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PEDIATRIC
NURSING
VITAMIN DEFICIENCY
DISORDERS
(FAT SOLUBLE VIT.)
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.
Vitamin are divided into 2 groups:-
vVITAMIN
VITAMIN A,D ,E &
K
VITAMIN B &
VITAMIN C
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.
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.
 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)
ABSORPTION-
 Vitamin-A is absorbed through
lymphatic system into blood stream
along with fat & stored in large amount
in liver.
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.
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.
SOURCE OF VIT.A-
There are mainly 2 types of sources –
 ANIMAL FOODS
 PLANT FOODS
IN ANIMAL FOODS-
EGGS FISH MEAT
BUTTER CHEESE MILK
IN PLANT FOODS-
SPINACH PAPAYA MANGO
PUMPKIN CARROTS
VIT.A DEFICIENCY-
Lack of vitamin A is called vitamin A
deficiency.
Night blindness is one of the first sign
of vitamin A deficiency.
CAUSES
 Breast milk
 Malabsorption
 Malnutrition
SIGN & SYMPTOMS-
 Night blindness
 Xeropthalmia
 Xerosis conjuctiva
 Xerosis cornea
 Bitot’s cornea
 Keratomalacia
 Impaired immunity
 Growth retardation
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.
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.
DAILY INTAKE-
 Infants- 400ug/day
 Children- 300-400ug/day
 Pregnancy- 750ug/day
 Lactating- 1200-1300ug/day
HYPERVITAMINOSIS ‘A’ -
An excess intake of retinal causes
nausea,anorexia,& sleep disorders
followed by desquatmation.
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.
ABSORPTION
Vitamin D is absorbed in presence of
bile & fat .
Its stored in LIVER.
FUNCTIONS OF VIT.D-
 It promote absorption of calcium &
phosphorus.
 Reabsorption & mobilization.
 It causes mineralization of the bones.
 It has immune regulatory role.
SOURCE OF VIT. D-
SUNLIGHT EGG YOLK
BUTTER CHEESE
DAILY REQUIREMENTS
 Infants, children, pregnant &
nursing women need 400I.U of
vitamin D.
 Older children & adults require 200
I.U of vitamin D.
VITAMIN D DEFICIENCY-
Lack of vitamin D result in vitamin D
deficiency in children.
Deficiency of vitamin D leads to a
disease called RICKETS.
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.
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.
SIGN & SYMPTOMS-
 Common skeletal deformities
 Delayed closure of anterior fontaneles
 Enamel defect
 Enlargement of long bones around wrist &
ankel
 Bow legs
 Osteomalacia
COMPLICATIONS
 Permanent skeletal deformity
 Poor motor skills
 Delay in physical growth
 Severe vitamin D deficiency can lead to
seizures.
DIAGNOSTIC EVALUATION-
DIAGNOSTIC EVALUATION
 Medical History
 ABG
 Blood test
 LFT
 Blood vitamin D level
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.
PREVENTION
 Providing enough vitamin D in diet
 Exposure to sunlight
 Adminstration of vitamin D
HYPERVITAMINOSIS ‘D’-
Excess of vitamin D intake of leads to
hypervitaminosis D.
It is manifested by-
• Dehydration
• Vomiting
• Decreased appetite
• Irritability
• Fatigue
• Muscle weakness
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.
ABSORPTION
Vitamin E is absorbed with fat in
intestines. It is stored in liver
muscles & body fat.
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.
SOURCES OF VIT-E
 CEREAL GERM OIL
 CORN GERM OIL
 VEGETABLE OIL
 FATS
DAILY REQUIREMENTS
Daily requirements of vit.E is 15
IU/day
VITAMIN ‘K’
Vitamin K is a fat soluble vitamins which
occur in 2 forms-
1. Vitamin K1 is phylloquinane
2. Vitamin K2 is farnesoquinane
FUNCTIONS OF VIT.K-
 Synthesis of prothrombin.
 It is involved in electron transport chain
& oxidative phosphorylation.
SOURCE OF VITAMIN K
SPINACH CABBAGE
EGG YOLK
DAILY REQUIREMENTS
Sufficient amount of vitamin K is
synthesized by intestinal bacteria so
there is no dietary requirements.
VITAMIN K DEFICIENCY-
Vitamin K deficiency occurs when the
child does not get enough vitamin K.
It interference with child’s normal
physiological changes.
SIGN & SYMPTOMS-
 Abnormal bleeding even small test.
 Spontaneous nose bleeding.
 Bruise.
 Bleeding gums.
 Blood in urine or stool.
MANAGEMENT
 Dietary intake of vitamin K rich food
items.
 Adminstration of oral suspension of
vitamin K.
 Injection vitamin K can be given
intramusculary.
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
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.
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?
ASSIGNMENT
TOPIC-
NURSING MANAGEMENT OF PATIENT
WITH VITAMIN D DEFICIENCY
DISORDER.
SUBMITTED DATE- 01/03/2021

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Pediatric nursing

  • 2.
  • 3.
  • 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
  • 6.
  • 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.
  • 8.
  • 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.
  • 12.
  • 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.
  • 15.
  • 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.
  • 20.
  • 21. CAUSES  Breast milk  Malabsorption  Malnutrition
  • 22.
  • 23. SIGN & SYMPTOMS-  Night blindness  Xeropthalmia  Xerosis conjuctiva  Xerosis cornea  Bitot’s cornea  Keratomalacia  Impaired immunity  Growth retardation
  • 24.
  • 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.
  • 26.
  • 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.
  • 30.
  • 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.
  • 33.
  • 34. FUNCTIONS OF VIT.D-  It promote absorption of calcium & phosphorus.  Reabsorption & mobilization.  It causes mineralization of the bones.  It has immune regulatory role.
  • 35.
  • 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.
  • 39.
  • 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.
  • 41.
  • 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.
  • 43.
  • 44. SIGN & SYMPTOMS-  Common skeletal deformities  Delayed closure of anterior fontaneles  Enamel defect  Enlargement of long bones around wrist & ankel  Bow legs  Osteomalacia
  • 45.
  • 46. COMPLICATIONS  Permanent skeletal deformity  Poor motor skills  Delay in physical growth  Severe vitamin D deficiency can lead to seizures.
  • 48. DIAGNOSTIC EVALUATION  Medical History  ABG  Blood test  LFT  Blood vitamin D level
  • 49.
  • 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.
  • 51.
  • 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
  • 54.
  • 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.
  • 57.
  • 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.
  • 59.
  • 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
  • 62.
  • 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
  • 64.
  • 65. FUNCTIONS OF VIT.K-  Synthesis of prothrombin.  It is involved in electron transport chain & oxidative phosphorylation.
  • 66.
  • 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.
  • 70.
  • 71. SIGN & SYMPTOMS-  Abnormal bleeding even small test.  Spontaneous nose bleeding.  Bruise.  Bleeding gums.  Blood in urine or stool.
  • 72.
  • 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
  • 75.
  • 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.
  • 77.
  • 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