Xerophthalmia

Subject: Community Health Nursing II

Overview

For kids, vitamin A is a crucial nutrient. In addition, a lack of vitamin A increases a child's risk of developing diarrhea, respiratory infections, malnutrition, and other infectious disorders. Measles, inadequate vitamin intake, and malnutrition are the causes of vitamin A deficient illness. Clinical symptoms include corneal ulcer, bitot's spot, conjunctival xerosis, and night blindness.

Vitamin A Deficiency Disease -"Xerophthalmia"

For kids, vitamin A is a crucial nutrient. According to estimates, one youngster in our nation loses their vision every day as a result of vitamin A deficiency. In addition, a lack of vitamin A increases a child's risk of developing diarrhea, respiratory infections, malnutrition, and other infectious disorders.

A persistent vitamin A deficit in the diet causes the syndrome of xerophthalmia, which is more common in children between the ages of 6 and 36 months. It frequently has PEM in mind.

Causes

  • A diet poor in vitamin A or carotene.
  • Child suffering from prolonged diarrhea.
  • Malnutrition.
  • Measles.

Clinical Features

XN: Night blindness

X1A: Conjunctival xerosis

X1B: Bitot spots

X2: Corneal xerosis

X3A : Corneal ulceration

X3B: Corneal ulceration

XS: Corneal scar

Treatment

  • Local Ocular Therapy: For conjunctival xerosis, artificial tears should be instilled every 3-4 hourly.
  • Vitamin A Therapy: Immediately on diagnosis, oral vitamin A is administered in a dose of 50,000 IU, 1,00,000 IU and 2,00,000 IU in children aged < 6 months, 6-12 months and >1 year respectively.
  • Treatment of Underlying Disease: Local antibiotics drop or ointments should be applied three times a day to prevent secondary infection in the event of the presence of a corneal ulcer.

Prevention

  • Consumption of vitamin A rich food should be encouraged including locally available carotene rich food.
  • Children suffering from measles and severe PEM, diarrhea, dehydration, parasite infestation should be administered two doses of oral vitamin A.
  • The pregnant and lactating mother should get enough retinol in a diet.
  • Fortification has commonly eaten food with vitamin A.
  • Nutritional education about vitamin A.

Responsibilities and Activities of a Nurse in Child Health Clinics

  • To keep the clinic neat and tidy.
  • To prepare necessary equipment ready.
  • To admit and register children for a clinic.
  • To carry out routine care;
    • Vital signs
    • Weight and height
  • To do a physical examination for prevention of disease.
  • To supervise the management and cleanliness of the clinics.
  • To maintain a regular inventory of equipment and supplies.
  • To provide immunization dose for the prevention of disease.
  • To maintain record and reports.
  • Health education according to a need of the mother.
  • To refer children to facilitated place.
  • Follow-up medical treatment.
  • Make a statistical report of attendance of children.
  • Report of communicable disease.
  • Supervise and provide guidance to community health workers at the grass root level.

Reference

  • Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).
  • Dr.Suwal S.N. & Tuitui R. (2063) A Textbook of Community Health Nursing, 1st edition, Vidyarthi Prakashan (P). Ltd. Kamalpokhari, Kathmandu
  • HealthLine. 2005. 2017 http://www.healthline.com/health/eye-health/xerophthalmia
  • Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.
  • Management of the Child with a Serious Infection or Severe Malnutrition, 2000, Department of Child and Adolescent Health & Development, WHO
  • MedicineNet. 1996. 2017 http://www.medicinenet.com/script/main/art.asp?articlekey=6040
Things to remember
  • For kids, vitamin A is a crucial nutrient.
  • According to estimates, one youngster in our nation loses their vision every day as a result of vitamin A deficiency.
  • In addition, a lack of vitamin A increases a child's risk of developing diarrhea, respiratory infections, malnutrition, and other infectious disorders.
  • A long-term lack of vitamin A in the diet causes the xerophthalmia syndrome.
  • Frequently linked to PEM
  • Malnutrition, inadequate vitamin A consumption, and measles are the primary causes of vitamin A insufficiency.
  • The cornea and conjunctiva of the eyes appear to be its primary clinical characteristics.
  • Local ocular therapy, vitamin A therapy, and the treatment of underlying disorders are all options for treatment.
Questions and Answers

Children require adequate amounts of vitamin A. Every day, one child in our country is estimated to go blind due to vitamin A deficiency. Aside from that, vitamin A deficiency increases a child's risk of dying from diarrhea, respiratory tract infection, malnutrition, and other infectious diseases.

Prolonged vitamin A deficiency in the diet causes xerophthalmia, which is most common in children aged 6-36 months. It is frequently associated with PEM.

 

Causes

  • A diet deficient in vitamin A or carotene.
  • A child with persistent diarrhea.
  • Undernourishment
  • The Measles

Clinical characteristics

  • Night blindness XN
  • Conjunctival xerosis (X1A)
  • Bitot spots X1B
  • X2- xerosis of the cornea
  • corneal ulceration X3A
  • corneal ulceration X3B
  • corneal scar XS
  •  

 

Treatment

  • Local ocular therapy
    • Artificial tears should be injected every 3–4 hours for conjunctival xerosis.
  • Vitamin A therapy
    • Immediately after diagnosis, oral vitamin A is given to children aged 6 months, 6-12 months, and > 1 year in doses of 50,000 IU, 1,00,000 IU, and 2,00,000 IU, respectively.
  • Treatment of underlying disease
    • Generic antibiotics If there is a corneal ulcer present, drops or ointments should be applied three times per day to prevent secondary infection.

Prevention

  • Foods high in carotene that are readily available locally should also be promoted as sources of vitamin A.
  • Oral vitamin A should be given twice to children who have measles, severe PEM, diarrhea, dehydration, or parasite infestation.
  • The mother who is expecting or nursing should consume adequate retinol.
  • Putting vitamin A in regularly consumed food.
  • Information on vitamin A nutrition.

 

Responsibilities and Activities of a Nurse in Child Health Clinics

  • To maintain the clinic's cleanliness.
  • Equipment required for preparation is ready.
  • To register and admit kids to the clinic.
  • To provide standard care;
    • Vital signs
    • Weight and height
  • To conduct a physical examination in an effort to ward off illness.
  • To keep an eye on clinic administration and hygiene.
  • To regularly maintain an inventory of goods and equipment.
  • To administer vaccinations in order to avoid disease.
  • Keep records and reports.
  • Health instruction tailored to the mother's needs.
  • To direct children to a facility.
  • Additional medical care.
  • Make a statistical analysis of the attendance of the kids.
  • Report of a contagious sickness.
  • At the local level, supervise and offer direction to community health workers.

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