Question

Create a power about Neonatal Diabetes. Discuss its etiology, complications and nursing interventions.

Answer 1

Neonatal Diabetes Mellitus:

-1st 6 months of life
-100,000 - 500,000 live births
-infants don't produce enough insulin

Two types:
1) 40% condition is transient= disappers in infancy and reappears late in life ( transient neonatal diabetes mellitus)

2) permanent diabetes mellitus (60%)
-genes= KCNJ11 (30%) and ABCC8 (20%) both code for K-ATP dependent Channels
INS gene (20%) AD or AR
frequency 1 in 200,000

Neonatal diabetes Mellitus

-sever growth retardation
-failure to grow
-ketoacidosis

Etiology:

Excess bilirubin (hyperbilirubinemia) is the main cause of jaundice. Bilirubin, which is responsible for the yellow color of jaundice, is a normal part of the pigment released from the breakdown of "used" red blood cells.

Normally, the liver filters bilirubin from the bloodstream and releases it into the intestinal tract.

- A newborn's immature liver often can't remove bilirubin quickly enough, causing an excess of bilirubin. Jaundice due to these normal newborn conditions is called physiologic jaundice, and it typically appears on the second or third day of life.

Other causes:

• Internal bleeding (hemorrhage)
• An infection in your baby's blood (sepsis)
• Other viral or bacterial infections
• An incompatibility between the mother's blood and the baby's blood
• A liver malfunction
• An enzyme deficiency
• An abnormality of your baby's red blood cells that causes them to break

Complications:

• Developmental delay such as muscle weakness and learning disabilities
• Diabetic ketoacidosis
• Low birth weight
• Muscle weakness
• Epilepsy
• Macroglossia - a larger than normal tongue

Nursing intervention:

• Assessment of vital signs, skin condition
• Phototherapy as per Dr order
• Covering of eyes and male reproductive organ so as to avoid directly contact with phototherapy
• Encouraging breastfeeding
• Strict Intake Output charting
• Preventing injury/progression of condition,
• Providing support/appropriate information to family,
• Maintaining physiological homeostasis with bilirubin levels declining
• Preventing complications.
• Careful monitoring