PATCHS PROGRAM PUBLIC HEALTH NURSING ADVOCATES TEACHING CHILD HEALTH AND SAFETY HEALTH CARE PROGRAM FOR CHILDREN IN FOSTER CARE (HCPCFC)
Volume 1, Issue 1		JUNE 2001

Medical Information Fact Sheet

Failure to Thrive:

Definition:
Failure of growth and development in infants, toddlers, preschoolers, school-age children or adolescents to realistic expectations due to genetic, physical, psychological or social factors.

Causes and risk factors:
Failure to thrive is noticed when a child fails to gain height and weight. This can be due to a number of factors including dysfunction with a child's metabolism, growth hormone deficiency, central nervous system problems, respiratory problems, blood disorders and disorders like Down's Syndrome and Cerebral Palsy. Failure to thrive can also be caused by parental withdrawal, rejection or hostility. Environmental factors may include exposure to toxins or parasites. Other factors may include underlying diseases, poverty, negative emotional environments and crowded or unsanitary living conditions.

Symptoms:

• Height, weight and head circumference in an infant or young child do not progress normally according to standard growth charts.
• Physical skills such as rolling over, sitting, standing, and walking are slow to develop. Mental and social skills are delayed
• Development of secondary sexual characteristics are delayed in adolescents.

Signs and tests:

• A physical exam will be done to measure height, weight and body proportions. A detailed history will be taken about prenatal, birth, psychosocial and family history. A Denver Developmental Screening test will done and will show delayed development.
• Lab tests may be performed to find any physiological abnormalities.

Treatment:
Depends on the cause of the delayed growth and development. First would be to correct the problem including a well balanced diet, living conditions and family dynamics.

Expectations:
If the Failure to Thrive period was short and the cause determined and corrected, normal growth and development will resume. If the period is prolonged the effects may be long lasting.

Permanent mental, emotional, or physical delays may occur.

Prevention:
Early detection at routine well baby examinations and periodic follow-up with school-age and adolescent children.

Oxygen. (2001). Failure to Thrive. [Online]. Available: http://thriveonline.oxygen.com/medical/library/article/000991.html

Bipolar Disorder (Manic Depression):

Bipolar disorder is a condition where a person's mood swings from the depths of depression to the intense highs of mania. Commonly known as manic depression this disorder will affect nearly one in 100 people at some point in their lives.

Symptoms: Manic Phase

• Feeling on top of the world. A sensation of sheer and utter happiness that nothing-not even bad news can change.
• Grandiose delusions. Individuals believe they have special connections with God, celebrities or political figures.
• Invincibility. The person feels that nothing can prevent him/her from completing the task.
• Hyperactivity. Scheduling more events in a day than can be accomplished; inability to relax or sit still.
• Excessively risky behavior. Reckless driving, outlandish spending, foolish business investments or out of character sexual behavior.
• Uncontrollable racing thoughts/rapid speech. Ideas that change from topic to topic. Rapid speech that will eventually become incoherent.
• Less need for sleep.
• Sudden irritability or rage, particularly when grandiose plans are thwarted.

Symptoms: Depressed Phase

• Intense sadness or despair. The person feels hopeless, helpless and worthless. ¨ No interest in activities once enjoyed.
• Loss of energy, fatigue.
• Sleep difficulties. Either sleeping too much or not at all.
• Changes in appetite. Either a noticeable increase in appetite or substantial weight loss unrelated to dieting.
• Difficulty Concentrating
• Constant thoughts of death or suicide.

Causes:
Bipolar can run in families, there is a high likelihood that there is a genetic cause for the illness. Noteworthy dates, incidents of trauma or everyday occurrences are important factors that may trigger episodes of illness and sustain them. Recent research suggest that it may be caused by and irregular production or release of hormones and imbalances in the way brain cells communicate.

Treatment:
This disorder can become quite disabling but is very treatable with medications like lithium. The problem is that many people do not comply during the manic phase. To treat the illness medications must be taken during all stages of the illness if a successful outcome is to be reached. There are many support groups for those who suffer from the illness and for their families.

American Psychiatric Association. (2000). Let's Talk Facts about Bipolar Disorder (Manic Depression)

HCPCFC PROGRAM UPDATES and ANNOUNCMENTS!!! Beginning April 1, 2001 Kristen Thompson became the full time PHN stationed at court. Since April 2001, 181 Health and Education Passports have been created/updated based on the court interviews obtained by Kristen Thompson, PHN and Peter Tran, PHN.

 

Editor: Kristen Thompson, PHN,Contributors: Hermia Parks, SPHN, MA, and Judy Earp, MHA, Director of Public Health Nursing.