SS malabsorption diarrhea and failure to thrive Tx during surgery every effort

Ss malabsorption diarrhea and failure to thrive tx

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S/S: malabsorption, diarrhea, and failure to thrive Tx: during surgery every effort is made to preserve as much bowel as possible; mainstay treatment is nutritional support; TPN primary source of nutrition; enteral nutrition started as soon as possible to allow intestines to adapt to food Nurse manages infant’s TPN and enteral feedings Strict aseptic technique during TPN feedings through central line
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33 Nurse carefully assesses and documents infant’s tolerance to enteral feedings and notes any signs of dehydration, electrolyte imbalances and nutritional deficits Nonnutritive sucking provided as well Caring for the SGA/LGA infant – 2 o SGA o Therapeutic management is focused on prevention with good prenatal care to identify and treat problems early o When growth restriction cannot be prevented, ultrasound exam may permit early discovery of the condition o Serial nonstress tests and biophysical profiles may help determine if the infant should be delivered early and preparation can be made for the expected complications at birth o Problems during and after birth are treated as they occur o They may include asphyxia, meconium aspiration, hypoglycemia, and polycythemia o SGA infants have a greater surface area and higher metabolic rate than infants who are appropriate for gestational age o This increases their risk for temperature instability o Care must be adapted to the specific problems of the infant o When signs of growth restriction are present, the nurse must observe for complications that commonly accompany it o The general appearance and measurements give an indication of the type of growth restriction that has occurred o Nurse should assess for hypoglycemia o Caloric needs are greater than normal infant, making early and more frequent feedings important o Temperature and respiratory support are additional concerns o Observation for jaundice is important in infants with polycythemia o LGA o Therapeutic management based on identification of increased size during pregnancy by measurements of fundal height and ultrasound exam o Delivery problems may lead to use of vacuum extraction, forceps, or c- section o Birth injuries and complications are treated as they arise o The nurse assists in difficult delivery and c-section resulting from dystocia when the infant if LGA o After birth the infant is carefully assessed for injuries or other complications such as hypoglycemia or polycythemia o Nursing care is geared to the problem presented Gavage feedings – 1 o Usually started before oral feedings for preterm infants
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34 o A small, soft catheter is inserted through the nose or mouth every 2-3 hours for intermittent (bolus) feedings o An indwelling catheter may also be used to provide for intermittent or continuous feedings o Inserting the catheter at each feeding may be more traumatic than leaving it in place o Frequent oral placement may cause vomiting or increase infant aversion to oral stimuli, which may lead to difficulty with oral feedings later o
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