abnormalities of infants

8/8/2019 Abnormalities of Infants

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ABNORMALITIES OF INFANTS

Physiologic JaundiceThe infant skin is sclera of the eyes appears noticeably yellow. This

happens because the high red blood cells count built up in utero is destroyed, heme and

globin are released.

GLOBIN is a protein components that is reused by the body and is not a factor in thisdeveloping jaundice.

HEME is further broken down into iron (which is also reused and not involve inthe jaundice and PROTOPOPHYRIN.

PROTOPOPHYRIN is the further broken down into direct bilirubin and indirectbilirubin is a fat soluble and cannot be excreted and be converted to the direct bilirubin:therefore it remains indirect bilirubin and as long as the buildup of indirect bilirubinremains in the circulatory system, the red coloring of the blood cell covers the yellow tintof the bilirubin has risen to more than 7mg/ml, however bilirubin permeates the tissueoutside the circulatory system and cause the infant to appear jaundice.

CEPHALHEMATOMA it is a hemorrhage of the blood into the subcutaneous tissue.

It is also a collection of blood under the periosteum of the skull bone, as bruisingin this location heals and the red blood cellshemolized, additional in indirectbilirubin in released and can be another cause of jaundice.

HEMANGIOMAS (BIRTHMARKS) Are vascular tumors or lesion of the skin. There are also hamangionas are common and normal to the baby and it is

sometimes it fades when reaches a school age ( 6 12 years) It is also associated between childbirth/hemangiomas to the development of

childhood cancer exist.

3 types of Hemangiomas

i) NEVUS FLAMMEUS is the muscular purple or red-dark lesion (sometimescalled a port-wine-strain because of its deep color. This type of lesion is onecommon found in face and sometimes in the thighs.

ii) STRAWBERY HEMANGIOMA refers to the elevated areas formed byimmature capillary and endothelial cells. Most are present at birth in the termneonate although they may appear up to 2 weeks after birth.

iii) CAVERNOUS HEMANGIOMA are dilated vascular spaces. They areusually rise and resembled a strawberry hemangioma in appearace.


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iv) Mongolian spot are collection of pigment cells (melanocytes) that appear asslate gray patches across the sacrum or buttocks and possibly on the armand legs.

VERNIX CASEOSA is a white cream cheese-like substance serves as a skin lubricant

in utero, usually it is noticeable on term newborns skin, at least in the skin folds at birth.

LANUGO APPEARS is a fine downy hair that covers a newborns shoulders, back andupper arms.

DESQUAMATION within 24 hours after birth, the skin of most newborns has becomeextremely dry. The dryness is particularly evident on palm of the hand and soles of thefeet.

MILIA all newborns sebaceous glands are immature. At least one point white papule(a plugged or unopened sebaceous glands) and can be found on the check or across

the bridge of the nose of almost every newborn.

ERYTHEMA TOXICUM - a new burn rash called ERYTHEMA TOXICUM and can beappears in the first fourth days of life but may appears up to two weeks of birth. It beginsas white papule, and increase severely to become erythema by the second day, andthen disappear by the third days.

HEMORRHAGIC DISEASE OF THE NEWBORN It is result from the deficiency of the VIT. K. VIT. K is essential for the formation of prothrombin function and impaired blood

coagulation VIT. K is also a formed by the action of the bacteria in the intestine. Is a phenomenon that can occur if twins are monozygotic (identical share the

same placenta) if abnormal arteriovenous shunts occur that direct more blood toone twin than the other twin.

NECROTIZING ENTEROCOLITIS (NEC) it develops in approximately 5% of allinfants in intensive care nurseries. The bowel develops necrotic patches, interfering withdigestion and possibly leading to a paralytic ileus.

RETINIPANOTHY OF PREMATURITY (ROP) an acquired ocular diseases that leadsto partial or total blindness in children, It caused vasoconstriction of the retinal bloodvessels.

PHOTOTHERAPY

Phototherapy, or light therapy, is a form of treatment for skin conditions usingartificial light wavelengths from the ultraviolet (blue light) part of the sunsspectrum. In this way, light of certain wavelengths can be delivered with a higher


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intensity, but without the light of all the other wavelengths that are present insunlight, e.g. visible light and infrared (heat producing light).

An infants liver process little bilirubin in utero because the mothers circulationdoes this for an infant.

TYPES OF PHOTOTHERAPY

Specialized light (Quarts halogen) if the baby has conversion potential of the liverthe infant is continuously exposed to specialized light (quarts halogen).

COOL WHITE DAY LIGHT or THE SPECIALIZE FLURECENT BLUE LAMP

The light are placed 12 to 30inches above the newborns bassinets or incubator.

SPECIALIZED FIBEROPTIC (FIBEROPTIC BLANKET or BILIBLANKET)

Also develop for infants newborn and are ideal for home care. The infant is undressed except for diaper so as much skin surface as possible to

expose the light. A newer innovation for hyperbilirbinemia management is the phototherapy

blanket that the baby should wrap around. Light generated by the blanket hasthe same effect on bilirubinlevels are that an infant can be held for long periodwithout interrupting the phototherapy and eye patches are neccesary.

EXCHANGE TRANSFUSION (Intensive Phototherapy)

In conjunction with hydration and close monitoring of serum bilirubin levels in thepreferred method of treatment in neonatal jaundice.

HOME PHOTOTHERAPY is primarily used for decreasing physiologic jaundice ratherthan that associated w/ blood incompatibility. It has advantage of allowing theinterrupted contact between the parents and newborn and therefore has the potential toaid bonding

The parents should know and understand the importance of the therapy to theinfant (baby) to avoid any disadvantages happened.

The light must be a full 12 inches away from the infant to prevent burning, andthe infant must continuously wearing the patches and diaper during phototherapyto protect retinas and ovaries or testes, and bilirubin level should be assessedapproximately every 12 hours.

OTHER TYPES OF PHOTOTHERAPY

Ultraviolet Light: UVB-Narrowband - treatment of psoriasis (3-5 treatments per week)


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UVB-Broadband - Treatment times for eczema / atopic dermatitis(2-3 treatmentsper week)

Fluorescent Lamp Tubes can treat vitiligo patients

NURSING INTERVENTION:

Call Your Health Care Provider If

All jaundice and other problem about infection and abnormalities of infant, and childshould be medically evaluated and always call your doctor immidiatly if symptompersist.

If Jaundice and other infection and abnormalities was not that severe we can just bring

the baby home, because the mother know already the home therapy

If Jaundice is not severe bring or just expose the child under the sun or the baby should

be exposing to sunlight.

abnormalities of infants

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