ABSTRACT
Essential facts Faltering growth, previously called failure to thrive, refers to a slower rate of weight gain in childhood than expected for age and sex. While newborns normally lose weight in the first days of life, persisting or large weight losses can cause concern.
Subject(s)
Failure to Thrive/diagnosis , Failure to Thrive/nursing , Child , Child, Preschool , Failure to Thrive/etiology , Humans , Infant , Infant, Newborn , Practice Guidelines as TopicABSTRACT
Failure to rescue is a major cause of mortality in acute care settings. Several factors contribute to this problem, and nurses hold a significant key to addressing the issue. Using bell curves to analyze patient assessment data enables nurses to recognize indicators of impending crisis and act expediently to safeguard the health of the patient.
Subject(s)
Critical Care/methods , Critical Care/standards , Failure to Thrive/diagnosis , Failure to Thrive/nursing , Nurse's Role , Nursing Staff/education , Education, Nursing, Continuing , Humans , Practice Guidelines as TopicABSTRACT
BACKGROUND: The aim of this study was to report on the clinical outcome and safety of jejunostomy tube feeding used in our clinical setting for more than 14 years. MATERIAL AND METHODS: A retrospective study of all children who underwent a surgical catheter jejunostomy placement between July 1996 and March 2010 was conducted. Data were collected regarding the outcome and complications. RESULTS: Thirty-three children (14 girls) were included. The median age at the time of primary surgery was 1.43 years (range, 0.15-17.7 years), and the median time of follow-up was 2.34 years (range, 0.27-12.6 years). Seventeen children were severely neurologically impaired (NI). Surgical insertion of a jejunostomy tube was performed due to 1 or more of the following indications: gastroesophageal reflux disease (GERD), failure to thrive, recurrent pneumonia, esophageal disease, or oral feeding difficulties. The effect of the indications showed a reduction in GERD and pneumonia. Feeding difficulties also decreased. Weaning was possible in 12 of 16 children without NI but in only 2 of 17 with NI. Major complications requiring surgical reoperation affected 8 children. No mortality was related to the jejunostomy feeding catheter. CONCLUSION: In selected cases, surgically placed jejunostomy tubes for feeding in children is an effective and safe method to overcome GERD, feeding difficulties, or recurrent pneumonia without major surgery.
Subject(s)
Enteral Nutrition/methods , Feeding Behavior , Intubation, Gastrointestinal/methods , Jejunostomy , Adolescent , Child , Child, Preschool , Esophageal Diseases/nursing , Failure to Thrive/nursing , Feeding and Eating Disorders of Childhood/nursing , Female , Gastroesophageal Reflux/nursing , Humans , Infant , Jejunostomy/adverse effects , Jejunostomy/methods , Jejunostomy/nursing , Male , Nervous System Diseases/nursing , Pneumonia/nursing , Retrospective Studies , Treatment OutcomeSubject(s)
Feeding and Eating Disorders of Childhood/nursing , Breast Feeding , Child, Preschool , Cooperative Behavior , Counseling , Education/methods , Failure to Thrive/nursing , Failure to Thrive/prevention & control , Female , Food Preferences , Germany , Humans , Infant , Infant Care , Infant Food , Interdisciplinary Communication , Male , Mother-Child Relations , Nutritional Requirements , Power, Psychological , WeaningABSTRACT
The acuity and number of children with life-threatening, life-limiting, and chronic conditions has increased dramatically over the past decade. The pediatric home care nurse needs a special body of knowledge and repertoire of tools to accurately assess, intervene, manage, evaluate, and provide resources to this most vulnerable population. Inherent in caring for these children is the need to support the family, nurturing the parents who care for chronically ill children at home.
Subject(s)
Home Care Services , Nurse's Role , Pediatric Nursing/methods , Developmental Disabilities/complications , Developmental Disabilities/nursing , Diarrhea, Infantile/complications , Diarrhea, Infantile/nursing , Failure to Thrive/complications , Failure to Thrive/nursing , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/nursing , Home Nursing/education , Horner Syndrome/complications , Horner Syndrome/nursing , Humans , Hydrocephalus/complications , Hydrocephalus/nursing , Infant , Infant, Newborn , Infant, Premature , Male , Muscle Hypotonia/complications , Muscle Hypotonia/nursing , Nursing Assessment/methods , Patient Care PlanningABSTRACT
Increasing numbers of older adults require rehabilitation therapy upon discharge from a hospital. This pilot study tested a tool developed to assess failure to thrive syndrome (FTT) in patients admitted to a long-term rehabilitation unit (N = 34), examined the association among commonly recognized FTT factors (persistent, unexpected impairment in physical function, cognitive impairment, and poor nutrition and mood state), and investigated relationships between FTT factors and discharge disposition. Patients with a high level of physical function differed from those with a low level of function in terms of age, mood state, and discharge disposition. Patients discharged home differed from patients who were unable to return home in mood state, physical function score, and admission serum albumin. Suggestions for practice and further research are offered.
Subject(s)
Data Collection/methods , Failure to Thrive/diagnosis , Geriatric Assessment/methods , Nursing Assessment/methods , Activities of Daily Living , Aged , Data Collection/standards , Failure to Thrive/nursing , Failure to Thrive/physiopathology , Failure to Thrive/psychology , Female , Geriatric Nursing/methods , Humans , Male , Mental Competency , Mental Health , Nursing Assessment/standards , Nursing Evaluation Research , Nursing Homes , Nutrition Assessment , Nutritional Status , Outcome Assessment, Health Care , Patient Discharge/statistics & numerical data , Pilot Projects , Prospective Studies , Quality of Life , Rehabilitation Centers , Rehabilitation Nursing/methodsABSTRACT
This paper describes a significant incident involving an infant admitted with Failure To Thrive (FTT), her young mother and the author as the nurse involved. This incident led to reflection on practice and exploration of the effects of making assumptions and premature judgments on the author's nursing actions. Previous experiences, personal beliefs and the influence of colleagues' opinions on the author's behaviour helped make this incident a practice changing experience.
Subject(s)
Communication , Failure to Thrive/nursing , Judgment , Nurse-Patient Relations , Pediatric Nursing , Adult , Female , Humans , InfantSubject(s)
Breast Feeding , Dietary Supplements , Failure to Thrive/nursing , Infant Food , Administration, Oral , Humans , Infant , Infant, NewbornABSTRACT
AIMS: To determine whether home intervention by a specialist health visitor affects the outcome of children with failure to thrive. METHODS: Children referred for failure to thrive were randomised to receive conventional care, or conventional care and additional specialist home visiting for 12 months. Outcomes measured were growth, diet, use of health care resources, and Bayley, HAD (hospital anxiety and depression), and behavioural scales. RESULTS: Eighty three children, aged 4-30 months, were enrolled, 42 received specialist health visitor intervention. Children in both groups showed good weight gain (mean (SD) increase in weight SD score for the specialist health visitor intervention group 0.59 (0.63) v 0.42 (0.62) for the control group). Children < 12 months in the intervention group showed a higher mean (SD) increase in weight SD score than the control group (0.82 (0.86) v 0.42 (0.79)). Both groups improved in developmental score and energy intake. No significant differences were found for the primary outcome measures, but controls had significantly more dietary referrals, social service involvement, and hospital admissions, and were less compliant with appointments. CONCLUSIONS: The study failed to show that specialist health visitor intervention conferred additional benefits for the child. However, the specialist health visitor did provide a more coordinated approach, with significant savings in terms of health service use. Problems inherent to health service research are discussed.
Subject(s)
Community Health Nursing , Failure to Thrive/nursing , Child Behavior , Child Development , Child Health Services/statistics & numerical data , Child of Impaired Parents , Child, Preschool , Diet , England , Female , Follow-Up Studies , Growth , Humans , Infant , Male , Mothers/psychology , Patient Dropouts , Referral and Consultation , Regression Analysis , Single-Blind MethodSubject(s)
Child Nutritional Physiological Phenomena , Community Health Nursing/methods , Failure to Thrive/diet therapy , Failure to Thrive/nursing , Child , Child, Preschool , Failure to Thrive/diagnosis , Failure to Thrive/etiology , Failure to Thrive/psychology , Humans , Infant , Infant, Newborn , Nursing Assessment/methods , Nutrition Assessment , Pediatric Nursing/methods , Psychology, Child , Risk FactorsABSTRACT
OBJECTIVE: To evaluate the effectiveness of a health visitor led intervention for failure to thrive in children under 2 years old. DESIGN: Controlled trial, randomised by primary care practice. SETTING: Newcastle upon Tyne health district. INTERVENTION: Structured health visitor management, with dietetic, paediatric, and social work input as required. SUBJECTS: 229 children (120 in intervention practices and 109 in control practices) were identified as failing to thrive by population screening during the first 2 years of life. Follow up was by home visit of a research nurse and review of the childrens' records at age 3 years. MAIN OUTCOME MEASURES: Follow up weight and height and number of routinely collected weights. RESULTS: 95 of the 97 families offered intervention completed at least the initial assessment. At follow up, 187 (82%) records were reviewed, and these suggested that 15 (16%) controls were lost to follow up immediately after the screening weight was taken compared with only one child in the intervention group. In the 134 (58%) families who consented to home visits, children in the intervention group were significantly heavier and taller and were reported to have better appetites than childen in the control group, although both groups were equally satisfied by the services they had received. When the children were last weighed, 91 (76%) in the intervention group had recovered from their failure to thrive compared with 60 (55%) in the control group (P<0.001). CONCLUSION: In failure to thrive, health visitor intervention, with limited specialist support, can significantly improve growth compared with conventional management.
Subject(s)
Community Health Nursing/methods , Failure to Thrive/nursing , Body Height , Cohort Studies , England , Failure to Thrive/diet therapy , Follow-Up Studies , Humans , Infant , Prognosis , Weight Gain , Weight LossABSTRACT
The inability to successfully feed a young infant or child is as worrisome to parents as it is to the health care provider. Early growth failures are likely to reflect difficulty with infant homeostasis and often respond to medical management of the physical problem that is temporarily interfering with the infant's ability to feed by mouth. In addition to medical management, however, treatment also necessitates investigation and management of behavioral problems that so universally accompany growth failure. This article presents a case study of a child who presented with poor growth and respiratory symptoms associated with nonregurgitant gastroesophageal reflux, a clinical entity that can be difficult to recognize. Although surgical management of this condition was successful, persistent failure-to-thrive continued and was seemingly recalcitrant to treatment. The use of cyproheptadine as an appetite stimulant to promote weight gain in this child is discussed with a review of the current literature regarding this pharmacologic approach to poor weight gain. A behavioral-based treatment plan is described as an alternate management method, avoiding the use of pharmacologic agents in general.
Subject(s)
Failure to Thrive/etiology , Gastroesophageal Reflux/complications , Cyproheptadine/administration & dosage , Failure to Thrive/drug therapy , Failure to Thrive/nursing , Gastroesophageal Reflux/nursing , Gastroesophageal Reflux/surgery , Gastrointestinal Agents/administration & dosage , Humans , Infant , Male , Patient Care PlanningABSTRACT
Estudio descriptivo, retrospectivo y longitudinal, el cual pretende describir en 4 instancias el crecimiento físico del lactante menor de un año que se controlan en el Consultorio "Los Castaños". La muestra en estudio corresponde al universo (N=41), que lo conforman todos los niños que cumplieron un año entre Marzo y Agosto de 1997 y que pertenecen al estudio Fondecyt (N§ 1950820). Los datos fueron extraídos de la ficha clínica de los niños y fueron procesados a través de programas computacionales. Los resultados muestran que si bien la mayoría de los niños presentan al nacer peso y talla normal, a medida que crecían se fue produciendo un deterioro progresivo, cuyo parámetro más afectado fue la talla, el que se evidenció particularmente en el sexo masculino. Se puede concluir que si bien los párametros peso y talla presentan una evolución con un peak al tercer mes de vida, se evidencia un deterioro progresivo de dichos parámetros a partir del sexto mes de edad. Se destaca la evolución normal del crecimiento físico del sexo femenino, por sobre el masculino. Se sugiere realizar un nuevo estudio, donde sea posible identificar tanto factores positivos como negativos que influyen en la talla del niño, para identificar factores modificables, sobre las cuales se puede realizar una intervención
