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