Cardiac or Respiratory Issues

Feeding and Growth Issues

Congenital Anomalies and Deformities

Usually on oxygen- most commonly given by Nasal Cannula- small flexible plastic tubing that fits inside the nose. May be low or high flow- meaning the amount of oxygen flowing through tubing. Other ways to provide oxygen are by trach collar or ventilator.

Cardio-respiratory monitors include readings with heart rate, respiratory rate, and Spo2 (which is a reading of how much oxygen your blood is caring). Spo2 monitors can be used alone as well.

 

Apnea monitor- record respiratory and heart rate reading, they are able to store information and reviewed at a later date, alarms are set to the Ordering Physicians specifications, the alarm for an apnea monitor is very loud- like a fire alarm, they are designed to wake you up if you are sleeping.

Example: You have a visit with a baby with Trisomy 21, 3 weeks old on a NC and Spo2 monitor.

Infant will tire easily

Possible poor tone- can lead to obstruction of airway, you will need to hold the infant and protect the airway as well

You see Oxygen so this infant either has cardiac or respiratory issues- we do know that he has downs so most likely cardiac related.

If doing anything “physical” with baby- you will need to watch his cues to make sure he is tolerating your activity, this will be especially important as the child grows.

Always remember when monitors alarm to check you child first-if pink and breathing it may be a false alarm, next check connections to monitor.

NG tube- nasogastric tube- goes from the nose to the stomach, used for infants that have difficulty with suck swallow reflex, oral aversions, or respiratory issues.

MIC- KEY button- tube that is surgically implanted to abdomen, used for long term feeding difficulties.

NJ- nasojejeunal tube- from nose to jejunum, needs to by placed by MD and needs radiology exam to check for placement. Used when gastric emptying is delayed or prevention of abdominal distention

Feeding pumps- used to provide nutrition, delivered over long period of time, usually at night, called continuous feeds.

Bolus feeds are a feeding given by gravity over short period of time.

You should not make child perform “physical” activities after feedings due to risk of aspiration. Many children with MIC-KEY button have had a Nissan Fundoplacation- there fore are not supposed to be able to aspirate due to inability to vomit.

Tubes are easily pulled out, if surgically implanted they require emergency intervention so entry site does not close.  If NG tube is pulled out during feeding child is at great risk of aspiration.

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Most require surgical intervention to “fix” deformity or to make activities of daily living easier on child and family. Prosthesis are used for some anomalies.

QUESTIONS?