PPT 14 NOTES.pdf AAAAAAAAAAAAAAAAAAAAAAA

MATERNAL AND CHILD HEALTH NURSING

1. NCM109
NEONATALDISORDERS
HIRSCHSPRUNGDISEASE
NeuralCrestCells-nervecellsaffectedinHirschsprungDx.
;Responsibleforthetensingortherelaxingoftheperistaltic
movementfromthebeginningtotheendoftheintestine
Largeintestine-housethedigestedfoodreadyfordisposal
Largeintestinelength-1.5meters
Smallintestine-forthebreakdownanddigestionoffood
Smallintestinelength-7.5meters
SigmoidColon-commonareaaffectedfortheHirschsprung
Dx.
Peristalsismovementbegintoappear@14weekAOG
@14-39weeks-expectedthatthebowelcanproduced2-3
timesperistalsismovementwhichcanlastat8-9seconds
ENS-responsibleforperistalsis

2. BariumLiquid-instilledintothelargeintestinethroughthe
anus
Ileostomyusesileostomypouch/bag
Colostomyusescolostomybag

3. AscendingColostomy-thetypeoffecalmaterialthatcanbe
collectediswatery,onethatcontainsenzymes,acidsorthe
liquidsofthestomach
TransverseColostomy-paste-likestools,oatmeal-likecan
becollectedinthistypeofcolostomy
DescendingandSigmoidColostomies-regularorsolidfecal
materialscanbecollectedinthistypeofcolostomy
***Othernotes
Fast-DigestingFoods(EasytoDigest)
Simplestarch(sugar,whiterice,whitebread,etc.)
→20-40minutes
Vegetables→30-60minutes
Breastmilk→1-2hours

4. Moderate-DigestingFoods
Grains(wholewheat,oats,brownrice,etc.)→90-
120minutes
Nuts→2-3hours
Formulamilk→3-4hours
Slow-DigestingFoods(TakeLongertoDigest)
Beef→3-4hours
Pork→4-5hours
Meatandfishproducts→Evenlongertodigest
SPINABIFIDA
NeuralTube-thestructureinadevelopingembryothat
eventuallybecomesthebaby’sbrain,spinalcordandthe
tissuesthatenclosethem;@28
th
dayafterconception-the
neuraltubecloses
Folate-avitaminthathelpformtheneuraltube;anatural
formofVitaminD
FolicAcid-syntheticformofVitaminD
OpenSpinaBifida
Lossofsensationbecausethespineisaffected
Paralysis
Bladded/bowelproblems
Scoliosis-acurveinthespine
Deformities(legs,feet,back)
Meningocele
Problemswithmovementandcontrolwithinurination
anddefecation

5. MaternalSerum-toassessthepresenceofalpha-fetoprotein
circulatingthemother’sblood
UTZ-todetectspecificdeformities
CTScan-todetermineifthesoinabifidaismild/severe
****Othernotes
ValproicAcid-contraindicatedinpregnancy;useupfolic
acid

6. HYDROCEPHALUS
Adultnormalcerebrospinalfluid-90-200mL
Newbornnormalcerebrospinalfluid-2mL/kg
Normalsizeofinfanthead-35cm
CongenitalHydrocephalus-ababyisbornwiththe
condition
AcquiredHydrocephalus-happensafterbirthandusually
duetobleedinginthebrainfromtraumaticheadinjuries,
tumororinfection
Aque-ductalStenosis-thenarrowingofasmallpassageway
thatconnectstwomajorventriclesinthebrain;primarycause
ofCongenitalHydrocephalus
Normalsizeofinfanthead-35cm
CTZ-locatedatthe4
th
ventricle
CSF-normallyproducedbythetissuesofthebrain
-CTZ
-hypothalamusisaffected
-duetocompressamigdala
-duetocompresshypothalamusandbrainstem
-frontallobe,temporalportionisaffected
-hypothalamusisaffected
-occipitallobe
-frontalcortex
-hypothalamus
-CTZ
-cerebelum
-hypothalamus
-brainstem/ponsis
-pressureincerebelum
-opticnerve,pre-frontalcortex
-pre-frontalcortex

7. Assessment
Perfectscore=15
Eyemovement=4
Verbal=5
Motorresponse=6
Ifbelow8-coma
Ifbelow3-emergencyactionisneeded
****Othernotes
Pinkishscalp-healthy
Reddish-activebleeding
-pre-frontalcortex
-cerebelum
-brainstem
-hippocampus,amigdala,
frontalandtemporalcortex

8. OTITISMEDIA
Otitisexterna(swimmer’sear)-duetocontaminatedwater
Middleear-responsibleforthetransferofsoundsand
vibration
Eardrum-protectsmiddleearfromdirectformofdirt,
bacteriaordebris
Otalgia-painfulear

9. Antibiotic-Cefuroxime
Antipyretic-Acetaminophine,Paracetamol
FEBRILESEIZURES
Tonicphase-moreonstiffeningofbody
Clonicphase-moreonthejerkingmotionintheextremities

10. *EEG-measuresbrainactivity
*Lumbarpuncture-detectsCNSinfection
U/ANormalresult-0-5puss
Diazepam-ifseizureisextensiveorlong
*****Othernotes
Roseola-aformofherpesvirus
Pyrogens-substancesthatcancausefever
Postictal-childreturnstonormalafterseizure
LabaRN!