disorders of elimination Flashcards
1
Q
when do kids usually develop bowel and bladder control
A
2-3yrs
2
Q
how often to children defecate
A
2-3x/wk
breast fed can be 1x/wk
3
Q
what is functional constipation
A
most common cause of chronic constipation in children
witholding due to pain e.g. fissure
mx - laxatives, bowel training, diet
4
Q
management of constipation
A
behaviour
- postition - foot stool, lean forward, elbows on knees
- toilet sits 5min x3/day after meals ]
- praise, star chart
diet
increase fibre
adequately hydrated
medication aim for 1 soft stool/day can take osmotic/lubricant safely for months most fail due to cease laxative in infants - coloxyl drops or lactulose children - movicol
5
Q
constipation vs hirschsprung
A
const
- age of onset -> > newborn
- passage of mec <48hrs
- soiling yes
- wt gain yes
- size of BM large
- anal fissure yes
HD
- age of onset newbowrn
- passage of mec delayed >48hrs
- soiling no
- wt gain no
- size of BM small
- anal fissure no
6
Q
what are the 3 types of enuresis
A
primary
seconday
diurnal
7
Q
primary enuresis
A
common 15% of 5yo wet bed more common in males causes - familial - decreased ADH production - stress - uti
8
Q
causes of secondary enuresis
A
- uti
- dm
- emotional
9
Q
causes of diurnal enuresis
A
- UTI
- neurogenic bladder
- psychogenic
- sexual abuse
10
Q
what hx is important in enuresis
A
- primary or secondary, trigger
- fam hx
- stress
- dm sx
- uti sx
- what have parents tried
11
Q
ix for enuresis
A
urinalysis ?UTI
urine dip stick ?DM
USS KUB ?congenital abnormality
12
Q
management of enuresis
A
often dont need intervention until 7yrs old behaviour - star chart, reward enuresis alarm bladder training meds - desmopressin
