SUBJECT - PEDIATRIC NURSING TOPIC - VITAMIN DEFICIENCY DISORDERS(FAT SOLUBLE VITAMINS). REFRENCES- RIMPLE SHARMA, NELSON PARUL DUTTA MARCIA L . LONDON

1. PEDIATRIC
NURSING
VITAMIN DEFICIENCY
DISORDERS
(FAT SOLUBLE VIT.)

4. INTRODUCTION
VITAMIN
• vitamin are a class of organic
compounds categorised as essential
nutrients.
• They are required by the body in very
small amounts.
• They fall in the category of micro
nutrients.

5. Vitamin are divided into 2 groups:-
vVITAMIN
VITAMIN A,D ,E &
K
VITAMIN B &
VITAMIN C

7. FAT SOLUBLE VIT-
The fat soluble vitamin A,D,E & K. Control
protein synthesis at either the
trancriptional or post transcriptional level.
Breast feeding is deficient in both vitamin
D & K and must be supplement with
these vitamins to protect breast feed
infants.

9. VITAMIN- ‘A’
 Vitamin-A is a fat soluble
vitamin.Vitamin-A activity is also
possessed by carotenoids found in plants.
 Hence, carotenoids are caused Pro
Vitamin-A.

10.  It occurs in 4 forms:-
Vit.A
(retinol)
Vit.A
(found in liver of
fresh water fish)
Vit.A acid
(retinoic acid)
Vit.A aldehyde
(retinol retinence)

11. ABSORPTION-
 Vitamin-A is absorbed through
lymphatic system into blood stream
along with fat & stored in large amount
in liver.

13. FUNCTIONS OF VIT-A-
 Production of retinal pigments.
 Its maintaing the integrity & the normal
functioning of glandular & epithelial
tissue.
 It supports the growth especially
skeletal muscles growth.
 It is an anti infective.

14. BENEFITS
 It is important for normal vision,and for the
immune system.
 Vitamin A also helps the heart, lungs,
kidney and others organs work properly.

16. SOURCE OF VIT.A-
There are mainly 2 types of sources –
 ANIMAL FOODS
 PLANT FOODS

17. IN ANIMAL FOODS-
EGGS FISH MEAT
BUTTER CHEESE MILK

18. IN PLANT FOODS-
SPINACH PAPAYA MANGO
PUMPKIN CARROTS

19. VIT.A DEFICIENCY-
Lack of vitamin A is called vitamin A
deficiency.
Night blindness is one of the first sign
of vitamin A deficiency.

21. CAUSES
 Breast milk
 Malabsorption
 Malnutrition

23. SIGN & SYMPTOMS-
 Night blindness
 Xeropthalmia
 Xerosis conjuctiva
 Xerosis cornea
 Bitot’s cornea
 Keratomalacia
 Impaired immunity
 Growth retardation

25. MANAGEMENT-
MANAGEMENT
Supplementation Dietary
consumption
Mild to moderate cases
Should be given 10,000ug/daily consumption of yellow
• Severe cases should get & orange fruits &
50,000ug/daily for few weeks. Vegetables.

27. PREVENTION
 Maternal high supplementation.
 Increased consumption of vit.A.
 Diet which rich in vitamin A.
 Adminstration of vit.A as a part of the
immunization schedule.

28. DAILY INTAKE-
 Infants- 400ug/day
 Children- 300-400ug/day
 Pregnancy- 750ug/day
 Lactating- 1200-1300ug/day

29. HYPERVITAMINOSIS ‘A’ -
An excess intake of retinal causes
nausea,anorexia,& sleep disorders
followed by desquatmation.

31. VITAMIN ‘D’
Vitamin D is referred to as-
‘SUNSHINE VITAMIN’.
Because it can be synthesised in body in
presence of the UV rays from sun.
Vitamin D is essential for bone growth or health
and regulation of calcium & phosphorus
levels.

32. ABSORPTION
Vitamin D is absorbed in presence of
bile & fat .
Its stored in LIVER.

34. FUNCTIONS OF VIT.D-
 It promote absorption of calcium &
phosphorus.
 Reabsorption & mobilization.
 It causes mineralization of the bones.
 It has immune regulatory role.

36. SOURCE OF VIT. D-
SUNLIGHT EGG YOLK
BUTTER CHEESE

37. DAILY REQUIREMENTS
 Infants, children, pregnant &
nursing women need 400I.U of
vitamin D.
 Older children & adults require 200
I.U of vitamin D.

38. VITAMIN D DEFICIENCY-
Lack of vitamin D result in vitamin D
deficiency in children.
Deficiency of vitamin D leads to a
disease called RICKETS.

40. RICKETS
Rickets occurs in a result of dietary
deficiency of vitamin D.
In rickets, the failure of mineralisation of
growing bones or osteoid tissue occurs.
Thus bones becomes weak & an adapts an
abnormal shape & under stress.

42. PATHOPHYSIOLOGY-
Vitamin D is useful for absorption of calcium from gut
Sunlight especially UV rays let human cells to convert vit.D from
in active stage
Inabsence of vitamin D
Dietary calcium is not properly absorbed
Resulting in hypocalcemia leads to skeletal deformities & neuro
muscular symptoms.

44. SIGN & SYMPTOMS-
 Common skeletal deformities
 Delayed closure of anterior fontaneles
 Enamel defect
 Enlargement of long bones around wrist &
ankel
 Bow legs
 Osteomalacia

46. COMPLICATIONS
 Permanent skeletal deformity
 Poor motor skills
 Delay in physical growth
 Severe vitamin D deficiency can lead to
seizures.

47. DIAGNOSTIC EVALUATION-

48. DIAGNOSTIC EVALUATION
 Medical History
 ABG
 Blood test
 LFT
 Blood vitamin D level

50. MANAGEMENT
For the treatment of the RICKETS &
OSTEOMALACIA, vitamin D is given
in a dose of 1000-5000IU, orally for a
month, followed by 800 IU daily for 6
months.

52. PREVENTION
 Providing enough vitamin D in diet
 Exposure to sunlight
 Adminstration of vitamin D

53. HYPERVITAMINOSIS ‘D’-
Excess of vitamin D intake of leads to
hypervitaminosis D.
It is manifested by-
• Dehydration
• Vomiting
• Decreased appetite
• Irritability
• Fatigue
• Muscle weakness

55. VITAMIN ‘E’-
Vitamin E is a group of 8 closely related fat
soluble compounds 4 Tocopherols & 4
Tocotrinols.
There are three components of vitamin E
viz. alpha, beta, gamma tocopherol.

56. ABSORPTION
Vitamin E is absorbed with fat in
intestines. It is stored in liver
muscles & body fat.

58. FUNCTION OF VITAMIN E
 It has an anti oxidant activity
 It prevent pre oxidation of poly
unsaturated fatty acids in tissues and cell
membranes.
 It protects RBCs from hemolysis due to
oxidazing agents.
 It has antisterility action.

60. SOURCES OF VIT-E
 CEREAL GERM OIL
 CORN GERM OIL
 VEGETABLE OIL
 FATS

61. DAILY REQUIREMENTS
Daily requirements of vit.E is 15
IU/day

63. VITAMIN ‘K’
Vitamin K is a fat soluble vitamins which
occur in 2 forms-
1. Vitamin K1 is phylloquinane
2. Vitamin K2 is farnesoquinane

65. FUNCTIONS OF VIT.K-
 Synthesis of prothrombin.
 It is involved in electron transport chain
& oxidative phosphorylation.

67. SOURCE OF VITAMIN K
SPINACH CABBAGE
EGG YOLK

68. DAILY REQUIREMENTS
Sufficient amount of vitamin K is
synthesized by intestinal bacteria so
there is no dietary requirements.

69. VITAMIN K DEFICIENCY-
Vitamin K deficiency occurs when the
child does not get enough vitamin K.
It interference with child’s normal
physiological changes.

71. SIGN & SYMPTOMS-
 Abnormal bleeding even small test.
 Spontaneous nose bleeding.
 Bruise.
 Bleeding gums.
 Blood in urine or stool.

73. MANAGEMENT
 Dietary intake of vitamin K rich food
items.
 Adminstration of oral suspension of
vitamin K.
 Injection vitamin K can be given
intramusculary.

74. HYPERVITAMINOSIS ‘K’
V itamin K toxicity is extremely rare.
When toxicity is occur, it manifested with signs of
jaundice, hyperbilirubinemia, hemolytic anemia &
kernicterus in infants.
It may result in –
• Nausea
• Diarrhoea
• Hemorrhage
• Heart palpitation

76. SUMMARIZE THE TOPIC-
 Definition of VITAMIN- A,D,E & K.
 Absorption of VITAMIN- A,D,E & K.
 Functions of VITAMIN- A,D,E & K.
 Sources of VITAMIN- A,D,E & K.
 Deficiency of VITAMIN- A,D,E & K.
 Causes of VITAMIN- A,D,E & K.
 Sign & symptoms of VITAMIN- A,D,E & K.
 Pathophysiology of VITAMIN- D.
 Management of VITAMIN- A,D,E & K.
 Prevention of VITAMIN- A,D,E & k.

78. RECAPTUALIZE THE TOPIC-
 Define the VITAMIN A,D,E & K ?
 What are the sources of VITAMIN A,D,E & K?
 What are the functions of the VITAMIN A, D,E & K ?
 Define the VITAMIN A,D,E & K deficiency?
 What are the causes of VITAMIN A,D,E & K deficiency?
 Which symptoms are appear in the VIT. A,D,E & K deficiency?
 What is the pathophysiology of VIT.D deficiency?
 How will manage the VIT.A,D,E & K deficiency?
 How will prevent the VIT. A,D,E & K deficiency?

79. ASSIGNMENT
TOPIC-
NURSING MANAGEMENT OF PATIENT
WITH VITAMIN D DEFICIENCY
DISORDER.
SUBMITTED DATE- 01/03/2021