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nurs 345: children > ch 41: GI dysfunction > Flashcards

ch 41: GI dysfunction Flashcards

EXAM 2 content -- all the important things i need to know (imo)

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1
Q

when will we need increased fluid?

A
  • fever
  • vomit
  • diarrhea
  • kidney fail
  • diabetic ketoacidosis
  • BURNS
  • shock
  • tachypnea
  • radiant warmer
  • phototherapy
  • post op bowel surgery
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2
Q

when will we need decreased fluids?

A
  • HF
  • SIADH
  • mech vent
  • after surgery
  • oliguric renal fail
  • incr intracranial pressure
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3
Q

what will we see in GI dysfunction?

A
  • growth fail
  • spitting/regurgitation
  • n/v, diarrhea, constipation
  • jaundice
  • dysphagia
  • fever
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4
Q

what are the causes of dehydration? what will we see w dehydration?

A
  • fluid loss
  • incr renal excretion
  • vomit & diarrhea
  • ketoacidosis
  • burns
  • incr RR
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5
Q

what are types of dehydration?

A
  • isotonic = lost in equal parts, primary form in children, risk for hypovolemia
  • hypotonic = loss of electrolytes, physical signs more severe
  • hypertonic = loss of water, specific fluid therapy
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6
Q

what should we measure to be accurate with intake & output?

A
  • urine & stools
  • vomit: # of episodes
  • sweat
  • V/S
  • skin turgor & mucous membranes
  • body weight
  • fontanels in infants, dehydration = sunken
  • sensory alterations
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7
Q

what are the manifestations of dehydration?

A
  • weight loss
  • VS changes
  • behavioral changes
  • thirst
  • sunken fontanel
  • tenting = not eating or drinking
  • decr cap refill
  • decr UOP
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8
Q

what is oral rehydration?

A

safer, less painful than IV
- promotes reabsorption of water
- reduced vomit, diarrhea & duration of illness

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9
Q

diarrhea – what do we need to know?

A
  • leading cause < 5 yo
  • 24% of deaths r/t diarrhea & dehydration of developing countries
  • types: acute, infectious, chronic, nonspecific, intractable diarrhea or infancy
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10
Q

causes of diarrhea?

A
  • gastroenteritis (stomach + intestines)
  • enteritis (small intestine)
  • colitis
  • enterocolitis (colon + intestines)
  • rota virus
  • salmonella, shigella, campylobacter organism
  • MOST COMMON: giardia organism
  • C diff
  • plesiomonas, yersinia organism
  • antibx effects
  • cryptosporidium organisms
  • INTESTINAL PARASITES: giardia & pinworms
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11
Q

what is the management of diarrhea?

A
  • assess fluid & electrolyte imbalance
  • rehydration
  • fluid therapy
  • slow introduction to adequate diet
  • support & education
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12
Q

how do we prevent diarrhea?

A
  • 2 rotavirus vaccines
  • personal hygiene
  • clean water, protect from contamination
  • careful food prep
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13
Q

what is the cycle of constipation?

A

big changes, fam problems, condition, psychosocial –> hold stool –> incre stool –> pain BM
- secondary to other disorders
- idiopathic constipation: no known cause
- chronic constipation: due to environment or psychosocial

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14
Q

what if meconium doesn’t pass in 24-36 hours after birth?

A

assess:
- intestinal atresia, stenosis
- hirschsprung disease, hypothyroidism
- meconium plug, meconium ileus

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15
Q

why would infants have constipation?

A
  • diet
  • breast milk has minimal residue
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16
Q

why would children have constipation? management?

A
  • environment changes
  • control over body
  • stress

ENCOPRESIS: inappropriate passage of poop, with soiling (watery)
- common in males
- psychological distress
- secondary to constipation
- determine cause, diet, manage
- psychotherapeutic interventions

management
- hx of BM, meds, diet
- educate
- diet modifications

17
Q

what is hirschsprung disease?

A

aka – CONGENITAL AGANGLIONIC MEGACOLON
- mechanical obstruction bc of inadequate motility of intestine
- more common in boys + down syndrome
- absence of ganglion cells in colon –> literally CANT PASS STOOL, no meconium at birth

18
Q

how do we diagnose hirschsprung disease?

A
  • diagnosed first few months of life
  • complete hx
  • x ray, barium enema studies
  • anorectal manometric
  • RECTAL BIOPSY
19
Q

how do we treat hirschsprung disease?

A

SURGERY
- 1st stage: temporary ostomy
- 2nd stage: pull thru procedure

pre op, post op, discharge, educate

20
Q

vomiting – what do we need to know?

A

forceful ejection of gastric content thru mouth
- with nausea
- nonbilious & bilious
- detect cause & prevent complications
- evaluate, look at hx

21
Q

gastroesophageal reflux (GER) – what do we need to know?

A

gastric contents in esophagus
- occurs w everyone
- abnormal if high frequency & persistency
- may occur without regurgitation
- kids have this bc systems are immature –> heart burn
- losing weight & not eating –> get checked out, smaller bites, & sit up more

22
Q

acute appendicitis – what do we need to know?

A

inflammation of the vermiform appendix
- diagnosis: Mcburney’s point

s/s
- more common in children
- low grade fever
- n/v
- stomach pain
- headache
- rebound tenderness

management:
- treat ruptured appendix
- monitor
- surgical removal to prevent rupture

23
Q

inflammatory bowel disease (IBD) – what do we need to know?

A

includes ulcerative colitis & crohn’s disease
- nutrition: high protein high calorie, well balanced + MVI, iron, folic acid
- prognosis: follow up medication compliancy

24
Q

what are the different types of hepatitis?

A

A B C D E

25
Q

how do we do infection control for hepatitis?

A

handwash & avoid illicit drug use

26
Q

biliary atresia – what do we need to know?

A

aka EXTRAHEPATIC BILIARY ATRESIA
- unknown cause
- if left untreated –> CIRRHOSIS

27
Q

cleft lip & cleft palate – what do we need to know?

A

facial malformations during embryonic development
- show separately or together
- multifactorial inheritance
- surgical correction of CLEFT LIP @ 2-3 mo of age –> protect suture line
- surgical correction of CLEFT PALATE @ 6-12 mo of age –> asap so there is no effects on feeding + speech development

28
Q

how do we help with feeding with kids with cleft lip & cleft palate? what are some problems?

A
  • techniques & interventions
  • special feeding equipment

problems:
- breast feeding issue
- growth failure

29
Q

esophageal atresia & tracheoesophageal fistula (TEF) – what do we need to know?

A
  • ESOPHAGEAL ATRESIA: failure of esophagus to develop has a continuous passage –> problems swallowing & feeding
  • TEF: failure of trache to separate into a distinct structure
  • can occur separate or together
  • unknown cause
  • risk for: aspiration & pneumonia
30
Q

how do we manage TEF?

A
  • maintain airway
  • prevent pneumonia
  • depress gastric or blind pouch
  • support
  • surgical repair
  • prognosis: good in healthy children!
31
Q

hernia – what do we need to know?

A

protrusion of portion of an organ thru abnormal opening –> danger of incarceration/strangulation

types
- diaphragmatic
- abdominal wall
- inguinal canal

32
Q

hypertrophic pyloric stenosis – what do we need to know

A

constriction of pyloric sphincter WITH obstruction of gastric outlet
- need surgery to correct
- VOMITING across the room
- hungry but vomits after

33
Q

intussusception – what do we need to know?

A

telescoping or invagination (folded back) of one portion of intestine INTO another
- 3mo - 3 yo
- sometimes due to intestinal lesions (10%)
- unknown cause
- RED JELLY POOP!!! EWWW
- we want to hear BM!!

34
Q

malrotation & volvulus – what do we need to know?

A

MALROTATION: abnormal rotation of intestine around superior mesenteric artery DURING embryologic development

VOLVULUS: twisting of intestine around ITSELF –> compromising blood supply to intestines

–> necrosis, peritonitis, preformation & death

35
Q

anorectal malformations – what do we need to know?

A

that these cause GI distress & issues passing stool

36
Q

malabsorption syndromes – what do we need to know?

A

chronic diarrhea & malabsorption of nutrients –> fail to thrive, anatomic & biochemical defects

37
Q

celiac disease – what do we need to know?

A

aka GLUTEN SENSITIVE ENTEROPATHY & CELIAC SPRUE
- steatorrhea
- first line management: diet changes
- low gluten diet

risk for –>
- general malnutrition
- abdominal distention
- secondary vit deficiencies

38
Q

obesity – what do we need to know?

A

obesity is intertwined in EVERY DISEASE PROCESS & worsening outcomes

nurs 345: children (23 decks)

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