Exam #2 Flashcards
1
Q
Structural GI Disorder:
- can occur in isolation or together
- can be bilateral or unilateral
- requires surgical repair
- these babies are encouraged to be breast-fed as there is more surface area & reduced additional air intake
- baby should be fed upright (45-90 degrees) and intermittently
A
Cleft Lip & Palate
2
Q
Structural GI Disorder:
- knot in the groin area
- dangerous as there are more structures nearby
- abdominal or pelvic contents travel to the inguinal canal
- requires reduction & possibly surgery
- 5x more common in boys due to undescended testicles
A
Inguinal Hernia
3
Q
Structural GI Disorder:
- more common type seen in premature infants
- GI issues do not typically arise
- surgical repair is commonly done for cosmetic purposes
- occurs due to weakening of the GI muscle
A
Umbilical Hernia
4
Q
Treatment for Hernias
A
Push it back in
- if its affecting them structurally, or pops out every time the child cries, then surgery is considered
5
Q
Obstructive GI Disorders:
- __________ sphincter is not opening which occurs when the muscle thickens over time (not born w/ it)
- cause is unknown
- what is entering the stomach cannot exit & will come right back up
- higher chance for boy to have it if father had it (unknown why)
- S&S: projectile vomiting, crying, not gaining weight, olive-shaped mass in RUQ
- seen around 3-6 weeks of life
- Dx: ultrasound
- Tx: pyloromyotomy - surgery to snip muscle, take thickened part out, and ensure opening remains
A
Pyloric Stenosis
6
Q
Obstructive GI Disorders:
- intestines telescope into itself
- more common in males
- occurs in kids a little older than 3-6 weeks and are intermittently fussy – when the child cries, they bear down and can pop it back out but the telescoping can happen again
- S&S: current jelly stools, acute sudden abdominal pain, sausage-like lump in lower abdomen (typically RLQ)
- Tx: barium or air enema (high risk of bowel perforation) OR surgery (rare)
A
Intussusception
7
Q
Obstructive GI Disorders:
- inflammatory disease of the intestinal tract
- life threatening and seen often in the NICU after the first few feeds – high mortality rate
- S&S: feeding intolerance (failure-to-thrive), lethargic, bradycardic, apneic spells, bloody diarrhea
- Tx: surgery to remove that portion of bowel, bowel rest (TPN), antibiotics
A
Necrotizing Enterocolitis (NEC)
8
Q
Inflammatory GI Disorders:
- inflammation of the affected organ
- S&S: ABD pain around belly button (RLQ), McBurney Point (rebound tenderness), poor appetite, N/V, fever (typically when perforation occurs), want to be in fetal position
- constipation & __________ present similarly
A
Appendicitis
9
Q
Abdominal Wall Defects:
- birth defect due to a herniation of the ABD wall during development – born with their intestines on the outside
- Dx: MSAFP – seen on ultrasound prior to birth
- after C-section, intestines are exposed to air since NOT covered by peritoneal layer
- Tx: wrapping & supporting the intestine (prevent hypothermia & fluid loss), surgical repair, SILO, TPN (bowel rest)
A
Gastroschisis
10
Q
Abdominal Wall Defects:
- protrusion of umbilical cord & is sealed by the peritoneal layer – typically the bowels, liver, kidneys, etc. (ALL) are developed outside the body
- Dx: MSAFP
- can be worse as it can take longer to put back in along w/ other complications
A
Omphalocele
11
Q
Functional GI Conditions:
- persistent & crying babies that are under 3 months old
- idea for cause is that baby has a lot of gas build-up (fed a lot, not burped enough) – unknown
- S&S: crying episodes lasting 3 hours, more than 3 days, more than 3 weeks; baby will pull legs & arms to a flexed position
- Tx: have parents place baby in safe space after eliminating every other cause & stepping away – shaken-baby syndrome risk
A
Infantile Colic
12
Q
Functional GI Conditions:
- excessive loss of fluids due to vomiting & diarrhea
- Causes: viral (most common), diet, meds, toxins
- BRAT diet: bananas, rice, applesauce, toast
- Tx: BRAT, rehydration, as long as dehydration not evident, can be treated at home
A
Gastroenteritis
13
Q
Functional GI Conditions:
- difficult or infrequent passage of hard stool
- S&S: hard stool, poor appetite, straining when defecating
- Tx: bowel retraining, nutrition, education (increasing fiber & water)
A
Constipation
14
Q
Functional GI Conditions:
- these babies spit-up a lot – need to know vomit vs. spit-up
- they have choking episodes as well as apneic episodes (acid building up)
- S&S: vomiting & regurgitation; fussiness; refusal to eat, choking, apnea, wheezing
- Dx: H&P, pH study or swallow study
- Tx: keep upright while feeding (30min-1hr) and NOT in a car seat, frequent burping, meds (Zantac)
A
Gastroesophageal Reflux Disease (GERD)
15
Q
Functional GI Conditions:
- congenital absence of Meissner and Auerbach autonomic plexus in the bowel wall
- S&S: failure to pass meconium within first 48 hrs of life, failure-to-thrive, poor feeding, enterocolitis
- Tx: surgical resection, colostomy, GI irrigation (cannot empty out, need to be flushed)
A
Hirschsprung Disease (Megacolon)
16
Q
Hepatic Disorder:
- liver is not working how its supposed to – blockage in bile duct
- can be a congenital defect sometime during fetal development but commonly its an inflammation shortly after birth – idiopathic
- S&S: jaundice, dark urine, light stools, bloated belly (round)
- Tx: Kasai procedure (remove damaged ____ duct & reconnect SM-intestine to liver) – even w/ Tx, most kids require liver transplant; TPN/Lipids & nutritional support
A
Biliary Atresia
17
Q
__________ system controls growth & development
A
endocrine
18
Q
- child will be shorter in stature & typically require growth hormone in order to grow
- underproduction of cells
- effects ALL of the following parts of the body: reproduction, kidney disease, heart issues, cognitive issues, etc. (every organ in the body)
- S&S: delayed growth (3rd-5th percentile), continue to maintain baby-like facial features, skeletal growth delayed, missed milestones, delayed bodily processes
- Dx: growth evaluation; labs; bone x-ray; brain MRI
- some studies show children in abusive households or are abused can experience delayed growth development
- w/o Tx, affects the entire body and leads to decompensation, and possibly death
A
HYPO-pituitary (growth hormone deficiency)
19
Q
- overabundance of cells (gonadotropin) – child develops at much quicker rate (reproductive organs develop much sooner)
- early onset of menarche can be seen as child abuse
- Boy S&S: facial hair, penile growth, masculinity
- Girl S&S: breast development, onset of menarche
- S&S: increase of LH, FSH, and testosterone
- Tx: growth hormone suppressant; psychological care for both child & parent
A
Pituitary HYPER-function (Precocious puberty)
20
Q
- these issues are preventable by treating the issue – w/o they can experience serious delays in development
- S&S: delayed growth, inability to tolerate cold, constipation, fatigue, poor feeding
- Tx: now included on newborn screening, meds (Levothyroxine [Synthroid])
A
Congenital HYPO-thyroidism
21
Q
- underacting thyroid (autoimmune disorder) that can be caused by genetic or environmental (pollutants) factors
- Risk factors: females, family Hx, radiation exposure, other autoimmune diseases
- S&S: poor temperature regulation (always cold), delayed growth, fatigue, hair loss (older kids), puffy moon-face, brittle nails – goiter (palpate enlarged thyroid)
- Dx: labs (TSH & T4)
A
Hashimoto
22
Q
- group of autosomal recessive inherited disorders affecting the adrenal glands
- insufficient supply of enzymes required for production of cortisol & aldosterone
- Cause: deficiency of 21 hydroxylase enzyme
- Boy S&S: large genital, hyper-pigmented scrotum & start puberty at age 2 years
- Girl S&S: in utero develops male sex characteristics, hypotension, hypoglycemia
- S&S: electrolyte imbalance
- Tx: meds (hydrocortisone), psychosocial care for both child & parents
A
Congenital Adrenal HYPER-plasia
23
Q
- damage due to autoimmune disorder – damage to gland resulting in releasing cortisol & aldosterone – hard time maintaining electrolyte balances (cannot use for energy, muscle growth, etc.)
- S&S: constantly fatigued, always irritable, constantly losing weight, consistent muscle weakness
- if left untreated: hypotension, kidney failure, and severe abdominal pain – will go into adrenal crisis (stress causes as well)
- Tx: meds
A
Addison’s Disease
24
Q
- poorly functioning pancreas leads to excessive glucose – affects major organs (body metabolizes fats for energy)
- autoimmune disorder
- S&S: losing weight, constantly peeing (up at night), always thirsty, constantly eating, fruity breath
- w/ DKA: too much ketones (acid) and presents as lethargic w/ Kussmaul respirations (NOT RESPIRATORY RELATED FOR EXAM)
- Tx: insulin (lifelong maintenance); teach child to carb-count and check glucose levels
A
Diabetes Mellitus Type I
25
Q
behavior modification
A
- set limits
- do not argue, bargain, or negotiate after limits are set
- consistent caregivers matter
- use a low-pitched tone
- redirect the child
- ignore inappropriate behaviors or educate why they are inappropriate
- praise self control & appropriate behaviors
26
Q
- Onset: infant or early childhood –> may notice developmental delays or loss of previous ability
- Cause: mainly genetic –> possibly environmental (pollutants)
- S&S: communication issues, prefer to be alone (not play w/ others), difficulty interpreting others emotions, repetitive movements or speech patterns, avoid eye contact, sensitive to loud noises, eccentric ways of moving
- Tx: NO cure; goal is to strive for optimal functioning (provide structured environment); family support
A
autism spectrum disorder
27
Q
Most common neurodevelopmental disorder of childhood
- Cause: genetic
- S&S: impulsive, hyperactive (cannot sit still), don’t pay a lot of attention, lack of self control (trouble keeping body calm)
- Tx: Meds [methylphenidate, dextroamphetamine; Adderall, Ritalin] & education [meds & school assistance - IEP plan]
A
attention deficit hyperactivity disorder (ADHD)
28
Q
any injury intentionally inflicted on a child
A
physical abuse
29
Q
sexual activity intended to provide pleasure to an adult
- can lead to inappropriate sexual behavior at a young age (child does not know its inappropriate)
A
sexual abuse
30
Q
witnessing abuse
A
emotional abuse
31
Q
failure to provide child w/ appropriate needs
- lack of food as punishment
- locked in a room as punishment
- has long-term effects on brain development & behavior
A
neglect
32
Q
Long-term impact of child maltreatment –>
A
- anxiety
- depression
- suicidal ideation
- drug & alcohol use
