Gastrointestinal

Question 1

feeding cleft lip/palate

Answer 1

breast or squeezable bottle, thicken feeds, burp frequently

Question 2

cleft surg post op risks

Answer 2

airway obstruction, aspiration, infection, tissue integrity

Question 3

s/s of TEF & EA

Answer 3

choking, coughing, cyanosis, apnea

Question 4

mgmt of TEF & EA

Answer 4

HOB 60, NG LIS, abx, cont pulse ox, D5NS w lytes

Question 5

mgmt of anorectal malformations

Answer 5

NPO, NG LIS, D5NS w lytes

Question 6

pt education anorectal malformations

Answer 6

some blood in ostomy post op expected, some may never get full bowel control

Question 7

mgmt of GER

Answer 7

HOB 30, thicken feeds, hold upright after feeds, NJ if severe, PPIs & H2 antagonists

Question 8

s/s of pyloric stenosis

Answer 8

palpable lump in RUQ, projectile nonbilious vomiting, apneic periods

Question 9

mgmt of pyloric stenosis

Answer 9

cont pulse ox, ambu bag nearby, NPO - D5 w lytes

Question 10

why can pts with pyloric stenosis become apneic

Answer 10

excess vomiting - low K & Cl; apneic to retain CO2 & correct alkalosis

Question 11

s/s of intussusception

Answer 11

red jelly stools, intermittent abd pain, palpable mass in RUQ, empty RLQ

Question 12

mgmt of intussusception

Answer 12

NPO, hydrostatic reduction, mon vitals - high sepsis risk

Question 13

s/s of NEC

Answer 13

poor feedings, bilious vomiting, apnea, distention, positive occult stools

Question 14

mgmt of NEC

Answer 14

daily abd girth, NPO w TPN, prophylactic abx, NG LIS, monitor vitals - high sepsis risk, feed slowly

Question 15

s/s of Hirschsprung’s

Answer 15

ribbon like stools, bilious vomiting, distention, constipation, diarrhea

Question 16

mgmt of Hirschsprung’s

Answer 16

NPO, D5, vitals for sepsis, abd girths, enemas before surgery

Question 17

when should a pt w celiac’s be encouraged to eat gluten?

Answer 17

before biopsy & colonoscopy

Question 18

s/s of celiac’s

Answer 18

steatorrhea, no nutrient absorption - FTT, muscle wasting, behavioral issues, severe diarrhea when exposed

Question 19

what foods should be avoided/substituted for a pt with celiac’s

Answer 19

avoid barley, rye, oats, wheat, avoid lactose in crisis, can eat corn & rice

Question 20

s/s of FTT

Answer 20

apathy, lethargy, staring, hypotonia, no subq fat, milestone delays