Risk Factors
Caused by environmental factors: maternal folic acid deficiency and intake of alcohol during pregnancy
Cleft lip/Cleft palate
caused by a failure of the medial nasal and maxillary processes to join
cleft lip
Pyloromyotomy, is when the pylorus muscle is surgically split down, but not including the submucosa, which allows for the enlarging of the lumen
Hypertrophic pyloric stenosis (HPS)
Skin- cold, dry, gray, loss of turgor, Mucous Membrane- dry, eyes- sunken, fontanelle-sunken, behavior- lethargic, pulse- rapid, weak, bp- low, RR- rapid
Dehydration
Cleft lip/Cleft palate
Failure to pass first stool, indicates possible intestinal atresia
constipation
caused by failure of palatal shelves to fuse
cleft palate
This surgery involves wrapping the fundus of the stomach around the distal esophagus to prevent reflux of the stomach contents into the esophagus
Nissen Fundoplication(Treatment for severe GER)
a small open notch, or opening extending all the way to the nose
cleft lip/cleft palate
Primary goal is to prevent aspiration. The best method for feeding is to support the infant's head in an upright position.
Hypertrophic pyloric stenosis
the result of many possible disease processes that cause abnormal fluid losses through the skin, respiratory, renal, and (most commonly) GI systems
Dehydration
H2- histamine receptor antagonists such as cimetidine(tagamet), ranitidine(Zantac), or famotidine (pepcid)
GER
malodorous stool, weight loss, sunken fontanelles, irritability progressing to lethargy
Diarrhea
Measurement of Intake and Output
Dehydration
Too much acid in the duodenum (first part of the small intestine) and certain congenital diseases, such as diabetes
Hypertrophic Pyloric Stenosis (HPS)
Infants that have a high protein or fat diet. Usually seen in formula fed babies
Restore the fluid and electrolyte balance and to treat the underlying cause
diarrhea/gastroenteritis
Vomiting, spitting up in the first week of life
GER
focus assessment includes: careful recording of I+Os , rehydrations, correction of electrolyte imbalance, age-appropriate nutrition.
Diarrhea
Gastric contents are regurgitated into the esophagus or oropharynx and produces symptoms
GER
incompetent lower esophageal (or cardiac) sphincter
GER
Implement small and frequent feedings that have been thickened with infant cereal
GER
projectile vomiting, hungry, avid nurser, weight loss, no signs of pain or discomfort, signs of dehydration, distended upper abdomen
Hypertrpohic Plyoric Stenosis
assessment of bowel patterns including stool characteristics, diet, and concomitant medications
Constipation