Toddler with failure to thrive secondary to atopic dermatitis

Toddler with failure to thrive secondary to atopic dermatitis

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Diseases have been pert of mankind for as long as one can remember, various diseases affect different parts of the body and the causes of such conditions are also different, the skin of a human being is also prone to some diseases. One of the diseases that affect the skin is Atomic dermatitis, the disease affects a significant number of the world’s population, and another aspect of the disease is that it is long lasting.

The term atopic is derived from a Greek word meaning “strange”. Dermatitis means “inflammation of the skin”. The condition causes the skin to become tremendously itchy, red, and even swelling. Cracking of the skin, scaling, vesicle formation and weeping are the other conditions associated with the disease. Another condition that affects almost all the people suffering from atopic dermatitis is dry skin. The disease mainly affects young children, and infants, but it may continue to adulthood.

JT is a 2 YOWM who is brought to the medical clinic by his mother, JT has been experiencing itchy rash on some parts of the body such as the hands, face, and neck. JT has been experiencing the condition for approximately 2 months, JT also coughs a lot during the night, and has congested chest. JT has another sibling 5 YO sister who is suffering from asthma. JTs mother and father are separated, the father is paying for the child support as for now but is threatening to stop, JT also has to be taken to a day care 3 times a week at a neighbor’s home.

The condition that JT is suffering from is at times hereditary, and after enquiries it was established that the family has numerous cases of allergies. JT’s father was diagnosed and treated of asthma as a child. Upon examination JT was found to show symptoms associated with dermatitis, he had crusted plaques, on the neck, extensor surfaces, groin, and face. He has also lost some weight from about 11.6 down to 11 kg. JT has no appetite, the mother is also not sure of the right food to give to JT.

JT currently is eating well according to the mother, but unfortunately he is loosing weight, the mother on the other hand is not sure on what to give JT. From the information gathered from the mother it can be ascertained the mother is not giving JT proper food. From a research carried out by the American Academy of Pediatrics it was established that feeding children exclusively on breast milk prevented them from developing dermatitis as opposed to children who were fed on milk formulas from the cows. Some children may also be allergic to some types of food thus it is very important that the type of food a child takes in not causing any reactions on the skin. JT reacted positively to some foods such as milk, wheat, and even milk that at times cause allergies to some people. JT also reacted positively to certain elements that at times causes allergies such as dust, and also cat dander. By getting access to such information I would be able to advise JTs mother accordingly on what food to give to the child so that the condition can be eliminated entirely or managed. Children of different ages need different food with nutritious value and such information will be helpful in providing proper guidance (Larsen, 2012).

So as to help JTs mother feed him properly, a menu had to be given to her. The menu that was devised took into consideration a number issues such as age. Children such as JT who is suffering from dermatitis needs to be fed on foods that will help in managing or eliminating the disease. After looking at the foods that were not affecting JT, the recommended menu is: For breakfast t the child should be given extensively hydrolyzed formulas mixed with some small amount of cereals. For lunch the child should be fed on a mixture of blended fruits and milk. For supper the child should be given any food made of cereals that the child can be able to eat comfortably.

When at home with the child, JTs mother should make sure that the child has breakfast at the same time on a daily basis, as it will make the child feed better. She should also ensure that the child is given some light food in between the day. Children feed well in the morning if given the food at a particular time, changing the time might have an effect on the child’s appetite. When the child is taken to day care the mother should always call just to remind whoever is looking after the child on the feeding time. JTs mother should also give a copy of the menu to the person looking after the baby together with feeding times (Larsen, 2012).

Case

JT is a 2 YOWM who is brought to the medical clinic by his mother, this after the mother noticed that he had some inflammation on the skin, the child was also coughing and had a congested chest. He had crusted plaques on various parts of the body such as the groins, neck, and the face. On admission the child weighed 11 kg and a length of 83 cm the weight was ideal for his height, but it was a decrease from the last visit when he weighed 11.6 at 18 months. JT was very irritable and did not cooperate in any way as he was very uncomfortable. Two months later JT had to be taken to an allergist as signs of dermatitis were still visible but was not irritated as the first visit. The allergist carried some tests so as to be able to ascertain the allergens that could aggravate atopic dermatitis. The RD confirmed that

Initial assessment and diagnosis

As it is required in any initial assessment, the medical records for the patient had to be reviewed by the RD. The health history given by the mother was able to reveal that the family had a history of allergies; JTs father had asthma as a child and was eventually treated. JTs sister was also suffering from asthma and was receiving treatment (Wong, 2011).

Nutrition Diagnostic Reasoning

After looking at the assessment the RD was able to compare the result with potential nutrition diagnosis and ruled out a possibility of the food taken by the child as the cause of the condition. Clearly JT had an irritated skin. The RD was not able to point out any considerable nutrition problems that were causing the allergy. The history of allergies in the family prompted the Physician to recommend Disprosone cream that was to be applied on all the affected areas.

Determining the Nutrition Prescription

The nutrition Prescription is based on the condition of the health of the patient and the result of the diagnosis. It is also based on the current standards of reference and the guidelines which have been adjusted to fit the needs of the patient (Wong, 2011).

Nutrition intervention

Nutrition intervention is specifically designed to improve the nutrition diagnosis. In this particular case the food prescribed will help in managing the condition as it is the only way that can be used together with the application of the cream. Once the diet is issued to the patient, the dietetic technician registered commonly known as the (DTR) will be at liberty to report any problem to the RD (Larsen, 2012).

Monitoring

As the child will be mostly at home with the mother it will be the responsibility of the mother to make sure that the child is fed on the recommended diet. The mother is also required to make sure that the child is taken back to the hospital for check ups or if there is a problem. The mother should also make sure that the child does not live in conditions that are likely to aggravate the condition. The measures that can be taken by the mother is making sure the areas where the child is staying is dust free, and the room free from cigar smoke (Wong, 2011).

Conclusion

Some medical conditions can be treated by giving the patient the right nutrition; however the method of implementation can really make a difference. Proper diagnosis of a condition is the first step towards eliminating or improving the condition. Atopic dermatitis is a disease that affects mostly the children, and then disappears by itself. At times the disease may persist even in adults mostly in cases where the disease has been inherited, but even in such cases the disease can be managed so that the condition is not aggravated.

Reference

Wong, D. L. (2011). Wong’s nursing care of infants and children (9th ed.). New York: Mosby/Elsevier.Larsen, L. (2012). Childhood diseases and disorders sourcebook: basic consumer health information about the physical, mental, and developmental health of pre-adolescent children … (3rd ed.). Detroit, MI: Omnigraphics.