Chapter 15: Gastrointestional Disorder

Question 1

Treatment and post care of pyloric stenosis

Answer 1

Surgery. Post OP: clear liquids, place infant in seat after feeding. may continue to vomit: report if vomiting after 48 hours. I/O daily weights. Home care: regular feeding hold baby, feed slowly, burp frequently

Question 2

the nurse caring for children in the emergency room teaches the student nurse about the injury statistics related to abdominal trauma, including:

Answer 2

Injuries are the leading cause of death in children and adolescents after the first year, injuries from motor vehicle accidents are the primary cause of accidental death in the United States, injuries to the abdominal and genitourinary area accounts for 10% of serious trauma

Question 3

Umbilical hernia

Answer 3

intestines protrude through the abdominal muscle through the belly button. Occurs when the fusion of the umbilical ring is incomplete at the point where the umbilical vessels exit the abdominal wall. 90% close by age 5. Failure to close requires surgery

Question 4

The nurse explains to the student nurse that ____ is characterized by projectile vomiting and a palpable olive-shaped mass in the epigastrium

Answer 4

pyloric stenosis

Question 5

What is gastroesophageal reflux?

Answer 5

Return of gastric contents into the esophagus from a relaxation of the lower esophagus sphincter

Question 6

an acute or chronic inflammation of the colon characterized by recurring bloody diarrhea

Answer 6

ulcerative colitis

Question 7

A pathological condition that occurs as an end stage to many liver and inflammatory conditions

Answer 7

Cirrhosis

Question 8

Diagnostic testing for malrotation and volvulus?

Answer 8

Upper GI series, CBC with electrolytes, ultrasound, barium enema

Question 9

A nurse teaches the family of a child with celiac disease the types of foods to avoid in the child’s diet. The nurse tells the parents to eliminate:

Answer 9

Rye and wheat. gluten products

Question 10

The nurse explains to the parents of an infant diagnosed with a bowel obstruction that one of the most common causes of intestinal obstruction in infancy is from _____

Answer 10

intussusception

Question 11

the nurse examining a child with hepatitis knows that the disease may be acute or chronic and involves an inflammation of the pancreas: T/F

Answer 11

False

Question 12

An infant with tracheosophqgeal fistula will present with?

Answer 12

Increasing respiratory distress until suctioned

Question 13

What is the treatment of malrotation and volvulus?

Answer 13

Surgical emergency, may need resection with significant damage

Question 14

The nurse is monitoring a child for signs of hepatitis. The nurse documents the following s/s related to the preicteric phase of hepatitis in the child’s charts

Answer 14

Nausea and anorexia

Question 15

Clinical manifestations of intussusception

Answer 15

Abrupt onset of abdominal pain vomiting, passage of brown stool alternating with period of comfort, fever, jelly-like stool. may have shock and sepsis after 12-24 hours

Question 16

What does celiac crisis cause?

Answer 16

Severe dehydration and diarrhea

Question 17

what diagnostic tests for appendicitis?

Answer 17

CBC w differential: shows WBC with left shift, urinalysis, ultrasound, CT scan

Question 18

The student nurse studying the digestive system knows that most of the work of absorption occurs through a system of villi and folds in the ______

Answer 18

Small intestines

Question 19

A nurse listens while a mother describes her toddler’s eating habits. The mother states that her daughter “refuses to eat veggies at mealtime” and “wants peanut butter sandwiches for every meal.” The nurse’s best advice to the mother is:

Answer 19

Reassure her that food jags are normal and the tendency will pass

Question 20

stool incontinence beyond the age of 4

Answer 20

encopresis

Question 21

Clinical manifestations for irritable bowel syndrome

Answer 21

hyperperistalsis, diarrhea, cramping, bloating, constipation, change in appearance of the stool, urgency to have a bowel movement, more common in woman than men

Question 22

Diagnostic testing and treatment for inguinal hernia

Answer 22

upright patient will cough or bear down to feel hernia, transillumination of hydrocele to eliminate hernia, report lump seen in groin area. Treatment: surgical repair

Question 23

The nurse is caring for a child with biliary atresia. The nurse knows that the s/s of this disease include:

Answer 23

pruritus, jaundice, and dark urine

Question 24

What can gastroesophageal reflux lead to?

Answer 24

esophagitis, failure to thrive, aspiration, pneumonia, respiratory airway disease, apnea

Question 25

Manifestations of incarceration hernia

Answer 25

Increased in pain, fever, tachycardia, bilious vomiting, NO STOOL, erythema and edema over a tender groin mass

Question 26

Treatment for ulcerative colitis

Answer 26

Aminosalicylates such as sulfasalazine or mesalamine orally or suppository, corticosteroids, immunosuppressives, cyclosporine A for sever, nutritional supplementation, surgery if medication doesn’t work

Question 27

A pediatrician diagnoses pathological gastroesophageal reflux in an infant. The nurse is aware that several conditions are associated with this condition, including:

Answer 27

esophagitis, failure to thrive and aspiration pneumonia

Question 28

clinical manifestation of ulcerative colitis

Answer 28

abdominal pain, bloody diarrhea, urgency to defecate, anemia, fatigue, weight loss, fever

Question 29

a disorder in which the proximal small bowel mucosa is damaged as a result of dietary exposure to gluten

Answer 29

Celiac disease

Question 30

A father brings his infant to the community clinic and tells the nurse that his son has been experiencing bouts of diarrhea for the past 2 days. The nurse notes that the infant is diagnosed with malabsorption syndrome and suspects the infant has:

Answer 30

osmotic diarrhea

Question 31

An inability to digest milk and some dairy products

Answer 31

lactose intolerance

Question 32

The pediatric nurse examines an infant who has an inguinal hernia. After researching the incidence of hernias, the nurse learns that:

Answer 32

Inguinal hernia is more prevalent in males than females

Question 33

Diagnostic tests for peptic ulcers

Answer 33

CBC, sedimentation rate, H. pylori antibody blood test antigen in stool, stool for occult blood, WBC, upper GI series, endoscopy with biopsy and H. pylori culture

Question 34

Treatment for intussusception

Answer 34

NG tube: decrease vomiting, decompress stomach, Hydrostatic reduction: use barium enema to straighten bowel, document passage of barium, surgical reduction

Question 35

What is a peptic ulcer

Answer 35

loss of the digestive tract mucosa from excessive acid secretions, bile salts, genes, lack of prostiglandins, bacteria-Helibacter pylori, psychological, stress, diet, and meds

Question 36

What is pyloric stenosis?

Answer 36

A condition in which the opening between the stomach and the small intestines thickens

Question 37

What is malrotation and volvulus?

Answer 37

Abnormal rotation or twisting of the intestine

Question 38

Treatment for peptic ulcers

Answer 38

patient should be seen immediately for sudden persistent stomach pain, bloody or black stools, bloody vomit, or coffee ground vomit, IV therapy for sever symptoms, triple therapy (two antibiotics and a photon pump inhibitor, no antacids 1+- antiulcer meds: interferes with absorption, no milk: stimulates acid production, no cola, coffee, ibuprophen, cigarettes

Question 39

Treatment and interventions for irritable bowel syndrome

Answer 39

change diet: no triggers, more fiber, small meals, laxatives or Imodium for symptoms, can drink milk, pain control for hyperperistalsis, usually normal growth and development, resolves around 20

Question 40

What is an incarceration hernia?

Answer 40

a portion of the intestine that can’t be returned to the cavity. Leads to obstruction, pain, strangulation, which leads to necrosis and death.

Question 41

What is intussusception?

Answer 41

Telescoping of the intestine into adjacent portion. Most common cause of obstruction.

Question 42

what is an inguinal hernia?

Answer 42

Protrusion of the bowel into the groin muscle. Needs prompt management to prevent incarceration hernia. More prevalent in males

Question 43

What is a trachesophageal fistula? How is it found? How is it treated?

Answer 43

Inability to handle secretions; cyanosis when feeding, resistance with passage of feeding tube. X-ray and contrast dye. Surgical repair

Question 44

caused by a congenital absence of Meissner and Auerbach plexus in the bowel wall

Answer 44

Hirschsprung disease

Question 45

What can’t a person with celiacs disease eat?

Answer 45

Wheat barley oats and rye

Question 46

clinical manifestations of Crohn’s disease

Answer 46

abdominal pain, often lower right quadrant like appendicitis, fever diarrhea, n and v, anorexia, intestinal blockage, exacerbation and remission

Question 47

Fibrous band that arises from a remnant of the fetal development in the midgut, which normally is obliterated by the seventh to eighth week of gestation but failed to do so. Requires surgery to prevent hypovolemic shock and hemorrhage

Answer 47

Meckel diverticulum

Question 48

What are the manifestations of an inguinal hernia?

Answer 48

Lump in the groin, commonly the right side, History of intermittent pain and swelling in the groin, feeling of weakness or pressure in groin with burning gurgling lump, patient with a hydrocele (fluid-filled sac around testes) should be checked for inguinal hernia

Question 49

Clinical manifestations of peptic ulcers

Answer 49

May be asymptomatic with recurrent abdominal pain, vomiting, anorexia. proceeds to cramping epigastric pain and changes in eating habits, proceeds to chronic episodic epigastric pain, vomiting with recurrent nocturnal awakening, anemia with GI bleeding, perforation of the stomach or duodenum

Question 50

The nurse documents the s/s of appendicitis, including abdominal pain that begins in the ____ area and moves to the right lower quadrant, accompanied by a low grade fever, _____, and occasional vomiting.

Answer 50

periumbilical: nausea

Question 51

an infection of the umbilical stump

Answer 51

omphalitis

Question 52

Clinical manifestations of pyloric stenosis

Answer 52

forceful, progressive, nonbilious vomiting after each feeding, poor weight gain, dehydration causes decrease in serum chloride, avid hunger, restless, irritable olive like mass upper right quadrant to the right umbilicus, metabolic acidosis

Question 53

a nurse on a pediatric unit is caring for a child with short bowel syndrome. When providing nutritional therapy for the child, the nurse checks for feeding intolerance and makes daily assessments of:

Answer 53

weight, input/output, and specific gravity

Question 54

Diagnostic testing for ulcerative colitis

Answer 54

CBC, electrolytes, liver enzymes, total protein, albumin, serum iron, stool for occult blood and white blood cells, colonoscopy

Question 55

What are some clinical manifestations of celiac disease?

Answer 55

Abdominal bloating, diarrhea, vomiting, flatulence, foul-smelling stools

Question 56

The difficult or infrequent passage of hard stool

Answer 56

constipation

Question 57

What percentage of peptic ulcers in infants is caused by stress?

Answer 57

80%

Question 58

Diagnostic testing for Crohn’s disease

Answer 58

CBC, electrolytes, liver enzymes, Serum calcium and phosphorus, stool for occult blood and white blood cells, ultrasound, CT scan, ophthalmic exam, colonoscopy with tissue biopsy

Question 59

Clinical manifestation of malrotation and volvulus

Answer 59

May be asymptomatic, symptoms of bowel obstruction, intense crying and pain, pulling up of the legs, abdominal distention, vomiting, usually bilious, tachycardia and tachypnea

Question 60

Inflammatory bowel disease

Answer 60

Crohn disease

Question 61

A mother brings her infant to the pediatrician for a check-up. She tells the pediatric nurse that almost every afternoon her infant fusses and holds his body in a rigid, flexed position for several hours. Based on this description, the nurse suspects that the infant has:

Answer 61

Infantile colic

Question 62

A patient on a pediatric unit receives a diagnosis of encopresis without constipation. When planning a diet for this patient, the nurse will be sure to include plenty of?

Answer 62

wheat

Question 63

hiatal hernia

Answer 63

A condition in which part of the stomach pushes up through the diaphragm muscle

Question 64

Treatment for Crohn’s disease

Answer 64

Pain w bleeding: immediate treatment, IV therapy, corticosteroid therapy for remission, infliximab therapy, azathioprine, methotrexate, nutritional supplementation, surgery if medication not working

Question 65

During a well-child visit, the pediatric nurse performs a physical assessment on a 2 year old patient. The nurse knows that developmentally at age 2 _______

Answer 65

The salivary glands reach adult size

Question 66

what are the s/s of appendicitis?

Answer 66

Fever, nausea and vomiting, abdominal pain, right leg flex relieves pain, increased WBC 15-20,000, usually no stool

Question 67

A nurse is caring for a 10-year old patient on the pediatric unit who has been vomiting upon arising for the past 2 days. The nurse knows that this symptom is often associated with:

Answer 67

neurological involvement

Question 68

Why don’t you apply a K pad (heat) to appendicitis?

Answer 68

May rupture the appendix and lead to peritonitis

Question 69

Diagnostic treatment for irritable bowel syndrome

Answer 69

CBC, stool studies for O and P, blood, WBC, culture, endoscopy if any bleeding to rule out IBS

Question 70

the nurse knows that appendicitis is considered the most common condition that requires abdominal surgery in children: T/F

Answer 70

True