Families Exam 5 - acute infectious GI disorders Flashcards
What happens to the stool of a patient with celiac disease?
steatorrhea
What happens to the weight of a patient with celiac disease?
less than expected
What vitamin deficiencies occur with celiac disease and what do they cause?
- B12: anemia
- A: vision problems
What should be increased in the diet of someone with celiac disease?
- protein
- calories
- vitamins
What should be decreased in the diet of someone with celiac disease?
- gluten
- fat
- dairy
What does the stool look like with Meckel’s diverticulum?
- bloody
- mucus
How is hypovolemia corrected before surgical removal of the diverticulum?
blood transfusion
How is hypovolemia corrected after surgical removal of the diverticulum?
rehydration therapy
What is the stool like with rotavirus? How long does this last?
- watery
- foul-smelling
- diarrhea
- 5-7 days
How long does vomiting last with rotavirus?
2 days
What precautions are used with rotavirus?
contact
What should be avoided with rotavirus?
rectal temps
How should oral replacement therapy be given?
75-90 sodium mEq/L at 40-50 mL/kg over 4 hours
How should oral maintenance therapy be given?
40-60 sodium mEq/L at a limit of 150 mL/kg/day
How should diarrheal stools be replaced?
with 10 mL/kg of ORS
What foods should someone with rotavirus avoid?
- fruit juices
- carbonated soda
- gelatin
- caffeine
- chicken/beef broth
- bananas
- rice
- applesauce
- toast
What is the incubation period of rotavirus?
48 hours
How often should a child with rotavirus wash their clothes and linens?
DAILY
What should you teach parents of a child with rotavirus NOT to do?
- shake linens
- share toys
- share dishes/utensils
What is isotonic dehydration?
water and sodium are lost equally
What is likely with isotonic dehydration?
- bleeding
- diarrhea
What is hypotonic dehydration?
electrolyte loss is greater than fluid loss
What is likely with hypotonic dehydration?
shock
What is hypertonic dehydration?
water loss is greater than electrolyte loss
What is likely with hypertonic dehydration?
neurological changes
What weight loss occurs with mild dehydration?
< 5%
What weight loss occurs with moderate dehydration?
6-9%
What weight loss occurs with severe dehydration?
> 10%
What happens to BP and HR with dehydration?
- decreased BP
- increased HR
What is sunken with dehydration?
- fontanel
- eyes
What should be monitored with dehydration?
- cap refill
- VS
- weight
- I&O
How much oral rehydration is used for mild dehydration?
50 mL/kg every 4-6 hours
How much oral rehydration is used for moderate dehydration?
100 mL/kg every 4-6 hours
How much parenteral fluid therapy is used for dehydration if the child cannot drink enough oral fluids?
- 20 mL/kg IV bolus
- possible repeat for isotonic and hypotonic
What is contraindicated for hypertonic dehydration?
rapid fluid replacement
What does the hole caused by cleft lip/palate cause?
the inability to suck
When is a cleft lip repair done?
between 2-3 months
When is a cleft palate repair done?
between 6-12 months
What should be avoided with cleft lip/palate?
- spoons
- forks
- straws
- tongue depressors
- hard pacifiers
- rigid utensils
- hard-tipped sippy cups
- suction catheters
How should a cleft lip/palate incision site be cleaned?
- normal saline
- water
- diluted hydrogen peroxide
How can drainage and breathing be helped after repair of a cleft lip/palate?
changing positions frequently
How long should a clear liquid diet be ordered after a cleft lip/palate repair?
24 hours
How should a baby lay after a cleft PALATE repair?
belly
How should a baby lay after a cleft LIP repair?
- back and upright
- on their side
What type of nipple should be used for a baby with a cleft lip?
wide-based
How can the gap be decreased when feeding a baby with a cleft lip?
by squeezing their cheeks together
What position should a baby with a cleft palate/lip and palate be fed in?
upright with head cradled
What type of valve and nipple should be used to feed a baby with cleft palate/lip and palate?
- one-way valve
- specially cut nipple
What should be done frequently while feeding a baby with a cleft palate/lip and palate?
burping
What should be reported in a baby with a cleft lip/palate?
- ear infections
- hearing loss
What is present in the vomit of an infant with GERD?
blood
When is a cough, heartburn, abdominal/chest pain, and difficulty breathing seen with GERD?
in children
What medication is given for GERD?
PPI (prazole)
What should patients with GERD do after eating?
sit up, raise HOB
What should be done to the formula for an infant with GERD?
- thicken
- 1tsp-1tbsp rice cereal per 1oz formula
What foods should be avoided with GERD?
- caffeine
- citrus
- peppermint
- spicy/fried
What findings should be reported with GERD?
- pneumonia
- weight loss
- failure to thrive
Where is appendicitis pain felt?
RLQ
What happens to the breathing of a child with appendicitis?
rapid, shallow
What does an absence of pain mean with appendicitis?
rupture
What should be avoided with appendicitis?
- heat
- enemas
- laxatives
What should be given before surgery for a non-ruptured appendix?
- IV fluids
- antibiotics
What should be given before surgery for a ruptured appendix?
- fluid replacement
- NG tube decompression
- IV antibiotics
What should be kept after surgery if bowel sounds are absent or the appendix was ruptured?
NPO
What are s/sx of peritonitis?
- fever
- increased pain
- rigid/distended abdomen
When does projectile vomiting occur with pyloric stenosis? What does it look like?
- after feeding
- blood-tinged
Where is the mass located with pyloric stenosis? What does it look like?
- RUQ
- olive-shaped
What GI disorder causes constant hunger?
pyloric stenosis
What medications are given after a pyloromyotomy?
- antiemetics
- analgesics
When should clear liquids be started after surgery for pyloric stenosis? When can breastmilk/formula be started?
- CL: 4-6 hours after
- BM/F: 24 hours after
When would you see a sausage-shaped abdominal mass?
intussusception
What does stool look like with intussusception?
- blood and mucus
- jelly-like
When would a child be screaming and in a knee-to-chest position?
intussusception
How can dehydration be prevented with intussusception?
IV fluids
What procedure is done for intussusception?
air enema with or without contrast
