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CPN INFO > Gastrointestinal Conditions (high priority; 20 questions) > Flashcards

Gastrointestinal Conditions (high priority; 20 questions) Flashcards

1
Q

Diarrhea and gastroenteritis

A

prevention: Rotavirus vaccine; d/c antimicrobial agents for C.diff
tx: manage symptoms
- fluid replacement
- nutritional support

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2
Q

Diarrhea & gastroenteritis - what kind of electrolyte imbalance?

A

metabolic “ass”idosis - due to lots of stool

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3
Q

vomiting - what kind of electrolyte imbalance?

A

L for linguistics (tongue/mouth)
“if it’s coming out of your mouth (vomiting/hyperventilating) –> alkalosis

metabolic alkalosis

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4
Q

vomiting interventions

A
  • anti emetic meds
  • if gut works, use it
  • if not, IV fluids
  • evaluate feeding methods (burping, air in nipple)
  • teach positioning
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5
Q

Pyloric stenosis

A
  • skinny, angry babies
  • presents over time - between 1-3 mos of life
  • projectile vomiting (no bile)
  • dehydration - assess for metabolic alkalosis from frequ emesis

Dx - palpation of classic “olive-like” mass in abdomen
- abdominal US

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6
Q

Intervention for pyloric stenosis

A
  • hydration and electrolyte balance
  • NPO pre-op
  • begin PO feeding 4-6 hours s/p surgery
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7
Q

Gastoesophageal Reflux (GER) - risk factors and complications

A
  • prematurity
  • bronchopulmonary dysplasia
  • CP

complications: aspiration pna, failure to thrive

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8
Q

Gastoesophageal Reflux (GER) - interventions

A
  • small, more freq feeding (thicken formula)
  • positioning - upright for 30 post feeding; avoid sitting in car seat (reclined position); back to sleep
  • antacids; PPIs

Prep for Nissen fundoplication – if all else fails

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9
Q

necrotizing enterocolitis – assessment

A

common in preemies

  • abdom distention
  • incr gastric residual vol
  • vomiting
  • bloody stool
  • glucose + stool
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10
Q

necrotizing enterocolitis - intervention

A
  • bowel rest (NPO, TPN)
  • decompress abd (NGT to low suction)
  • abx
  • reduce stress (cluster care; maintain body temp)

Complications: colostomy; abd perforation (can lead to sepsis, shock, death

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11
Q

cleft lip and palate - nursing considerations

A

Pre-surgery:

  • feed slowly and in upright position
  • burp freq
  • use special nipple
  • small, freq feedings

Prep for surgery:

  • cleft lip: 1-4 mos of age
  • cleft palate: when baby able to drink from a cup (6-12 mos) – don’t want them to suck
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12
Q

cleft lip and palate - post op considerations

A

cleft lip - observe for resp distress; maintain sutures; keep infants’ hands away from mouth

cleft palate - nothing in mouth (nipples, pacy, straws, toys)

  • feed w/open cup, syringe
  • elbow restraints until palate healed
  • speech therapy
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13
Q

Esophageal Atresia and Tracheoesophageal Fistula

A
  • do not feed orally (g-tube)
  • always have suction at bedside
  • surgical repair done in stages
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14
Q

Appendicitis - S/S

A

Pain - localizes at McBurney’s point; rebound tenderness
Infection s/s - fever, incre WBC
GI signs - decr bowel sounds, N/V, abd distention, rigidity, guarding

S/S of peritonitis - if appendix bursts –> sudden relief of pain, followed by diffuse pain

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15
Q

Celiac disease - s/s, treatment

A

s/s - steatorrhea (fatty stools)

  • abdom distention
  • failure to thrive

Tx - Gluten free diet; vitamin suppl. (multi, folic acid, iron)

Teaching: GF diet; assume anything w/thickness has gluten
- low residue diet during bowel inflammation (low residue = low fiber)

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16
Q

Hirschsprung Disease (Congenital Aganglionic Megacolon)

A
  • ribbon-like, liquid stools
  • abd distention
  • constipation

intervention: temp ostomy; surgical repair

17
Q

Intussusception (intestinal telescope)

A

Most common in kids 3 mo to 2 years

  • currant-jelly stools (later sign)
  • sudden onset of pain
  • bilious vomiting (drawing up of knees)
  • inconsolable crying

Dx - best is Barium Enema

Nonsurgical tx: successful 80% of time (hydrostatic reduction w/barium enema OR water soluble contrast w/air pressure

Surgical tx: manual reduction w/or w/o surgical resection of gangrenous bowel resection

18
Q

Encopresis

A
  • fecal soiling of underwear in child older than 4 years
  • often due to resistance to having bowel movements
  • constipation - treat w/stool softeners, lubes, suppositories, enemas; high fiber diet, encourage fluid intake, psych support
19
Q

2 types of Inflammatory Bowel Disease

A
  1. Ulcerative Colitis - inflammation in colon and rectum only; affects 2 layers of bowel wall
  2. Crohn’s Disease - inflammation can be in any part of GI tract; affects all layers of bowel wall
20
Q

Inflammatory Bowel Disease s/s

A
  • bloody diarrhea
  • abdominal cramps/pain
  • weight loss
  • growth retardation
21
Q

Inflammatory Bowel Disease tx

A

Goal - achieve remission
Medications:
- analgesic and antispasmodic (pain relief)
- corticosteroids (inflammation)
- immunomodulators (methotrexate and cyclosporine)
- biologics (Remicade = infliximab)
(SE - chills, dizziness, fatigue, pain in chest or stomach, infection)

Nutritional support - enteral & TPN (for gut rest)

  • high protein, high calorie
  • vitamins: multi, folic acid, iron

Surgical - total colectomy

22
Q

Biliary Atresia

A
  • can cause liver failure and death - no way for bilirubin to leave liver

S/S - jaundice; itching; pale stool (no bile)
–> failure to thrive/poor weight gain: caused by decreased absorption of fat soluble vitamins –> ADEK

Intervention: administer fat soluble vits; Kasai procedure (but only bandaid; kids need liver transplant by 5-6 years old), BUT make great candidates for the transplant

23
Q

NGT

A

pH < 5

confirm Q4H w/continuous feeds; w/each medication and feeding

24
Q

Acetaminophen dosage

A

10-15 mg/kg/dose Q4H

25
Q

Tylenol w/Codeine

A

Black Boxed for peds - converts to morphine in liver; some kids create too much – can lead to death

Alternatives: hydrocodone-acetaminophen (Vicodin, Hycet); oxy-acetaminophen (Percocet, Tylox); morphine, fentanyl, demerol

CPN INFO (17 decks)

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