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ALTERATIONS IN NUTRITIONPowerPoint PresentationTo be covered…..CLEFT LIP / CLEFT PLALATESlide 5Slide 6Slide 7ETIOLOGYDIAGNOSISTREATMENTOperation SmilesSlide 12Slide 13NURSINGNURSING - BEFORE REPAIR:NURSING - BEFORE REPAIR:NURSING - AFTER REPAIR:NURSING - AFTER REPAIR:Nursing cont.Slide 20TeachingPyloric StenosisAssessmentSlide 24DIAGNOSISSlide 26TREATMENTNURSING CAREINTUSSUSCEPTIONSlide 30Slide 31Slide 32DIAGNOSESSlide 34Nursing Care (if surgery is needed)Nursing CareCELIAC DISEASEETIOLOGYSlide 39Slide 40Treatment / Nursing CareTreatment / Nursing CareFoods in a Gluten Free DietCONGENITAL AGANGLIONIC MEGACOLON (Hirschsprung's Disease)Slide 45Slide 46Slide 47Slide 48COMPLICATIONSSlide 50Slide 51Slide 52ESOPHAGEAL ATRESIA AND TRACHEOESOPHAGEAL FISTULASlide 54Slide 55Slide 56Slide 57ESOPHAGEAL ATRESIA AND TRACHEOESOPHAGEAL FISTULA “C” “A” “E”(H) “B” “D”Slide 59Slide 60ESOPHAGEAL ATRESIA: “Blind pouch” How to prevent accumulation of secretionsSlide 62Slide 63Slide 64Slide 65Slide 66FAILURE TO THRIVESlide 68Slide 69Slide 70Slide 71DIABETESSlide 73Slide 74Slide 75Slide 76Slide 77What do you think?Slide 79Slide 80DIABETES: TreatmentSlide 82Slide 83DIABETES: EMERGENCY SITUATIONSDIABETES – Hypoglycemia cont.DIABETES: TX of HYPOGLYCEMIASlide 87DIABETES: Nursing CareSlide 89Slide 90DIABETES: Age Appropriate TeachingSlide 92Slide 93Slide 94Slide 95THE END!!!ALTERATIONS IN ALTERATIONS IN NUTRITIONNUTRITIONStudy Guide # 15Study Guide # 15By By Professors Dillon and HidleProfessors Dillon and HidleUpdated Spring 2010Updated Spring 2010Nutritional ProblemsNutritional ProblemsTo be covered…..To be covered…..Cleft lip and cleft palateCleft lip and cleft palatePyloric stenosisPyloric stenosisIntussusceptionIntussusceptionCeliac diseaseCeliac diseaseHirschprung’s diseaseHirschprung’s diseaseEspophoteal and tracheoesophageal fistulaEspophoteal and tracheoesophageal fistulaFailure to thriveFailure to thriveDiabetes (Pediatrics)Diabetes (Pediatrics)CLEFT LIP / CLEFT PLALATECLEFT LIP / CLEFT PLALATE Cleft lipCleft lip is a opening in the upper lip alone, while a cleft is a opening in the upper lip alone, while a cleft palate is an separation in the hard palate (roof of the mouth) palate is an separation in the hard palate (roof of the mouth) or the soft palate (tissue in the back of the mouth ).or the soft palate (tissue in the back of the mouth ).Cleft lipCleft lip can range from a slight notch to a complete can range from a slight notch to a complete separation from the floor of the nose.separation from the floor of the nose.Cleft lipCleft lip (>in males), or lip in combination with palate occur (>in males), or lip in combination with palate occur in about 1 in every 1,000 white babies, slightly higher in in about 1 in every 1,000 white babies, slightly higher in American Indians (about 3.6 per 1,000) and less frequently in American Indians (about 3.6 per 1,000) and less frequently in African-Americans (approximately 1 per 2,500). African-Americans (approximately 1 per 2,500). Cleft palateCleft palate can include nasal distortion, midline or bilateral can include nasal distortion, midline or bilateral cleft, with extensions to the uvula or soft/hard palates. cleft, with extensions to the uvula or soft/hard palates. Cleft palateCleft palate (>in females) is seen less often in about 1 in (>in females) is seen less often in about 1 in 2,000 babies with no differences noted in racial groups.2,000 babies with no differences noted in racial groups. EitherEither can be found in isolation of the other or they can occur can be found in isolation of the other or they can occur together (cleft lip/palate). together (cleft lip/palate).Unilateral Cleft Lip and PalateCleft PalateBilateral Cleft Lip Unilateral Cleft Lip and PalateBilateral Cleft LipETIOLOGY ETIOLOGY Both occur because of incomplete development of Both occur because of incomplete development of the lip and/or palate in the early fetal the lip and/or palate in the early fetal development (lip and primary palate begin to development (lip and primary palate begin to develop between 4 to 6 weeks gestation, with the develop between 4 to 6 weeks gestation, with the hard palate complete by about week 9 -10). hard palate complete by about week 9 -10). Although causes are not clearly understood, some Although causes are not clearly understood, some medication side effects have been associated with medication side effects have been associated with cleft formation (i.e. sulfa drugs, anticonvulsive cleft formation (i.e. sulfa drugs, anticonvulsive drugs), as well as genetic factors, environmental drugs), as well as genetic factors, environmental factors, infections, maternal illnesses, maternal factors, infections, maternal illnesses, maternal alcohol use and, possibly, deficiency of folic acid. alcohol use and, possibly, deficiency of folic acid. Cleft palate does not seem to be associated with Cleft palate does not seem to be associated with anticonvulsive drug use or maternal alcohol use. anticonvulsive drug use or maternal alcohol use. Frequently, cleft defects frequently accompany Frequently, cleft defects frequently accompany other defects (about13%). other defects (about13%).DIAGNOSIS DIAGNOSIS There are no laboratory tests other than X-ray to There are no laboratory tests other than X-ray to see extensiveness of cleft palate. see extensiveness of cleft palate. Upon physical exam, the examiner may note as Upon physical exam, the examiner may note as small as a simple notch in the upper lip to a large small as a simple notch in the upper lip to a large opening in the lip that extends into the nostril. opening in the lip that extends into the nostril. If not outwardly visible, gloved inserted finger If not outwardly visible, gloved inserted finger into infants mouth when testing suck may identify into infants mouth when testing suck may identify cleft palate. cleft palate. Some infants with cleft palate will drip formula Some infants with cleft palate will drip formula from the nares during feeding. from the nares during feeding. Cleft lip can be unilateral or bilateral, with or Cleft lip can be unilateral or bilateral, with or without involvement of the palate, always assess without involvement of the palate, always assess (>70 % cleft lip have cleft palate).(>70 % cleft lip have cleft palate).TREATMENT TREATMENT Surgical repair is


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CUNY SCR 270 - Alteration in Nutrition

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