Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

peds > ch 25 GI dysfunction > Flashcards

ch 25 GI dysfunction Flashcards

1
Q

5 types GI secretions

A

-enzymes
-hormones
-hydrochloric acid
-mucus
-water and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is absorbed from the large intestine

A

water
sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

primary purpose upper GI system (mouth, esophagus, stomach)

A

-take in food and fluids
-begin the digestive
process
-propel food into the
intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

primary purpose lower GI system (Duodenum, liver, gallbladder,
pancreas, jejunum, ileum, cecum,
appendix, colon, rectum, and
anus)

A

-digest and absorb nutrients
-detoxify and excrete unwanted waste
-aid in fluid and electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

most common complications GI dysfunction in children

A

-malabsorption
-fluid and electrolyte disturbances
-malnutrition
-poor growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 types diarrhea

A

-acute
-chronic
-intractable
-chronic nonspecific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

possible causes acute diarrhea

A

-infectious (bacteria, virus, parasite)
-illness (URI, UTI)
-med (Abx, laxatives)
-diet (excess sugar in formula or juice)
-functional (IBS)
-other enterocolitis (pseudomembranous, hirschprung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

possible causes chronic diarrhea

A

-malabsorption
-allergy
-immunodeficiency
-IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx diarrhea

A

-oral rehydration therapy (ORT)
-IV hydration
-assess and correct fluid and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

-Most important cause of serious Gastroenteritis in Children
-Most common cause of diarrhea associated hospitalizations
-spread through fecal oral route

A

rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S+S mild dehydration (5-6%)

A

-increased thirst
-slightly dry mucous membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx mild dehydration

A

-oral rehydration: 50 mL/kg over 4 hrs
-replacement of stool losses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

S+S moderate dehydration (7-9%)

A

-dry mucous membranes
-sunken fontanels
-sunken eyes
-no tear production
-loss of skin turgor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx moderate dehydration

A

-oral rehydration: 100 mL/kg over 4 hrs
-replacement of stool losses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S+S severe dehydration (>9%)

A

signs of moderate dehydration +
-rapid thready pulse
-cyanosis
-rapid breathing
-lethargy
-coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx severe dehydration

A

-IV fluids: bolus NS 20 mL/kg over 20 mins, LR 40 mL/kg/hr until pulse and LOC normal
-switch to oral rehydration as soon as possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

an eating disorder characterized by
compulsive and excessive ingestion of
both food and non-food substances for at
least one month

A

pica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

frequently aspirated items

A

most common:
-peanuts
-nuts
-seeds

other:
-hotdogs
-vegetables
-metal/plastic objects
-bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when should foreign ingested objects be removed

A

-if sharp object, magnet, or battery in esophagus (especially multiple batteries)
-if airway is compromised
-if in esophagus for 24+ hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

conditions that may cause delayed passage of meconium in newborn

A

-hirschprung disease
-hypothyroidism
-meconium plug
-meconium ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

inappropriate/involuntary passage of
feces, often with soiling

A

encopresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx childhood constipation/encopresis

A

-miralax
-debulking of stool
-diet
-hydration
-exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what age can you give mineral oil

A

after 1 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

risk of giving mineral oil

A

aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

longterm Tx constipation

A

phase 1 (3-5 days)
-oral clean out (mineral oil, polyethylene glycol, magnesium)
-enema clean out (milk and molasses, normal saline, microlax, mineral oil, hypertonic phosphate)
-NG lavage if hospitalized

phase 2 (6-12 months)
-oral laxatives (polyethylene glycol, mineral oil, lactulose, magnesium)
-high fiber diet
-increased fluids

phase 3
-gradual tapering laxatives
-high fiber diet
-increased fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mechanical obstruction from inadequate motility of intestine

A

hirschsprung disease/ congenital aganglionic megacolon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dx hirschprung disease

A

-xray
-barium enema
-anorectal manometric exam
-rectal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

S+S hirschprung disease in newborn

A

-failure to pass meconium in first 1-2 days
-refusal to feed
-bilious vomiting
-abdominal distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

S+S hirschsprung disease in newborn

A

-failure to pass meconium in first 1-2 days
-refusal to feed
-bilious vomiting
-abdominal distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

S+S hirschsprung disease in infancy

A

-failure to thrive
-constipation
-abdominal distention
-V/D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

S+S hirschsprung disease in childhood

A

-constipation
-*ribbonlike, foul smelling stools
-abdominal distention
-easily palpable stool mass
-visible persitalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

possible complication hirschsprung disease

A

enterocolitis
-explosive watery diarrhea
-fever
-ill appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Tx hirschsprung disease

A

-surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tx GER/GERD

A

-avoid offending foods
-surgery: nissen fundoplication

changes for infant:
-thicken feedings
-upright position
-frequent burping during feeds
-avoid overfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

when would a nissen fundoplication be indicated for GER/GERD

A

-aspiration pneumonia
-apnea
-severe esophagitis
-severe failure to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Tx IBS
-general
-meds
-school considerations

A

-diet (fiber, fluids, identify triggers)
-meds (probiotics for diarrhea, PPI - nexium, provasid)
-inform school so they can have bathroom privileges
-keep change of clothes with them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

hirschsprung disease periop teaching/care

A

-teaching colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

warnings for probiotics (preparation)

A

-don’t open and mix in room if pt has central line
-wear gloves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

when do kids get rotavirus vaccines

A

2, 4, 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

when to avoid removal of foreign ingested body

A

if already in bowel and not sharp/batteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

first sign that patient may have CF at birth

A

delayed passing meconium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

why could formula cause constipation

A

contains iron, causes constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

who is hirshsprung disease more common in

A

males
down syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

when is Tx indicated for GERD (pathologic)

A

-failure to thrive
-resp problems
-dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

how do you figure out how thick formula needs to be for feeding baby with GERD

A

radiology study with different thickness of feedings, using different nipples (slow flow)

46
Q

S+S appendicitis

A

-referred pain
-epigastric pain, mcburneys point
-rebound tenderness
-fever
-N/V
-increased WBCs

47
Q

Dx appendicitis

A

-ultrasound - preferred
-CT (if high BMI)

48
Q

Tx nonruptured appendicitis

A

-lap removal
-possible watch and wait
-Abx preop
-IV fluids and electrolytes

49
Q

S+S ruptured appendicitis (peritonitis)

A

-sudden relief of pain
then:
-diffuse pain
-abdominal distention, rigid
-fever
-chills
-tachycardia
-rapid shallow breathing
-pallow
-irritability

50
Q

Tx ruptured appendicitis

A

-surgical removal
-IV fluid and electrolytes
-Abx
-NGT suction to reduce abdominal distention

51
Q

postop care appendicitis

A

-realistic pain goal
-walk (premedicate atleast 30 mins before)
-heating pads
-splint with pillow when getting up
-wound care:

52
Q

2 forms inflammatory bowel disease

A

ulcerative colitis
crohns disease

53
Q

S+S ulcerative colitis

A

-frequent bloody stools
-anemia
-fever
-weight loss

54
Q

Tx ulcerative colitis

A

-diet: avoid triggers
-med: iron supplement, antiinflammatory

55
Q

Tx crohns disease

A

-pain management

56
Q

Dx IBD

A

colonoscopy

57
Q

S+S crohns disease

A

-some diarrhea
-pain
-anorexia
-weight loss
-growth retardation
-anal/perinanal lesions
-fistulas and strictures

58
Q

bacteria that causes peptic ulder disease

A

helicobacter pylori

59
Q

Tx peptic ulcer disease

A

-antacids
-PPI
-Abx
-teach stress management
-avoid acidic foods (juices), spicy foods, caffeine

60
Q

common side effects PPI/ H2 receptor antagonist

A

-hypoTN
-LOC depression
-N/D
-rash, sweating, flushing
-thrombocytopenia

61
Q

can meds can you not give to kids with PUD

A

NSAIDs

62
Q

S+S hypertrophic pyloric stenosis (HPS) (seen within first few weeks of life)

A

-nonbilious projectile vomiting
-visible peristalsis/olive shaped mass above umbilicus
-failure to thrive
-dehydrated
-irritable (always hungry)
-metabolic alkalosis

63
Q

Tx HPS

A

-surgery (pyloromyotomy)

64
Q

nursing consideration preop surgery HPS

A

-check hydration and electrolytes

65
Q

telescoping/invagination of one portion of intestine to another

A

intussusception

66
Q

risks with intussusception

A

-sepsis from bowel necrosis and rupture

67
Q

S+S intussusception

A

-*“currant jelly like stools”
-sudden onset abdominal pain
-abdominal mass “sausage like”
-bloody stool

68
Q

Dx intussusception

A

-ultrasound
-palpation

69
Q

Tx intussusception (conservative/nonsurgical)

A

-air enema (with or without contrast)
-hydrostatic enema (saline) - ultrasound guided

70
Q

Tx intussusception (if conservative measures unsuccessful)

A

-surgical reduction/fixation
-excision of nonviable bowel

71
Q

abnormal rotation around superior mesenteric artery during embryonic development

A

malrotation

72
Q

when intestine becomes twisted around itself and compromises blood flow to intestines

A

volvulus

73
Q

S+S malrotation and volvulus

A

bilious emesis in newborn

74
Q

Tx malrotation and volvulus

A

emergency surgery

75
Q

S+S malabsorption syndrome

A

-chronic diarrhea
-failure to thrive

76
Q

complications of malrotation and volvulus post-surgery

A

short bowel syndrome
malabsorption
*need TPN and lipids

77
Q

S+S celiac disease

A

-steatorrhea
-abdominal distention
-secondary vitamin deficiencies
-general malnutrition

78
Q

Dx celiac disease

A

gluten elimination diet
endoscopy possible

79
Q

Tx short bowel disease

A

TPN (through central line) and lipids
ostomy

80
Q

nursing consideration with TPN

A

check ingredients in TPN (can’t just scan barcode)
compare ingredients in TPN to lab values

81
Q

S+S upper GI bleed

A

stomach:
-coffee grounds emesis
-hematemesis
-*black tarry stools

esophageal
-vomiting bright red blood

82
Q

S+S lower GI bleed

A

-bright red (rectal bleeding) - hematochezia

83
Q

Dx GI bleed

A

stool cultures
CBC

84
Q

Tx GI bleed

A

-assess blood loss
-possible blood transfusion
-emergency: IV, O2, suction if severe

85
Q

nursing considerations for transfusing blood

A

-2 nurses
-consent
-blood type on record
-cross match on record
-infuse with NS only
-stay with pt first 15 mins

86
Q

time limit for using bag of blood for infusion

A

4 hours

87
Q

S+S blood transfusion reactions

A

-fever
-tachycardia
-LOC change
-hypo/HTN
-rash/hives

88
Q

S+S hepatitis

A

-jaundice
-anorexia
-fatigue
-malaise

89
Q

transmission hep A

A

fecal oral

90
Q

transmission hep B

A

perinatally acquired

91
Q

transmission hep C

A

parenteral exposure (blood)

92
Q

transmission hep D

A

people who already had hep B

93
Q

transmission hep E

A

contaminated water
fecal oral
(worse in pregnant women)

94
Q

what types hepatitis have vaccines

A

A and B

95
Q

S+S biliary atresia

A

-prolonged jaundice

96
Q

Tx biliary atresia

A

cosine procedure (stent for biliary duct)
possible liver transplant if stent unsuccessful

97
Q

S+S tracheoesophageal fistula

A

-choking
-pneumonia
-fever
-frothy saliva

98
Q

common cause esophageal atresia and tracheoesophageal fistula

A

VATAR disease

99
Q

S+S esophageal atresia

A

-failure to thrive
-vomiting right after eating
-aspiration pneumonia

100
Q

Tx tracheoesophageal fistula

A

-maintain airway
-suction
-thermoregulation
-fluid and electrolytes
-surgery
-postop: upright with feeding

101
Q

protruding bowel covered with peritoneal sac

A

omphalocele

102
Q

Tx omphalocele and gastroschisis before birth

A

C-section

103
Q

bowel herniation through abdominal bowel not covered with peritoneal sac

A

gastroschisis

104
Q

nursing considerations gastroschisis preop

A

-keep covered
-keep moist
-watch for color changes in bowel

105
Q

when does an umbilical hernia need emergency surgery

A

can’t be reduced (pushed back in)

106
Q

S+S inguinal hernia

A

-painless inguinal/scrotal swelling
-tender abdominal distention
-anorexia
-difficulty with bowel movement

107
Q

possible complications inguinal hernia

A

-herniation
-obstruction
-strangulation of bowel

108
Q

Tx inguinal hernia

A

surgery

109
Q

possible complication imperforate anus

A

sepsis (no passing of meconium)
distention
perforation of bowel

110
Q

when should H2 receptor antagonists be given if pt is also receiving antacid

A

H2 receptor antagonist 2 hours before

peds (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions