Cretinism

Definition

Is a severe deficiency of thyroid hormones in newborns

Clinical Menistafication

Decreased activities

Poor feeding and weight gain

Large anterior fontanelle

Jaundice

Umbilical hernia

Pale skin

Stunted growth

Pathophysiology

An optimal level of maternal thyroid status and iodine level counts for fetal growth

maternal thyroid hormone is the only source that crosses placenta for fetal brain development.

TH also plays a role in skeletal muscle development

Absence of thyroid hormone will affect nervous system development

Thyroid hormone is essential for growth, branching and myelination of neuronal cells of CNS at fetal and neonatal stage

So during cretinism more soft tissue is developing

It can be also due to Genetic enzyme defects

Nursing care plan

Imbalanced nutrition

Fatigue

Deficiency of knowledge

Nursing diagnosis

Expected outcome

Assessment

Intervention

Family history should be carefully reviewed for information about similarly affected infants

caregivers verbalized correct information about hypothyroidism and taking thyroid hormone replacement.

Introduce family to appropriate hypothyroidism diet.

Learn more about disease

Deficient knowledge related to lack of exposure to hypothyroidism and unfamiliarity with information sources.

Assessment

Nursing diagnosis

Imbalanced nutrition more than body requirements related to greater intake than metabolic needs as evidenced by hypotonia.

maternal history of a thyroid disorder and mode of treatment

Expected outcome

Intervention

Eat iodine rich diet and maintain weight

Evaluation

Maintain stable weight

Educate family about low fat and rich fiber diet

Client maintained a stable weight and takes in necessary nutrients

Nursing intervention

Nursing diagnosis

Evaluation

Assessment

Physical exam and history taking on daily activities

Fatigue related to impaired metabolic state

promote an environment conducive to relieve fatigue

Caregivers identified basis of fatigue and individual areas of control