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Discussion

Failure to thrive, Care plan

I had a patient this week in Peds clinical who was 7 months old and failure to thrive. He got distracted VERY easily so we limited him to a half hour to each bottle and he only drank 5 oz. He had reduced muscle tone, could not sit or crawl. He had a disinterested in food. Mom said he did not like to take food from spoon but seemed to from others. He had changes in his weight (6.3 kg).

My first diagnosis was imbalanced nutrition.

I cannot think of a second one...

Thank you! :)

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Impaired parenting

With low muscle tone and feeding issues, risk for aspiration is very real and could be a reason for low feeding volume. A baby can micro aspirate without a color change. Interventions would be a speech evaluation.

I strongly disagree with impaired parenting soley on the basis that nurses can get him to take solids. Diffuse hypotonia is an organic problem, not at all psychosocial, and is in fact most likely the primary cause of his lagging milestones and feeding issues.

A PT consult also would definitely be required. This child needs early intervention services for PT/OT in addition to a medical work up. Medical causes could be as benign as congenital hypotonia all the way up to an undiagnosed neuromuscular dystrophy, a chromosomal deletion, and Prader Willi syndrome. A genetics and neurology consult may be required.

i had a pt like this and he was" physical reconditioning, you can use impaired skin integrity, impaired physical mobility

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Thank you so much! Helped a lot :)

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