
• Palatoplasty (Palate Repair Surgery)
 • Posterior sagittal pull-throughwith a • Constipation/ Congenital
colostomy • Abdominal obstruction/ Abnormal feeding
• Colostomy closure • Syndrome Downs (Down Syndrome)
• Diet • Meconium does not pass
• Activity • Failure to thrive

Pharmacologic management Diagnostic Procedures

• Antibiotic prophylaxis • Laboratory studies
• Laxatives • Plain abdominal radiography
• Unprepared single-contrast barium enema
Nursing Management • Rectal biopsy
• Avoid infection • Rectal manometry
• Protect skin integrity
• Restore balanced fluid volume Medical Management
• Maintaining adequate hydration • Initial therapy
• Maintaining stable vital signs • Decompression
• Diet
Surgical Management Pharmacologic management
• Temporary Colostomy • Antibiotics
• Perineal anoplasty
Nursing Management
3 Nursing Diagnosis • Promote skin integrity.
• Imbalanced nutrition, less than body • Promote comfort.
requirements, related to bowel obstruction • Maintain fluid balance.
and inability for oral intake • Provide oral and nasal care.
• Impaired tissue integrity at rectum related • Provide family teaching.
to surgical incision
• Risk for impaired parenting related to Surgical Management
difficulty in bonding with infant ill from • Leveling Colostomy
birth • Single-stage Pull-through Procedure

Hirschsprung’s Disease (Aganglionic 3 Nursing Diagnosis

Megacolon) • Constipation related to reduced bowel
➢ absence of ganglionic innervation to the function
muscle of a section of the bowel • Imbalanced nutrition, less than body
requirements, related to reduced bowel
Etiology function
✔ Arrest of aboral neuroblast migration • Risk for compromised family coping
related to chronic illness in child
Risk Factors:
• Genetics factors Otitis Media
• Down syndrome ➢ Inflammation of the middle ear
• Males
Etiology
Signs and Symptoms ✔ Common in Infants and Children
• Sigmoid Colon ✔ Lower socioeconomic group
• Absence of movement ✔ Viral infections
• Ribbon shaped stool (older kids) ✔ Organisms invade the middle ear
Risk Factors: Medical Management
• Being between 6 and 36 months • Antibiotic therapy
• Using pacifier Pharmacologic management
• Bottle fed • Antimicrobial agents
• Drinking while laying down
• Exposed to cigarette smoke Nursing Management
• Exposed to higher levels of air pollution • Positioning. Have the child sit up, raise
• Being in cold climate head on pillows, or lie on unaffected ear.
• Having had a recent cold, flu, sinus, or ear • Heat application. Apply heating pad or a
infection warm hot water bottle.
• Diet. Encourage breastfeeding of infants
Signs and Symptoms as breastfeeding affords natural immunity
• Crying to infectious agents; position bole-fed
• Irritability infants upright when feeding.
• Sleeplessness • Hygiene. Teach family members to cover
• Pulling on the ears mouths and noses when sneezing or
• Ear pain coughing and to wash hands frequently.
• Headache • Monitoring hearing loss. Assess hearing
• Neck Pain ability frequently.
• Feeling of fullness in the ear
• Fluid drainage from the ear Surgical Management
• Fever • Myringotomy and TT placement
• Vomiting • Adenoidectomy
• Diarrhea
• Lack of balance 3 Nursing Diagnosis
• Hearing loss • Pain related to inflammation and erythema
secondary to ear infection
Diagnostic Procedures • Risk for injury related to hearing loss,
• Laboratory tests decreased visual acuity.
• Tympanocentesis or Tympanometry test • Impaired verbal communication related to
• Reflectomy Test effects of hearing loss
• Hearing Test