Exam 2 - GI Flashcards
when is the GI system formed during embryonic development
first 4 weeks
the GI tract arises from the ___ layer
endoderm
can an infant still breastfeed with a cleft lip
yes but depends on the severity
when is a cleft lip repair
1-2 months and again at 4-5 years
you want complete closure by 6-24 months
cleft lip puts children at higher risk for ___ ___ and ___ ___
ear infection; hearing loss
what is esophageal atresia
congenital malformation where the esophagus terminates before reaching the stomach
3 C’s for esophageal atresia
coughing
choking
cyanotic
HOB should be at least __ degrees for esophageal atresia
30
how often to suction with esophageal atresia
q5-10 minutes
what 2 meds need to be administered ASAP d/t aspiration risk
IVF
abx
what are the 4 motility disorders
GERD
constipation, encopresis
recurrent abdominal pain
IBS
s/sx of physiological GERD
painless emesis after meals
rarely occurs during sleep
weight gain
no aspiration
will outgrow by 1-2 y/o
s/sx of pathologic GERD
FTT
aspiration PNS and/or asthma
apnea
coughing, choking
frequent emesis with abdominal pain, crying
risk for aspiration, ear infection
meds and/or sx for treatment
GERD management
diet
positioning
meds
tx acute bleeding
surgery (fundoplication)
constipation/encopresis management
overcoming withholding
diet changes
change retention habits
emotional support
home care
evaluation
toileting schedule
keep a change of clothes on hand
IBD management
corticosteroids
immune suppressants (MTX)
abx
low fat, low fiber diet
high protein diet
appendicitis s/sx develop slowly over __ hour period
12
s/sx of appendicitis
pain
anorexia
N/V
fever
pain proceeding vomiting, appendicitis is likely
possible position of child with appendicitis
knee-chest
what are the 4 obstructive disorders
hypertrophic pyloric stenosis
intussusception
volvulus
Hirschsprung’s disease
when does hypertrophic pyloric stenosis occur
within the first few weeks after birth
cause of hypertrophic pyloric stenosis
unknown but can be genetic predisposition
what to assess with hypertrophic pyloric stenosis
frequency, consistency and amount
concern with hypertrophic pyloric stenosis
dehydration
weight loss
where may there be a palpable mass with hypertrophic pyloric stenosis
R of the umbilicus
preop: hypertrophic pyloric stenosis
NPO
IVF
NGT
elevate HOB
postop: hypertrophic stenosis
elevate HOB
PO rehydrating solution (when bowel sounds return)
formula started if PO hydration is tolerated x24 hours
I&Os (weigh diapers, daily weight)
when does intussusception occur
5 months to 3 years
s/sx of intussusception
abdominal pain
mass in RUQ
red, currant jelly like stools
vomiting
fever
lethargy
intussusception treatment
NPO until active bowel sounds
radiographic air enema
saline enema
NGT
sx is LAST resorT
what must always be documented with intussusception
see and document all characteristics of BM
Hirschsprung disease is commonly seen in individuals with ___ ___
Down Syndrome
strong heredity
Hirschsprung disease is d/t ___ ___ in 1 part of the GI tract
inadequate immobility
s/sx of Hirschsprung disease
delayed meconium passage
chronic constipation first month of life
abdominal pain, distention
FTT
ribbon like stools
Hirschsprung disease can lead to a ___ ___
permanent colostomy
Hirschsprung pre op
NPO
abx
monitor abdominal circumference
monitor electrolytes
Hirschsprung post op
bowel sounds
s/sx infection
BM
anal dilators
most common malabsorption disorder
lactose intolerance
what are the 4 types of lactose intolerance
primary
secondary
congenital
developmental
primary vs. secondary vs. congenital vs. developmental lactose intolerance
P: around 5 y/o
S: secondary to illness or injury
C: rare, hereditary
D: seen in premature babies, gets better over time
where is tropical sprue Celiac disease seen mostly
Caribbean
India
SE Asia
what is short bowel syndrome
congenital malformation
50% less bowel than normal individual
lactose intolerance is more common in ___ and ___ ___
Asians
Native Americans
how to dx lactose intolerance
stool test
where is gluten seen
protein seen in wheat, barely, rye, and oats
how to Dx Celiac
Bx jejunum
IgA blood work
which form of hepatitis is most prevalent in children
hepatitis A
what is biliary atresia
inflammation, obstruction of the bile duct
hard time with fats and bile salts
1 indication for liver transplant in children
biliary atresia
treatment for cirrhosis of the liver in children
no treatment, supportive measures
