Activity 7: Reading and Comprehension

Common diseases during infancy

GARCES, SHERLYN M. APRIL 14, 2022

Newborn Diseases during infancy

I. INTUSSUCEPTION
- Intussusception is a serious condition in which part of the intestine slides into an
adjacent part of the intestine. This telescoping action often blocks food or fluid from
passing through. Intussusception also cuts off the blood supply to the part of the
intestine that's affected. This can lead to a tear in the bowel (perforation), infection and
death of bowel tissue.
Signs and Symptoms
- Stool mixed with blood and mucus
- Vomiting
- Lump in abdomen
- Weakness
- Diarrhea
Medical Treatment
- Water soluble contrast or air enema for both diagnostic procedure and treatment.
- Surgery may also be required if the intestine is torn or enema is unsuccessful in
correcting the problem.
Nursing Intervention
- Assess child for signs of intussusception and history. Physical findings include sausage-
shaped mass and emptiness in LRQ abdomen.
- Administer IV fluids as necessary and give blood or plasma as ordered is patient is in
shock.
- Monitor input and output of the patient accordingly.
- Educate family on what happens during intussusception and answer their question to
reduce anxiety.

II. FAILURE TO THRIVE

- Children are diagnosed with failure to thrive when their weight or rate of weight gain is
significantly below that of other children of similar age and sex. Infants or children that
fail to thrive seem to be dramatically smaller or shorter than other children the same
age
Signs and Symptoms
The following are delayed or slow to develop:
- Physical skills such as rolling over, sitting, standing, and walking
- Mental and social skills
- Secondary sexual characteristics (adolescents)
Medical Treatment
- Treatment depends on the cause of the delayed growth and development. Delayed
growth due to nutritional factors can be resolve by educating parents to provide well-
balanced diet. If psychosocial factors are involve, treatment should include improving
the family dynamins and living conditions.
Nursing Intervention
 - Attempt to cuddle the child and talk to him/her in a warm, soothing tone and allow
physical activities appropriate for child’s age.
- Maintain adequate nutrition and fluid intake
- Instruct about post feeding and instruct caregiver to be involve in child’s feedings.
- Document intake and monitor output patterns.
- Promote skin integrity by applying ointment at least every 2 hours.
- Provide family teaching.

III. COLIC
- Colic is frequent, prolonged and intense crying or fussiness in a healthy infant. Colic can
be particularly frustrating for parents because the baby's distress occurs for no apparent
reason and no amount of consoling seems to bring any relief. These episodes often
occur in the evening, when parents themselves are often tired
Signs and Symptoms
- Intense crying that may seem more like screaming or an expression of pain
- Crying for no apparent reason, unlike crying to express hunger or the need for a diaper
change
- Extreme fussiness even after crying has diminished
- Predictable timing, with episodes often occurring in the evening
- Facial discoloring, such as skin flushing or blushing
- Body tension, such as pulled up or stiffened legs, stiffened arms, clenched fists, arched
back, or tense abdomen
Medical Treatment
- Treatment under investigation includes the use of good bacteria or probiotics to create
an appropriate bacterial balance to improve overall digestive health.
Nursing Intervention
- Assess pain characteristics; acknowledge reports of pain immediately; provide rest
periods to promote relief, sleep, and relaxation; place infant on a position of comfort to
reduce pain.
- Educate caregivers and parents on the disease.
- Interview parents, noting their perception of situational and individual concerns;
educate parents regarding child growth and development, addressing parental
perceptions; involve parents in activities with the infant that they can accomplish
successfully; recognize and provide positive feedback for nurturing and protective
parenting behaviors.

IV. TRISOMY 21
- Also known as Down syndrome, is a genetic disorder caused when abnormal cell division
results in an extra full or partial copy of chromosome 21. This extra genetic material
causes the developmental changes and physical features of Down syndrome.
Signs and Symptoms
- Each person with Down syndrome is an individual — intellectual and developmental
problems may be mild, moderate or severe. Some people are healthy while others have
significant health problems such as serious heart defects. Most children with Down
syndrome have mild to moderate cognitive impairment. Language is delayed, and both
short and long-term memory is affected.
Medical Treatment
- Trisomy 21 cannot be cured. Early treatment programs can help improve skills.
 Nursing Intervention
- Provide adequate nutrition. Assess child’s ability to swallow provide information on the
proper way of giving food, and provide good nutrition counseling.
- Encourage parents to have the child’s hearing and vision checked regularly.
- educate the parents about Down syndrome and the care of a child with the disease.
- Provide emotional support and motivation.

V. CLEFT PALATE
- Cleft palate is an opening of the palate and occurs when the palatal process does not
close as usual at approx. weeks 9 to 12 of intrauterine life. The incomplete closure is
usually on the midline and may involve the anterior hard palate, the posterior soft
palate or both. It may occur as a separate anomaly or in conjunction with a cleft lip. As a
single entity, in contrast to cleft lip, it tends to occur frequently in girls than boys.
Almost 30% of children with both cleft lip and palate have associated birth defects, or
the cleft palate occurs as only a portion of a larger syndrome.
Signs and Symptoms
- Crooked, poorly shaped or missing teeth
- Misalignment of teeth and jaw
- Deformities of the maxilla
- Speech problems
- Hole between mouth and nose cavity
- Defects in the bone that supports the teeth
Medical Treatment
- Children with a cleft lip or palate will need several treatments and assessments as they
grow up. A cleft is usually treated with surgery. Other treatments, such as speech
therapy and dental care, may also be needed.
Nursing Intervention
- If the cleft lip is unilateral, the nipple should be aimed at the unaffected side; the infant
should be kept in an upright position during feeding.
- Lamb’s nipples (extra-long nipples) and special cleft palate nipples molded to fit into the
open palate area to close the gap may be used; one of the simplest and most effective
methods may be the use of an eyedropper or an Asepto syringe with a short piece of
rubber tubing on the tip (Breck feeder).
- Encourage the family to verbalize their feelings regarding the defect and their
disappointment; serve as a model for the family caregiver’s attitudes toward the child.
- Give the family information about cleft repairs; encourage them to ask questions and
reassure them that any question is valid.
- Explain the usual routine of preoperative, intraoperative, and post-operative care;
written information is helpful, but be certain the parents understand the information.

VI. IMPERFORATED ANUS

- An imperforate anus is stricture or the absence of the anus. In week 7 of intrauterine
life, the upper bowel elongates to pouch and combine with a pouch invaginating from
the perineum. These two sections of bowel meet, the membranes between them are
absorbed, and the bowel is then patent, to the outside. If this motion toward each other
does not occur or if the membranes between the two surfaces does not dissolved, an
imperforate anus occurs. This disorder can be relatively minor, just requiring surgical
 incision of the persistent membrane, or much more severe involving section of bowel
that are many inches apart with no anus.
Signs and Symptoms
- The opening to the anus us missing or not in the usual place. In girls, it may appear near
the vagina
- No passage of poop within a 1-2 days
- Passing poop through another opening, like urethra or vagina
- Swollen belly
Medical Treatment
- For mild, the steps involves enlarging the opening where the stool drains, so stool can
pass more easily. Surgery involves closing any small tube-like openings (fistula), creating
an anal opening, and putting the rectal pouch into the anal opening (anoplasty).
Nursing Intervention
- Keep colostomy clean with soap and water and diaper the baby in the usual way
- Monitor WBC count.
- Always keep hand clean by washing it, also inform caregiver/ parents to wash hands
before touching the patient.
- Put protective ointment to protect skin around the colostomy.
- Monitor site for any signs of infection such as change of color, redness, swelling,
warmth, and pain.
- Administer parenteral fluids as prescribed.
- Instruct patients how to monitor input and output in the home.

VII. HIRSCHSPRUNG’S DISEASE

- Hirschsprung's disease is a condition that affects the large intestine (colon) and causes
problems with passing stool. The condition is present at birth (congenital) as a result of
missing nerve cells in the muscles of the baby's colon. Without these nerve cells
stimulating gut muscles to help move contents through the colon, the contents can back
up and cause blockages in the bowel.
Signs and Symptoms
- Swollen belly
- Chronic constipation
- Gas
- Failure to thrive
- Fatigue
Medical Treatment
- For most people, it is treated with surgery to bypass or remove the part of the colon
that’s lacking nerve cells. There are two ways this can be done: a pull-through surgery or
an ostomy surgery.
Nursing Intervention
- Record and report any redness, irritation, and rashy appearances of the skin around the
stomach.
- Observe for signs of pain and provide comfort measures.
- Maintain fluid balance.
- Provide oral and nasal care.
- Instruct family on how to take care for colostomy at home.

VIII. SPINA BIFIDA

 - It is a condition that affects the spine and usually apparent at birth. It is a type of neural
tube defect (NTD). Spina Bifida can happen anywhere along the spine if the neural tube
does not close all the way.
Signs and Symptoms
- Open spinal canal over some vertebrae, usually in the middle or lower part of the back
- Membranes and spinal cord pushed outside the back in an exposed or skin-covered
sack.
- Weak or paralyzed leg muscle
- Seizures
- Deformed feet
- Hips that are not even
- Scoliosis
Medical Treatment
- Fetal surgery during pregnancy or surgery on the baby right after birth.
Nursing Intervention
- Prevent infection and observe for any signs of infection to the site.
- Maintain skin integrity
- Educate the family about the condition and provide support.

IX. HYDROCEPHALUS
- It is the buildup of fluid in the cavities (ventricles) deep within the brain. The excess fluid
increases the size of the ventricles and puts pressure on the brain.
Signs and symptoms
- Head is unusually large
- Rapid increase in the size of the head
- Bulging or tense soft spot on the top of the head
Medical Treatment
- Mostly, surgical insertion of a drainage system
Nursing Intervention
- At least every 2 to 4 hours, monitor the newborn’s level of consciousness; check the
pupils for equality and reaction; monitor the neurologic status, and observe for a shrill
cry, lethargy, or irritability; measure and record the head circumference daily, and keep
suction and oxygen equipment convenient at the bedside.
- Closely observe for and promptly report any signs of infection; perform wound care
thoroughly as ordered, and administer antibiotics as prescribed.
- The newborn needs social interaction and needs to be talked to, played with, and given
the opportunity for activity; and provide toys appropriate for his mental and physical
capacity.
- Explain to the family the condition and the anatomy of the surgical procedure in terms
they can understand; encourage them to express their anxieties and ask questions; and
give accurate, nontechnical answers that are easy to understand.
- Demonstrate care of the shunt to the family caregivers and have them perform a return
demonstration; provide them with a list of signs and symptoms that should be reported,
and discuss appropriate growth and development expectations for the child, and stress
realistic goals.

X. OTITIS MEDIA
 - An ear infection (sometimes called acute otitis media) is an infection of the middle ear,
the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear.
Children are more likely than adults to get ear infections.
Signs and symptoms
- Ear pain
- Loss of balance
- Hearing difficulties
- Unusual irritability
- Difficulty sleeping or staying asleep
- Tugging or pulling at one or both ears
- Fever
- Fluid draining from ears
Medical Treatment
- Chronic conditions of otitis media are difficult to treat. Furthermore, otitis media is often
treated with antibiotics administered as drops. Patient may also be instructed on how to
suction fluids out through the canal before administering drops.
Nursing Intervention
- Have the child sit up, raise head on pillows, or lie on unaffected ear.
- Apply heating pad or a  warm hot water bottle to lessen pain
- Encourage breastfeeding of infants as breastfeeding affords natural immunity to
infectious agents; position bole-fed infants upright when feeding.
- Teach family members to cover mouths and noses when sneezing or coughing and to
wash hands frequently.
- Assess hearing ability frequently.

XI. MENINGITIS
- Meningitis is an inflammation (swelling) of the protective membranes covering the brain
and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and
spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and
other types of infections also can cause meningitis.
Signs and symptoms
- High fever
- Constant crying
- Excessive sleepiness or irritability
- Difficulty waking from sleep
- Inactivity waking from sleep
- Inactivity or sluggishness
- Not walking to eat
- Poor feeding
- Vomiting
- Bulge on the soft spot on the top of a baby’s head
- Stiffness in the body and neck
Medical Treatment
- Acute bacterial meningitis must be treated immediately with intravenous antibiotics and
sometimes corticosteroids. This helps to ensure recovery and reduce the risk of
complications, such as brain swelling and seizures. Antibiotics can't cure viral meningitis,
and most cases improve on their own in several weeks. Treatment of mild cases of viral
 meningitis usually includes: bed rest, plenty of fluid intake, over-the-counter pain
medications to help reduce fever and relieve body aches.
Nursing Intervention
- Monitor vital signs and neurological status
- Assess for nuchal rigidity, twitching, increased restlessness, and irritability
- Monitor arterial blood gases (ABGs) and oxygen saturation.
- Maintain head or neck in midline position, provide small pillow for support.
- During reposition, avoid bending of the knee and pushing heels against the mattress.
- Provide comfort measures and Decrease external stimuli such as quiet environment,
soft voice, and gentle touch.
- Elevate the head of the bed 30°, and avoid neck flexion and hip flexion.
- Administer medicine as prescribed

XII. FEBRILE SEIZURE

- A febrile seizure is a convulsion in a child that's caused by a fever. The fever is often
from an infection. Febrile seizures occur in young, healthy children who have normal
development and haven't had any neurological symptoms before.
Signs and Symptoms
- Fever higher than 100.4 F (38.0 C)
- Lose consciousness
- Shake or jerk the arms and legs
Medical Treatment
- Most children don’t need any medication. Treatment of recurrent febrile seizures
includes doses of medicine plus dose of diazepam gel administered rectally.
Nursing Intervention
- Assess the child’s airway patency using the look, listen and feel approach.
- Auscultate lungs for the presence of normal or adventitious breath sounds.
- Place the child on a flat surface then turn the head on the side during a seizure episode.
- Loosen any restrictive clothing, especially on the neck, chest, and abdomen.
- Suction secretions gently as indicated.
- Provide supplemental oxygenation as indicated.
- Prepare for/assist with possible intubation as indicated.

XIII. AUTISM
- Also called Autism Spectrum Disorder (ASD), is a complicated condition that includes
problems with communication and behavior. It can involve a wide range of symptoms
and skills. ASD can be a minor problem or disability that needs full-time care in a special
facility.
Signs and Symptoms
- Social communication and Social interaction:
o Avoids or does not keep eye contact
o Does not respond to name b 9 months of age
o Does not show facial expressions like happy, sad, angry, and surprised by 9
months of age
o Does not play simple interactive games by 12 months of age
o Uses few or no gestures by 12 months of age
 o Does not share interests with others by 15 months of age
o Does not point to show you something interesting by 18 months
o Does not notice when others are hurt or upset by 24 months
o Does not notice other children and join them and play by 36 months
o Does not pretend to be something else, like teacher or hero by 48 months
o Does not sing, dance or act for you by 60 months
- Restricted or repetitive behaviors or interests
o Lines up toys or other objects and gets upset when order is changed
o Repeat words or phrases over and over (echolalia)
o Plays with toys the same way every time
o Is focused on parts of objects
o Gets upset by minor changes
o Has obsessive interests
o Must follow certain routines
o Flap hands, rocks body, or spin self in circles
o Has unusual reactions to the way things sound, smell, taste, look, or feel
- Other characteristics
o Delayed language skills
o Delayed movement skills
o Delayed cognitive or learning skills
o Hyperactive, impulsive, or inattentive behavior
o Epilepsy or seizure disorder
o Unusual eating and sleeping habits
o Gastrointestinal issues
o Unusual mood or emotional reactions
o Anxiety, stress, or excessive worry
o Lack of fear or more fear than expected
Medical Treatment
- There is no current standard treatment for ASD. The most effective way to help
minimize symptoms and maximize abilities is through therapies. The most effective
therapies and interventions are often different for each person. Therapies includes:
behavior management therapy, cognitive behavior therapy, early intervention,
educational and school-based therapy, join attention therapy, medical treatment,
nutritional therapy, occupational therapy, parent-mediated therapy, physical therapy,
social skills training, and speech-language therapy.
Nursing Intervention
- Tailor care based on sensory sensitivity and ability to communicate of the patient/
- Dim the lights, use weighted blanket or vests.
- Allow repetitive movement that doesn’t hinder care

XIV. CONGENITAL HEART DISEASE

- Congenital heart disease is one or more problems with the heart's structure that exist
since birth. Congenital means that you're born with the defect. Congenital heart
disease, also called congenital heart defect, can change the way blood flows through
your heart. Some congenital heart defects might not cause any problems. Complex
defects, however, can cause life-threatening complications
Signs and Symptoms
 - Rapid heartbeat
- Rapid breathing
- Swelling of legs, tummy, or around the eyes
- Extreme fatigue and tiredness
- Cyanosis
- Tiredness and rapid breathing when baby is feeding
Medical Treatment
- Mostly, children with congenital heart disease don’t need treatment, but others do.
Treatment can include medicines, catheter procedures, surgery, and heart transplant.
The treatment depends on the type of defect, how severe it is, and child’s age, size, and
general health.
Nursing Intervention
- Assess heart rate and blood pressure
- Note skin color, temperature, and moisture
- Check for peripheral pulses, including capillary refill
- Assess for fatigue and reduced activity tolerance
- Assess for heart sounds for gallops
- Monitor ECG for rate, rhythm and ectopy
- Provide adequate rest periods
- Position child in semi-fowler’s position
- Administer oxygen as prescribed.
- Administer medication as prescribed.

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