Lactose Intolerance

Definition: This is the inability to digest lactose due to a lack of the enzyme lactase in the intestines. Lactose is commonly found in dairy products.

Signs and Symptoms: Abdominal pain, diarrhea, constipation, bloating, and abdominal distension.

Diagnostics: Hydrogen breath test.

Drug Therapy: Enzyme medications such as Lactaid are administered. Mineral oil is given for constipation. Calcium with vitamin D is also advised.

Nursing Care: Replace dairy products with soy. A nutritionist may be consulted to speak about dietary contents. Advise the parents and the child about any age-appropriate foods that may need to be avoided.

Celiac Disease

Definition: Inability to digest gluten due to abnormal mucosa in the intestines.

Signs and Symptoms: Foul-smelling stool, diarrhea, nausea, vomiting, irritability, anemia, and weakness.

Complications: Celiac crisis and metabolic acidosis can occur.

Diagnostics: Stool sample and biopsy of the small intestine.

Drug Therapy: Iron, folic acid, supplements of the fat-soluble vitamins A, D, E, and K are administered.

Nursing Care: Teach the parent to avoid foods with wheat, rye, barley, and oats in the diet. Administer supplements as ordered. Monitor for celiac crisis. A nutritionist may be consulted for dietary instructions.

Failure to Thrive

Definition: This is an organic or inorganic cause of failure of a child to grow appropriately. Organic causes are drug/al- cohol abuse, poverty, single parenthood, and disturbance in the mother-child bond. Common inorganic causes are AIDS, chronic renal failure, neurological imbalances, congenital heart defects, Down syndrome, and cystic fibrosis.

Signs and Symptoms: Weight loss, growth impairment, anorexia, irritability, loss of appetite, and flat affect.

Complications: Severe weight loss and malnutrition can occur.

Diagnostics: CBC and electrolytes can determine malnutrition.

Drug Therapy: Parenteral nutrition, increased calories, and IV fluids are administered.

Nursing Care: Gastric feedings may be needed in severe cases. Daily weights are done in the morning. IV fluids are administered to maintain hydration. Teach parents the importance of increasing calorie intake. Support for the family is also needed.

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