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Peds exam 1 > Alteration in Elimination > Flashcards

Alteration in Elimination Flashcards

1
Q

when does the gastrointestinal tract mature

A

2 years old

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2
Q

where is the lower esophageal sphincter

A

between the stomach and esophagus

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3
Q

when does the lower esophageal sphincter fully develop

A

around 1 month old

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4
Q

if the lower esophageal sphincter doesnt fully develop what is the outcome

A

regurg and dysphagia

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5
Q

what is the stomach capacity at birth

A

10-20ml

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6
Q

what is the stomach capacity for adolescents

A

1500ml

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7
Q

what is the stomach capacity for adults

A

2000ml

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8
Q

how long are the small intestines at birth (full term)

A

250cm

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9
Q

how long are the small intestines for adults

A

600cm

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10
Q

when are pancreatic enzymes at adult levels

A

by age 2

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11
Q

what is the liver size for an infant

A

large because of extra blood volume from mother

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12
Q

do infants or adults need a greater fluid intake

A

infants because they have greater output, have a greater risk for fluid loss with illness

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13
Q

how much extracellular fluid does an infant have

A

makes up about half of the total body water - results in more rapid and greater fluid volume loss

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14
Q

how much does an infant lose in fluid with ever 1 increase in temp

A

7ml/kg

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15
Q

how much does an infant lose in fluid through the skin

A

2/3 of all fluid loss

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16
Q

is an infant or adults body surface area

A

infants are 2-3x larger then adults

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17
Q

do infants or adults have a higher basal metabolic rate

A

infants have a higher basal metabolic rate

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18
Q

why are infants at a higher risk for dehydration

A

because their kidneys are immature and cannot concentrate urine

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19
Q

what are some risk factors for dehydration

A

diarrhea, vomiting, decreased oral intake, sustained high fever, diabetic ketoacidosis, burns

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20
Q

How would you collect a stool sample from a diaper

A

use a tongue blade to scrape a specimen into the collection container

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21
Q

how would you collect a stool sample from runny stool

A

a piece of plastic wrap in the diaper may catch the specimen, but may require application of a urine bag to the anal area

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22
Q

how would you collect a stool sample from a ambulatory child

A

get from a clean collection container fitted to the toilet - may sure the pee first so they dont mix

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23
Q

how would you collect a stool sample from a bed ridden child

A

from a clean bedpan, but dont let urine contaminate the sample

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24
Q

what should oral rehydration solutions contain

A

75mmol sodium chloride, 13.5g/L glucose
standard include pedialyte, infalyte and ricelyte

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25
Q

what are some non appropriate options for oral rehydration

A

tap water, milk, undiluted fruit juice, soup, broth

26
Q

mild to moderate dehydration requires how much oral rehydration solution

A

50-100ml/kg over 4 hours

27
Q

what are some medication options for management of GI disorders

A

histamine 2 blockers, PPI, antibiotics, corticosteriods, immunosuppresants, stimulants, laxatives, antidiarrheals, antiemetics, anticholinergic, anti-inflammatories

28
Q

what are some risk factors for GI disorders

A

permaturity, family history, genetic syndromes, chronic illness, prenatal factors, exposure to infectious agents, foreign travel, immune deficiency, chronic steroid use

29
Q

what are some examples of acute GI disorders

A

dehydration, vomiting, diarrhea, oral candidasis, oral lesions, hypertrophic pyloric stenosis, necrotizing entercolitits, intussception, malrotation, appendicitis

30
Q

what are some causes of acute diarrhea

A

viral is most common, antibiotic use, eating raw meat, contaminated water

31
Q

how long do you have to have diarrhea for it to be considered chronic diarrhea

A

more then 2 weeks

32
Q

what are some causes infants have chronic diarrhea

A

intractable, milk/soy protein intolerance, infectious enteritis, Hirschsprung disease

33
Q

what are some causes toddlers have chronic diarrhea

A

viral enteritis, ulcerative colitis, celiac disease

34
Q

what are some causes that school age children have chronic diarrhea

A

inflammatory bowel disease, appendiceal abscess, lactase deficiency, constipation with encopresis (stool liquifies to get past blockage)

35
Q

what is pyloric stenosis

A

hypertrophy or hyperplasia of the pyloric stenosis preventing emptying of the stomach cause projectile vomiting

36
Q

who is more at risk for pyloric stenosis

A

presents at 3-6 weeks of life, first born males more at risk

37
Q

how can pyloric stenosis be fixed

A

requires surgical intervention

38
Q

what is intussusception

A

telescoping of a proximal bowel segment into a more distal bowel segment

39
Q

what does intussusception cause

A

edema, vascular compromise, partial or total bowel obstruction, fatal if not ID in 2-5 days shown by currrant jelly stool, sudden intermitten severe cramping pain, lethargy, sausage shaped mass on abdomen

40
Q

who does intussusception affect

A

5-9 month old, more often males

41
Q

what is intussusception caused by

A

pathological point- meckel diverticulum, duplication cysts, polyps, hemangiomas, tumors, or the appendix

42
Q

what increases the risk of getting intussusception

A

cystic fibrosis, celiac disease

43
Q

how is intussusception diagnosed

A

air or barium enema (can sometimes reduce it), WBC elevation and dehydration

44
Q

how is intussusception treated

A

Spontaneous reduction, Barium enema reduction, Surgical reduction and resection of necrotic bowel

45
Q

what are some anomalies that are associated with cleft lip and palate

A

heart defects, ear malformations, skeletal deformities, genitourinary abnormality

46
Q

what are some complications that can arise from cleft lip and palate

A

feeding difficulties, altered dentition, delayed or altered speech development, otitis media

47
Q

what can treat all peoples constipation

A

bowel habits vary with infants and children so treatment should be individualized

48
Q

Functional constipation is the presence of at least of 2 of what

A

Less than three BM weekly
At least one episode of fecal incontinence weekly (after toilet training)
History of excessive stool retention
Hard or painful BM
Large fecal rectal mass
Stool passage of a volume to clog the toilet
Stool withholding behavior (retention posturing

49
Q

what is encopresis

A

soling of fecal contents into the underwear from stool liquifying to pass blockage

50
Q

what are some causes of constipation for infants

A

meconium plug, hirschsprung disease, cystic fibrosis, diabetes, withholding

51
Q

what are some causes for constipation for toddlers

A

anal fissures, withholding, toliet refusal, short segment, hirschsprung

52
Q

what are some causes for constipation for school age

A

toliet limitations, unability to recognize cues, tether cord, withholding

53
Q

what is hirschsprung disease

A

Intestinal tract motility disorder resulting in an obstruction of the colon. Absence of ganglion cells; may occur in the small intestines all the way into the rectosigmoid colon.
Characterized by the failure to pass stool within the first 24-hours of life

54
Q

what is the cause of hirschsprung disease

A

abnormal gene on chromosome 10

55
Q

who does hirschsprung more often affect

A

males

56
Q

how can you treat hirschsprung disease

A

Surgical intervention to remove the aganglionic colon is required
An ostomy is created to allow sufficient time for remaining bowel to heal

57
Q

what are some signs and symptoms of crohns disease and ulcerative colitis

A

abdominal crmaping, nighttime symptoms like waking to poop, fever, weight loss, poor growth and sexual development from not getting all the nutrients

58
Q

what is the 12 week criteris for IBS

A

Abdominal pain relieved by defecation
Onset of pain or discomfort associated with a change in frequency of stool
Onset of pain or discomfort associated with a change in form of stool
No structural or metabolic explanation for this abdominal pain

59
Q

what does OLD CART stand for

A

onset, location, duration, characteristic, alleviating/aggravating factors, radiating/relieving factors, timing, severity

59
Q

what does OLD CART stand for

A

onset, location, duration, characteristic, alleviating/aggravating factors, radiating/relieving factors, timing, severity

Peds exam 1 (12 decks)

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