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CPN Exam > CPN Exam GI Conditions > Flashcards

CPN Exam GI Conditions Flashcards

1
Q

Diarrhea/Gastroenteritis Etiology

A

Rotavirus = most common cause
C. difficile = most common antimicrobial associated
Bacteria, parasites, food intolerances

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2
Q

C.Diff

A

Bloody diarrhea
fever
abdominal pain

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3
Q

C.Diff complications

A

Metabolic acidosis
Dehydration

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4
Q

C.Diff Management

A

Prevention - Rotavirus Vaccine
Discontinue antimicrobial agent

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5
Q

Vomiting complications

A

Dehydration
Metabolic Alkalosis
Aspiration

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6
Q

Vomiting Management

A

May withhold feeding for 4-6 hours with IV fluid
Positioning
Rehydration Therapy

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7
Q

Pyloric Stenosis

A

Thickening of abdominal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
More common in males

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8
Q

Pyloric Stenosis Assessment

A

1-3 months old
Projectile Vomiting - no bile
Dehydration

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9
Q

Pyloric Stenosis Diagnosis

A

Olive-like mass in abdomen
Abd US
Upper GI

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10
Q

Pyloric Stenosis surgical treatment

A

Involves splitting the overdeveloped muscle around the pyloric valve of the stomach, thereby spreading open the muscle and enlarging the pylorus to relieve the obstruction

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11
Q

Gastroesophageal Reflux

A

The passage of abdominal contents to the esophagus from an incompetent or poorly developed lower esophageal sphincter (LES)

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12
Q

Risk Factors for GER

A

Prematurity
Bronchopulmonary Dysplasia (BPD)
Cerebral Palsy (CP)

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13
Q

Complications of GER

A

Aspiration Pneumonia
Failure to Thrive

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14
Q

GER Diagnosis

A

Barium Swallow
Upper GI

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15
Q

GER Management

A

Small, more frequent feedings
Thickened formula
Positioning - upright 30 min post feeding
Avoid sitting positions
Back to sleep

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16
Q

GER Medications

A

Cimetidine
famotidine
Proton pump inhibitors

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17
Q

GER Surgical Repair

A

Nissen Fundoplication

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18
Q

Necrotizing Enterocolitis

A

Common in premature infants during neonatal period and in babies with cardiac defects
Blood flow to the GI tract is compromised
Bowel mucosa becomes necrotic
Bacteria invades necrotic tissue
Formula feeding provides nutrients for bacteria to grow

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19
Q

Necrotizing Enterocolitis Assessment

A

Abdominal distention
Increased gastric volumes
Vomiting
Bloody stool
Glucose + stool
Lethargy
Bradycardia
Hypotension
Temperature instability

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20
Q

Necrotizing Enterocolitis Management

A

Bowel Rest
Decompress abdomen - NG tube
Antibiotics
Decrease Stress

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21
Q

Necrotizing Enterocolitis Complications

A

Abdominal Perforation
Colostomy

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22
Q

Cleft Lip & Palate

A

Congenital defect with hereditary component
Incomplete midline fusion of the bones and tissues of the upper jaw and palate

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23
Q

Cleft Lip & Palate Management

A

Assess suck/swallow
Assess for abdominal distention
Feed slowly, upright
Burp Frequently
Specially designed nipple

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24
Q

Cleft Lip & Palate Repair

A

Cleft Lip: 1-4 months
Cleft Palate - 6-12 months (weaned from bottle)

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25
Q

Esophageal Atresia

A

Occurs when the proximal end of the esophagus ends in a blind pouch; food cannot enter the stomach

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26
Q

Tracheoesophageal Fistula

A

Occurs when there isa connection between the esophagus and the trachea

27
Q

EA/TEF Assessment

A

History of polyhydramnios
Excessive oral secretions
Abdominal Distention

28
Q

EA/TEF Management

A

Do not feed orally
Maintain patent airway
Surgical repair - in stages

29
Q

Appendicitis

A

Acute inflammation and infection of the appendix

30
Q

Appendicitis Pain Signs

A

Begins as diffuse pain; then localizes in the right lower quadrant at McBurney’s point– Rebound tenderness

31
Q

Appendicitis Assessment

A

Fever, Increased WBC
Decreased bowel sounds, Nausea/vomiting, rigidity, guarding

32
Q

Appendicitis Rupture

A

Sudden relief of pain followed by diffuse pain

33
Q

Appendicitis Treatment

A

IV Antibiotics/PO antibiotics
Appendectomy

34
Q

Celiac Disease

A

An enteropathy caused by an insensitivity to the gluten found in wheat

35
Q

Celiac Disease Assessment

A

Steatorrhea
Abdominal Distension
Failure to thrive
Muscle Wasting

36
Q

Celiac Disease Management

A

Gluten-free diet
Vitamin Supplementation (MTV, Folic Acid, Iron)

37
Q

Hirschsprung Disease (Megacolon)

A

A congenital anomaly of decreased intestinal motility resulting in mechanical obstruction of the intestine

38
Q

Hirschsprung Disease Assessment

A

Abdominal Distention
Constipation
Ribbon-like, liquid stools

39
Q

Hirschsprung Disease Management

A

Diagnosis: Rectal Biopsy
Surgical correction with or without an ostomy

40
Q

Intussusception

A

One portion of the intestine telescopes into another leading to:
Lymphatic and venous obstruction resulting in Ischemia Mucous backflow into the intestine
Leaking of blood into the intestine

41
Q

Intussusception Prevalence

A

3 months - 2 years
Males > Females
90% idiopathic

42
Q

Intussusception Assessment

A

Sudden onset abdominal pain
Knees to chest
Inconsolable crying
Bilious vomiting
Currant-Jelly stools

43
Q

Intussusception Management

A

Abdominal Xray
Abd US
Barium Enema - Gold Standard

44
Q

Intussusception Treatment

A

Hydrostatic Reduction with Barium Enema
Water Soluble Contrast with Air Pressure
80% successful

45
Q

Intussusception Surgical Repair

A

Manual reduction, possible resection of gangrenous bowel

46
Q

Encopresis

A

Fecal soiling of underwear in a child older than 4 years
Most commonly caused by constipation

47
Q

Inflammatory Bowel Disease

A

Chronic intestinal inflammation
-Ulcerative Colitis
-Crohn’s Disease

48
Q

Ulcerative Colitis

A

Inflammation involves the colon and rectum only
Affects 2-layers (mucosa and submucosa) of the bowel

49
Q

Crohn’s Disease

A

Inflammation can involve any part of the GI tract
Affects all layers of the bowel wall

50
Q

IBD Symptoms

A

Bloody diarrhea
Abdominal pain/cramps
Weight loss
Growth retardation (common presenting symptom)

51
Q

IBD Medications

A

Analgesic and antispasmodics (pain relief)
Corticosteroids (inflammation)
Immunomodulators (methotrexate and cyclosporine)
Biologics (Remicade = infliximab)

52
Q

IBD Nutrition

A

Enteral and parenteral nutrition
High-protein, High-calorie diet
Low residue (low fiber) diet during periods of bowel inflammation
Vitamin supplementation: multi-vitamin, folic acid, iron

53
Q

IBD Surgical Treatment

A

Total Colectomy (often cures UC)

54
Q

Hyperbilirubinemia

A

Unconjugated/Indirect
Congugated/Direct

55
Q

Unconjugated/Indirect Bili

A

Biproduct of red blood cell breakdown
Passes blood-brain barrier in neonates (when levels are high) Elevated in physiologic/neonatal jaundice
- Treated with phototherapy

56
Q

Conjugated/Direct Bili

A

Formed when unconjugated/indirect bilirubin travels to the liver and is conjugated with glucuronic acid
Elevated in biliary atresia
Treated surgically

57
Q

Biliary Atresia

A

A congenital anomaly involving the obstruction, obliteration or absence of extrahepatic biliary structures
Unknown etiology
Can cause liver failure/death

58
Q

Biliary Atresia Assessment

A

Jaundice
Pruritis - causing irritability
Pale Stool
Hepatomegaly, ascites, splenomegaly
Failure to thrive
Increased LFT’s - direct bilirubin, Alk Phos, PT

59
Q

Biliary Atresia Management

A

Administer Fat-Soluble Vitamins (A,D,E,K)
Kasai procedure
Liver transplant

60
Q

NG Tube Placement

A

pH ≤ 5 = gastric placement of NG tube tip
pH > 5 requires other methods to confirm placement
Check tube length
Obtain x-ray

61
Q

NG Tube Patency

A

Check tube placement with each medication/feeding
Flush and clamp tube after each medication administered

62
Q

Acetaminophen Dosing

A

10-15 mg/kg per dose every 4 hours
Non-Therapeutic - <10mg/kg dose
Overdose = Liver Failure - treated with Acetadote, Mucomyst

63
Q

Tylenol with Codeine

A

NOT recommended in Children - metabolized in liver and converted to morphine - genetic predisposition can cause morphine overdose

CPN Exam (10 decks)

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