Ss malabsorption diarrhea and failure to thrive tx

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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 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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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