Bowel Elimination/GI Disorders Flashcards
Mouth
highly vascular
entry point of infection
Esophagus
LES not fully developed until age 1, causing regurgitation
What is the stomach capacity of a newborn?
10-20 mL
Biliary System
liver relatively large at birth
pancreatic enzymes develop postnatally until around 2 yrs
Palpable kidney’s may indicate what?
tumor or hydronephrosis
Right lower quadrant pain and rebound tenderness may indicate?
appendicitis
What is the most common result of GI illness?
dehydration
What tests are necessary in many pediatric GI disorders?
monitoring the blood count, electrolyte levels, and liver function tests
Lab/Diagnostic Tests for Appendicitis
- CT scan
- C-reactive protein
How often is an ostomy pouch changed?
q 1-4 days
How to change an ostomy pouch?
- set up equipment
- take off pouch
- observe stoma and surrounding skin, clean as needed
- measure stoma, mark new pouch backing and cut new backing to size
- apply new pouch
Structural Anomalies of the GI Tract
- cleft lip and palate
- omphalocele
- gastroschisis
- hernias
- anorectal malformation
Anomalies associated w/ Cleft Palate
- heart defect
- ear malformations
- skeletal deformities
- genitourinary abnormality
Complications w/ Cleft Palate
- feeding difficulties
- altered dentition
- delayed or altered speech development
- otitis media
Nursing Management for Cleft Palate Repair
- prevent injury to suture line
- promote adequate hydration
- encourage bonding
- provide emotional support
S/S of Meckel Diverticulum
- bleeding, anemia
- colicky abdominal pain
- abdominal distention
- hypoactive bowel sounds
- guarding
- abdominal mass
- rebound tenderness
Management for Meckel Diverticulum
- administer ordered blood products and IV fluids
- maintain NPO status
- perform postop care and family ed
Acute GI Disorders
- dehydration, vomiting, diarrhea
- oral candidiasis/lesions
- hypertrophic pyloric stenosis
- necrotizing enterocolitis
- intussusception, malrotation, volvulus
- appendicitis
Risk Factors for Dehydration
- diarrhea
- vomiting
- decreased oral intake
- sustained high fever
- diabetic ketoacidosis
- extensive burns
What fluids are NOT appropriate for oral rehydration?
- tap water
- milk
- undiluted fruit juice
- soup/broth
Children w/ mild to moderate dehydration require how much fluid?
50-100 mL/kg over 4 hours
Oral rehydration solutions should contain what?
75 mmol/L sodium chloride and 13.5 g/L glucose
What to do for dehydration r/t vomiting?
- wait 1-2 hours after emesis
- give 0.5-2 oz to infant q 15 minutes
- increase as tolerated
Homemade oral rehydration solution
1 qt water, 8 tsp sugar, and 1 tsp salt
What alternative ORS are safe to use in children over 2 for vomiting?
- ginger capsules
- candied ginger
- ginger tea
Risk Factors for Oral Candidiasis
- young age
- immune suppression
- antibiotic use
- corticosteroid inhalers
- fungal infection in mother
Medication Therapy for Oral Candidiasis
appropriate administration of oral antifungal agents by administering Mycostatin suspension 4 times per day following feeding to allow meds to maintain contact w/ lesions
Imperforate Anus
congenital malformation of the anorectal opening
Hypertrophic Pyloric Stenosis
circular muscle of the pylorus becomes hypertrophied, causing thickness in the luminal side of the pyloric canals
What is one of the most common conditions requiring surgery in the first 2 months of life?
Hypertrophic pyloric stenosis
What is performed by cutting the muscle of the pylorus and relieve the gastric outlet obstruction?
Pyloromyotomy
Intussusception
a process that occurs when a proximal segment of bowel “telescopes” into a more distal segment causing edema, vascular compromise, and ultimately partial or total bowel obstruction
S/S of Intussusception
- abdominal pain
- vomiting
- diarrhea
- currant-jelly stools
- gross blood/hemocult positive stool
- lethargy
What is the hallmark sign of Intussusception?
sausage-shaped mass in upper midabdomen
What is the most common cause of emergent abdominal surgery in children?
appendicitis
What is the most common cause of neonatal intestinal obstruction and is characterized by constipation?
Hirschsprung Disease
Gastroesophageal Reflux
passage of gastric contents into the esophagus
When should GER resolve by?
12-18 months
GERD
complications developed from the reflux of gastric contents back into the esophagus or oropharynx
Short Bowel Syndrome
clinical syndrome of malabsorption and excessive intestinal fluid and electrolyte losses that occurs following a massive small intestine loss or surgical resection
Encopresis
soiling of fecal contents into the underwear beyond the age of expected toilet training
What are the 2 major idiopathic inflammatory bowel diseases of children?
Crohn’s disease and Ulcerative colitis
S/S of Inflammatory Bowel Disease
- abdominal cramping
- fever
- weight loss
- poor growth
- delayed sexual development
Celiac Disease
immunologic disorder in which gluten causes damage to the small intestine
Biliary Atresia
absence of some or all of the major biliary ducts resulting in obstruction of bile flow
Cholelelithiasis
presence of stones in the gall bladder
S/S of Cholellithiasis
- right upper quadrant pain radiating substernally or to right shoulder
- N/V
- jaundice
- fever
Hepatitis
inflammation of the liver
