ACUTE INFECTIOUS GI DISORDERS

Question 1

what are clinical manifestations of celiac disease?

Answer 1

1. steatorrhea
2. abdominal bloating/cramping
3. diarrhea
4. anemia/vitamin B12 and A deficiencies
5. vision problems from vitamin A deficiency

Question 2

what type of foods should children with celiacs disease avoid?

Answer 2

wheat, barley, and rye should be avoided

Question 3

what type of diet should a child with celiacs disease be put on?

Answer 3

gluten free diet

Question 4

what is meckel diverticulum?

Answer 4

this is a complication resulting from failure of duct to fuse during embryonic development

Question 5

what are clinical manifestations of meckel diverticulum?

Answer 5

1. painless rectal bleeding

2. bloody, mucous stools

Question 6

what is the main nursing intervention to perform with a patient who has meckel diverticulum?

Answer 6

prep this patient for surgery–> surgical removal of the diverticulum is the intervention for these patients

Question 7

what are preop care interventions to perform for a patient with meckel diverticulum before surgery?

Answer 7

provide blood transfusions to correct the hypovolemia due to the blood loss and provide bed rest

Question 8

what are post op care interventions to perform for a patient with meckel diverticulum after surgery?

Answer 8

maintain NPO and maintain NG tube to low, continuous suction

Question 9

what does rotavirus cause?

Answer 9

rotavirus is the most common cause of diarrhea in children less than 5 years of age

Question 10

what are clinical manifestations of rotavirus?

Answer 10

1. fever
2. foul smelling diarrhea for 5-7 days
3. vomiting for about 2 days

Question 11

what type of precautions will a patient with rotavirus be place on?

Answer 11

contact precautions

Question 12

what are nursing interventions to practice with a patient who has rotavirus?

Answer 12

1. avoid rectal temperatures (due to contact precautions)
2. complete oral rehydration therapy of 75-90 Na at 40-50 mL/kg over 4 hours
3. replace each diarrheal stool with 10 mL/kg of ORS for ongoing diarrhea
4. notify school of infection because rotavirus has 48 hour incubation period

Question 13

what nutritional guidelines should a patient with rotavirus follow?

Answer 13

avoid-

1. fruit juices and gelatin
2. caffeine
3. chicken or beef broth (too much sodium)
4. bananas, rice, applesauce, and toast (BRAT diet) because it has a high carb content and low electrolytes

Question 14

what is isotonic dehydration?

Answer 14

1. sodium levels are within normal ranges
2. major loss of fluid from extracellular fluid which leads to hypovolemic shock
3. these patients will be bleeding or have diarrhea
4. usually is LR or 0.9% NS or NaCl

Question 15

what is hypotonic dehydration?

Answer 15

1. electrolyte loss > water loss
2. shock and seizures are likely to occur
3. sodium is < 130

Question 16

what is hypertonic dehydration?

Answer 16

1. water loss > electrolyte loss
2. sodium is >150
3. neurological changes can occur such as changes in LOC, cerebral edema, or confusion

Question 17

what does mild dehydration consist of?

Answer 17

1. weight loss of 3-5 % which can lead to behavior changes
2. manifestations include slight thirst
3. replace fluids with 50 m/kg every 4-6 hours

Question 18

what does moderate dehydration consist of?

Answer 18

1. weight loss of 6-9%

2. replace fluids with 100 mL/kg every 4-6 hours

Question 19

what are manifestations of moderate dehydration?

Answer 19

1. slight elevation in HR and slight tachypnea
2. dry mucous membranes and decreased tears/ skin turgor
3. normal to orthostatic BP

Question 20

what does severe dehydration consist of?

Answer 20

weight loss of >10 % and give these patients a bolus of 20 m/kg

Question 21

what are manifestations of severe dehydration?

Answer 21

1. cap refill > 4 seconds
2. orthostatic BP –> shock
3. extreme thirst
4. very dry mucous membranes and tented skin with no tears
5. sunken eyeballs and anterior fontanels

Question 22

how much oral re-hydration can be given for patients with diarrhea?

Answer 22

replacement of diarrhea losses can be treated by giving 10 mL/kg for each stool

Question 23

what is contraindicated with hypertonic solution?

Answer 23

rapid fluid replacement is contraindicated due to risk of cerebral edema so give fluids slowly if they have this type of dehydration