Alteration in Nutrition,

Gastrointestinal
Metabolism, and
Endocrine

Presented by Group 5 Block A

 Objectives

Discuss what is Alteration in Nutrition, Gastrointestinal

Metabolism, and Endocrine
Discuss the Effects of Alteration on Nutrition, Gastrointestinal
Metabolism, and Endocrine
Discuss one common disease of Alteration in Nutrition,
Gastrointestinal Metabolism, and Endocrine
Discuss the NCP for Alteration in Nutrition, Gastrointestinal
Metabolism, and Endocrine
 Introduction
Alteration in Nutrition, Gastrointestinal Metabolism, and Endocrine
refers to a complex set of conditions involving disruptions or
abnormalities in the body's processes related to nutrition, digestion,
and hormone regulation.

Alteration in Nutrition: This refers to any deviation from the

optimal nutritional status, including deficiencies, excesses, or
imbalances in nutrient intake, which can lead to various health
problems such as malnutrition, obesity, or nutritional deficiencies.
 Introduction
Gastrointestinal Metabolism: This involves disturbances in the
digestive processes and metabolism within the gastrointestinal
tract. It includes conditions like constipation, diarrhea,
gastrointestinal reflux disease (GERD), and disorders of nutrient
absorption.

Endocrine Dysfunction: This involves disruptions in the function of the

endocrine system, which is responsible for producing and regulating
hormones that control metabolism, growth, energy balance, and other
essential functions. Conditions such as diabetes mellitus, thyroid
disorders, adrenal insufficiency, and hormonal imbalances fall under
this category.
 Introduction

Together, alterations in these areas can lead to a wide range of health

issues, affecting overall well-being and requiring comprehensive
management and treatment.
 Alteration in Nutrition, Gastrointestinal Metabolism, and
Endocrine refers to disruptions or abnormalities in the body's
processes related to nutrition, digestion, and hormone
regulation. This can encompass a wide range of conditions
affecting individuals across different age groups.
 Effects on Infants:
Gastrointestinal
Nutritional Alterations:
Metabolism:
Infants may experience Common gastrointestinal
alterations in nutrition due to
issues in infants include
improper feeding practices,
colic, reflux, constipation,
insufficient breast milk or
and diarrhea, which can
formula intake, or introduction
affect nutrient absorption
of solid foods at an
inappropriate age. and digestion.
Effects on Infants:

Endocrine Dysfunction:

Infants may be affected by

congenital endocrine disorders
such as congenital
hypothyroidism or congenital
adrenal hyperplasia, leading to
issues with growth,
development, and metabolism.
Effects on toddlers:
Gastrointestinal
Nutritional Alterations:
Metabolism:
Toddlers may exhibit picky
eating habits, leading to Issues such as constipation
imbalances in their nutrient and diarrhea are common
intake. Poor food choices and in toddlers, often due to
inadequate intake of essential
dietary factors or changes
nutrients can affect growth and
development. in routine.
Effects on toddlers:

Endocrine Dysfunction:

Disorders such as diabetes

mellitus type 1 can develop
during toddlerhood, requiring
careful management of blood
sugar levels and insulin
therapy.
 EffECTS ON PRESCHOOL
age children:
Gastrointestinal
Nutritional Alterations:
Metabolism:
Preschoolers may continue to Gastrointestinal issues
have picky eating habits, like constipation,
potentially leading to nutritional diarrhea, and abdominal
deficiencies. Poor dietary habits
pain may persist, often
and inadequate intake of fruits,
vegetables, and whole grains can influenced by dietary
impact overall health. factors or stress.
Effects on preschool
age children:

Endocrine Dysfunction:

This age group may develop

endocrine disorders such as
obesity, insulin resistance, or
early-onset puberty, which can
have long-term health
consequences if not addressed.
EffECTS ON adolescents :

Gastrointestinal
Nutritional Alterations:
Metabolism:
Conditions like irritable bowel
Adolescents may face issues
syndrome (IBS) or
with disordered eating, such as
inflammatory bowel disease
anorexia nervosa or bulimia
(IBD) may manifest during
nervosa, leading to severe
adolescence, affecting nutrient
nutritional imbalances and
absorption and causing
potential growth stunting. gastrointestinal discomfort.
Effects on adolescents:

Endocrine Dysfunction:

Hormonal changes during puberty

can exacerbate or reveal endocrine
disorders like polycystic ovary
syndrome (PCOS), thyroid
disorders, or diabetes mellitus type
2, requiring careful management to
prevent complications.
 IN SUMMARY:
Alterations in nutrition, gastrointestinal metabolism,
and endocrine function can significantly impact
individuals across different age groups, affecting
growth, development, and overall health.
Understanding these effects is crucial for providing
appropriate care and interventions tailored to each age
group's specific needs.
 Type 1 diabetes is one of the common diseases associated
with alterations in nutrition, gastrointestinal metabolism,
and endocrine systems due to its complex etiology and
interplay with these systems.

Genetic Factors: Type 1 diabetes has a strong genetic component. Certain genetic
variations predispose individuals to develop the condition. These genetic
alterations affect the immune system, making it mistakenly attack and destroy
insulin-producing beta cells in the pancreas. This autoimmune response leads to
insulin deficiency, a hallmark of type 1 diabetes.
Nutritional Factors: While nutrition itself doesn't directly cause type 1
diabetes, it plays a significant role in the development of the disease.
Studies suggest that early exposure to certain dietary factors, such as cow's
milk and gluten, may increase the risk of developing type 1 diabetes in
genetically susceptible individuals. Additionally, nutrition is crucial in
managing type 1 diabetes effectively. Maintaining a balanced diet and
managing carbohydrate intake are essential components of diabetes
management.
Gastrointestinal Metabolism: Alterations in the gastrointestinal (GI)
system can affect the absorption of nutrients, including carbohydrates,
which impact blood sugar levels. In type 1 diabetes, the lack of insulin
prevents glucose from being transported into cells, leading to high blood
sugar levels. GI issues such as celiac disease, which is more common in
individuals with type 1 diabetes, can exacerbate nutrient absorption
problems and glycemic control.
Endocrine Dysfunction: Type 1 diabetes is fundamentally an endocrine
disorder, characterized by the dysfunction of the endocrine system,
particularly the pancreas. The pancreas is responsible for producing
insulin, a hormone that regulates blood sugar levels. In type 1 diabetes,
the pancreas fails to produce insulin, leading to uncontrolled blood sugar
levels. Moreover, the interaction between various hormones in the body,
such as insulin, glucagon, cortisol, and growth hormone, plays a crucial
role in glucose metabolism, and any imbalance can affect blood sugar
regulation.
 Autoimmune Component: Type 1 diabetes is primarily an autoimmune
disease, where the body's immune system mistakenly attacks and destroys
insulin-producing beta cells in the pancreas. The exact triggers for this
autoimmune response are not fully understood, but both genetic and
environmental factors are believed to contribute. Autoimmune diseases
often have complex interactions with the endocrine system, influencing
hormone production and signaling.

Overall, type 1 diabetes is a multifactorial disease influenced by genetics,

nutrition, gastrointestinal metabolism, and endocrine dysfunction.
Understanding these factors is crucial for both preventing the disease in high-
risk individuals and effectively managing it in those already diagnosed.
The effects of type 1 diabetes can vary depending on the age of the
individual. Here's a breakdown of how type 1 diabetes can affect
infants, toddlers, preschool-age children, and adolescents:

Infants (0-1 year old):

Growth and Development: Type 1 diabetes can affect an infant's growth

and development if blood sugar levels are not well-managed. High blood
sugar levels can lead to excessive thirst, frequent urination, and poor
weight gain. This can affect overall growth and development milestones.
 Infants (0-1 year old):

Feeding Difficulties: Infants with type 1 diabetes may experience feeding

difficulties due to fluctuations in blood sugar levels. This can lead to
irritability, poor feeding, and weight loss.
Caregiver Challenges: Managing type 1 diabetes in infants can be
challenging for caregivers. They need to closely monitor blood sugar
levels, administer insulin injections, and adjust feeding schedules
accordingly.
Toddlers (1-3 years old):

Communication Challenges: Toddlers may have difficulty communicating

symptoms of high or low blood sugar levels. This can lead to challenges in
managing their condition effectively.
Toddlers (1-3 years old):

Hyperglycemia Symptoms: Toddlers with high blood sugar levels may

display symptoms such as increased thirst, frequent urination, fatigue, and
irritability.
Hypoglycemia Risks: Toddlers are at risk of hypoglycemia (low blood
sugar) due to their unpredictable eating habits and active lifestyle.
Hypoglycemia can cause confusion, irritability, shakiness, and even
seizures if not treated promptly.
Feeding Challenges: Toddlers may exhibit picky eating behaviors, which
can make it difficult to ensure they receive balanced nutrition. Managing
carbohydrate intake becomes crucial for maintaining stable blood sugar
levels.
Preschool Age (3-5 years old):

Increased Independence: Preschool-age children may begin to show signs

of independence, wanting to participate in self-care tasks such as testing
blood sugar levels or administering insulin with supervision.
Social Challenges: Children at this age may start to notice differences
between themselves and their peers. They may feel self-conscious about
checking blood sugar levels or receiving insulin injections in front of
others.
Preschool Age (3-5 years old):

School Transition: Many children start preschool during this age. Parents
and caregivers need to work closely with teachers and staff to ensure
proper diabetes management during school hours.
Emotional Impact: Coping with a chronic condition like type 1 diabetes
can have emotional effects on preschoolers. They may feel frustrated,
scared, or anxious about their condition and the changes it brings to their
daily life.
Adolescents (12-18 years old):

Hormonal Changes: Adolescence brings hormonal changes that can affect

insulin sensitivity and blood sugar levels. Hormonal fluctuations can make
blood sugar control more challenging during this time.
Peer Pressure: Adolescents may face peer pressure to conform, which can
affect their diabetes management. They may be tempted to skip insulin
doses, indulge in unhealthy foods, or engage in risky behaviors.
Adolescents (12-18 years old):

Independence Struggles: Adolescents crave independence, which can

lead to conflicts with parents or caregivers over diabetes management.
Some may rebel against diabetes self-care tasks, leading to poor blood
sugar control.
Psychological Impact: Adolescence is a critical period for identity
formation, and living with a chronic condition like type 1 diabetes can
impact mental health. Adolescents may experience feelings of isolation,
depression, or anxiety related to their condition.
 Overall, type 1 diabetes poses unique challenges at different stages of
childhood and adolescence. Close monitoring, support from caregivers, and
education about diabetes management are crucial for ensuring optimal health
and well-being in children and adolescents with type 1 diabetes.
 Nursing Care Plan for all age
groups with Alterations in
Nutrition, Gastrointestinal
Metabolism, and Endocrine
Functions

Patient Profile

Age Group: Pediatric (infants, toddlers, preschool-age children,

adolescents)
Medical History: Includes any known allergies, previous
hospitalizations, and family history of endocrine or gastrointestinal
diseases.
Current Symptoms: Varying signs such as poor weight gain, frequent
vomiting, diarrhea, constipation, signs of dehydration, or abnormal
blood glucose levels.
Medical Diagnoses: May include gastrointestinal disorders such as
gastroesophageal reflux disease (GERD), celiac disease, or endocrine
disorders like diabetes mellitus.

Laboratory Results: Pertinent results such as complete blood count,

electrolyte panel, blood glucose levels, and any specific tests related to
the diagnosed condition (e.g., HbA1c levels for diabetes, tissue
transglutaminase antibodies for celiac disease).
Nursing Assessment

1. Nutritional Assessment

Evaluate growth charts and compare them with pediatric age-related

norms.
Assess dietary intake, feeding patterns, and any difficulties with feeding
or swallowing.
Monitor for signs of malnutrition or obesity.
 Nursing Diagnoses

2. Gastrointestinal Assessment:
Observe stool frequency, consistency, and any presence of blood.
Note any abdominal pain, distension, or discomfort.
Assess for signs of GERD, such as frequent regurgitation.

3. Endocrine Assessment:
Monitor blood glucose levels at regular intervals.
Assess for signs of hypo- or hyperglycemia.
Examine for signs of thyroid dysfunction or other hormonal
imbalances.
Nursing Assessment
Imbalanced Nutrition: Less than body requirements related to inability
to digest or absorb nutrients.
Risk for Unstable Blood Glucose Level related to endocrine
dysfunction.
Altered Bowel Elimination related to gastrointestinal disorders.

Nursing Interventions and Rationales

Nutritional Interventions
Offer small, frequent meals to ensure adequate intake without
overwhelming the digestive system. (Rationale: Smaller meals can
be easier to digest and reduce the risk of vomiting or reflux.)
 Nursing Interventions and Rationales

Nutritional Interventions
Collaborate with a dietitian to create a nutrient-rich diet plan
tailored to the patient's needs. (Rationale: A dietitian can
provide specialized knowledge to address specific nutritional
deficiencies.)
Gastrointestinal Interventions
Elevate the head of the bed during and after feedings for
patients with GERD. (Rationale: This position helps prevent
the backflow of stomach contents into the esophagus.)
Provide appropriate medication as prescribed (e.g., proton pump
inhibitors for GERD, gluten-free diet for celiac disease). (Rationale:
Medications can help manage symptoms and prevent complications.)
 Nursing Interventions and Rationales
Endocrine Interventions
Regular monitoring of blood glucose levels to maintain within target
range. (Rationale: Frequent monitoring can help prevent hypo- or
hyperglycemia.)
Educate on insulin administration if applicable, including technique
and timing. (Rationale: Proper insulin management is crucial for
patients with diabetes.)
Evaluation
Monitor growth and development to ensure the patient is meeting
appropriate milestones.
Regular follow-up with laboratory tests to monitor the effectiveness of
dietary changes and medications.
Evaluation

Adjust the care plan based on patient response and any changes in
condition.

Patient Education Materials

Nutrition guides specific to age and condition, including portion sizes and
meal planning.
Instructional pamphlets on managing gastrointestinal symptoms at home.
Diabetes education for patients and families, including signs of hypo- and
hyperglycemia and emergency management.
Sources and group
members
Leader: Magatagñob, Shiera B.
Members:
Llaneta, Ysabella Gwen
Jamis, Loren
Hassan, Fharalyn
Magallones, Allyne Ann
 Sources and group
members
1. Nutritional Alterations in Infants:
American Academy of Pediatrics. (2021). Nutrition for Healthy Term Infants: Recommendations From Birth to Six Months. Pediatrics, 141(3). doi: 10.1542/peds.2017-3056
2. Gastrointestinal Metabolism in Infants:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). Digestive System Problems in Children. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut
rhoncus lacinia nisi eu tempus.
3. Endocrine Dysfunction in Infants:
American Academy of Pediatrics. (2006). Evaluation and Treatment of Cryptorchidism: AUA Guideline. The Journal of Urology, 177(4), 1457–1462. doi: 10.1016/j.juro.2007.01.367
4. Nutritional Alterations in Toddlers:
Centers for Disease Control and Prevention (CDC). (2021). Feeding & Nutrition Tips: Your 1- to 3-Year-Old. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus
lacinia nisi eu tempus.
5. Gastrointestinal Metabolism in Toddlers:
American College of Gastroenterology (ACG). (n.d.). Constipation in Children. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus lacinia nisi eu tempus.
6. Endocrine Dysfunction in Toddlers:
American Diabetes Association (ADA). (2021). Type 1 Diabetes in Children and Adolescents. Diabetes Care, 44(Supplement 1). doi: 10.2337/dc21-S008
7. Nutritional Alterations in Preschool Age Children:
Academy of Nutrition and Dietetics. (2019). Feeding Preschoolers: Nutrition and Healthy Eating for Ages 2 to 5. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus
lacinia nisi eu tempus.
8. Gastrointestinal Metabolism in Preschool Age Children:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). Irritable Bowel Syndrome in Children. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut
rhoncus lacinia nisi eu tempus.
9. Endocrine Dysfunction in Preschool Age Children:
National Institute of Child Health and Human Development (NICHD). (n.d.). Precocious Puberty. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus lacinia nisi eu
tempus.
10. Nutritional Alterations in Adolescents:
American Academy of Pediatrics. (2021). Eating Disorders. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus lacinia nisi eu tempus.
11. Gastrointestinal Metabolism in Adolescents:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). Inflammatory Bowel Disease (IBD) in Children. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed
sodales. Ut rhoncus lacinia nisi eu tempus.
12. Endocrine Dysfunction in Adolescents:
American Association of Clinical Endocrinologists (AACE). (2021). Thyroid Disease in Children and Adolescents. Retrieved from Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent rutrum maximus mauris sed sodales. Ut rhoncus
lacinia nisi eu tempus.
Thank
You