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pediatrics > gastrointestinal disorder in children > Flashcards

gastrointestinal disorder in children Flashcards

1
Q

diarrhea

A

mild to severe, and acute or chronic. It can result in mild to severe dehydration.

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2
Q

what is diarrhea secondary to

A

an infectious agent in the GI tract, upper respiratory infection, urinary tract infection, antibiotic use, or laxative use. self‑resolution occurs in less than 14 days if dehydration does not occur.

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3
Q

what its caused from

A

Acute infectious diarrhea is caused by a variety of viral, bacterial, or parasitic pathogens.

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4
Q

chronic diarrhea

A

an increase in frequency and change of consistency of stools for more than 14 days.

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5
Q

dehydration

A

a body fluid disturbance when the output exceeds intake. It results from causes such as fluid losses through the skin, or respiratory, urinary, or GI tract.

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6
Q

rotavirus
transmission
incubation

A
  • Most common cause of diarrhea in children younger than 5 years
  • Affects children of all ages
  • Fever
  • Onset of foul-smelling, watery stools
  • Diarrhea for 5 to 7 days
  • Vomiting for approximately 2 days
  • Transmission: fecal-oral
  • INCUBATION PERIOD: 48 hr
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7
Q

bacterial infectious causing diarrhea

A 
Yersinia enterocolitis
Escherichia coli
Salmonella nontyphoidal groups
Clostridium difficile
Clostridium botulinum
Shigella groups: Shigellosis
Norwalk-like organisms: Caliciviruses
Staphylococcus
Enterobius vermicularis (pinworm)
Giardia lamblia: parasitic pathogen
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8
Q

rotavirus diagonosis

A
  • CBC with differential to determine anemia and/or infection.
  • Hct, Hgb, BUN, creatinine, and urine-specific gravity levels are usually elevated with dehydration.
  • Stool test for occult blood.
  • Perform a urinalysis.
  • Tape test: Performed to check for Enterobius vermicularis.
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9
Q

diagnosis of certain virus

A
  • Rotavirus: (stool sample)
  • E.coli: (stool sample)
  • Salmonella: Gram-stained stool culture
  • C. difficile: Stool culture
  • C. botulinum: Blood and stool culture
  • Staphylococcus: stool, blood, food, or aspirate
  • G. lamblia: (stool sample)
  • Shigellosis: Blood and stool culture
  • Caliciviruses: (stool sample)
    Y- ersinia enterocolitis: stool, blood, oral secretions, urine, or bile
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10
Q

nursing care for diarrhea

A
  • Obtain baseline height and weight.
  • Obtain daily weights at the same time each day.
  • Avoid taking a rectal temperature.
  • Assess and monitor I&O (urine and stool).
  • Initiate IV fluids as ordered.
  • Administer antibiotic as prescribed (Shigella, C. difficile, and G. lamblia).
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11
Q

advoid antibiotics for

A

(C. botulinum, E. coli, Salmonella).

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12
Q

avoid antimotility for

A

E. coli, Salmonella, Shigella

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13
Q

start oral replacement solution (ORS)

A

75 to 90 sodium mEq/L at 40 to 50 mL/kg over 4 hr.

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14
Q

maintenance of therapy ors

A

40 to 60 sodium mEq/L and limit to 150 mL/kg/day.

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15
Q

ors

A
  • Give ORS alternately with appropriate intake.
  • Give infants water, breast milk, or lactose-free formula if supplementary fluid is needed.
  • Older children may resume their regular diets for additional intake.
  • Replace each diarrheal stool with 10 mL/kg of ORS for ongoing diarrhea.
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16
Q

meds for C. difficile and G. lamblia

A

Metronidazole and tinidazole

17
Q

flagile

A

antibiotic

- good for bacteria in gut

18
Q

meds for enterobius vermicularis

A

Mebendazole, albendazole, and pyrantel pamoate

  • Administer in a single dose that can need to be repeated in 2 weeks.
  • for children older than 2 years of age.
  • Entire family should be treated at the same time.
19
Q

foods to avoid

A
  • Fruit juices, carbonated sodas, and gelatin, which all have high carbohydrate content, low electrolyte content, and a high osmolality
  • Caffeine, due to its mild diuretic effect ­
  • Chicken or beef broth, which has too much sodium and not enough carbohydrates
20
Q

foods to eat

A

Bananas, rice, applesauce, and toast (BRAT diet, which has low nutritional value, high carbohydrate content, and low electrolytes)

21
Q

education

A
  • Have the parents inform the child’s school or day care of the infection/infestation.
  • Provide frequent skin care to prevent skin breakdown. (zink products, o2 blown, cleanse frequently)
  • Change bed linens and underwear daily for several days.
  • Cleanse toys and child care areas thoroughly to prevent further spread or reinfestation.
22
Q

clean education

A
  • Shower frequently.
  • Avoid undercooked or under-refrigerated food.
  • Perform proper hand hygiene after toileting and after changing diapers.
  • Do not share dishes and utensils. Wash them in hot, soapy water or in the dishwasher.
  • Clip nails and discourage nail biting and thumb sucking.
  • Clean toilet areas.
23
Q

istonic

A
  • Hypovolemic shock can result.

- Serum sodium is within normal limits (130 to 150 mEq/L).

24
Q

hypotonic

A
  • Electrolyte loss is greater than water loss.
    ­- Physical manifestations are more severe with smaller fluid loss.
  • Shock is likely.
  • Serum sodium is less than 130 mEq/L.
25
Q

hypertonic

A
  • Water loss is greater than electrolyte loss.
  • Fluid shifts from intracellular to extracellular.
  • Shock is less likely.
  • Neurologic changes (change in level of consciousness, irritability, hyperreflexia) can occur.
  • Serum sodium concentration is greater than 150 mEq/L.
26
Q

mild weightloss in infants

A

3-5%

27
Q

mild weight loss in children

A

3-4%

28
Q

mild weight loss s/s

A
  • Capillary refill greater than 2 seconds ­

- Possible slight thirst

29
Q

moderate weight loss infants

A

-6-9%

30
Q

moderate weight loss children

A

6-8%

31
Q

moderate weight loss s/s

A
  • Capillary refill between 2 and 4 seconds
  • Possible thirst and irritability
  • Pulse slightly increased with normal to orthostatic blood pressure
  • Dry mucous membranes and decreased tears and skin turgor
  • Slight tachypnea
  • Normal to sunken anterior fontanel on infants
32
Q

severe weight loss infants

A

greater than 10%

33
Q

severe weight loss children

A

10 %`

34
Q

severe weight loss s/s

A
  • Capillary refill greater than 4 seconds ­
    T- achycardia present, and orthostatic blood pressure can progress to shock
  • Extreme thirst
  • Very dry mucous membranes and tented skin
  • Hyperpnea
  • No tearing with sunken eyeballs
  • Sunken anterior fontanel
  • Oliguria or anuria
35
Q

nursing care for dehydration

A
  • Oral rehydration is attempted first for mild and moderate cases of dehydration.
  • Administer parenteral fluid therapy as prescribed.
  • Initiate when a child is unable to drink enough oral fluids to correct fluid losses, and those with severe dehydration or continued vomiting.
  • Isotonic solution at 20 mL/kg IV bolus with possible repeat for isotonic and hypotonic dehydration.
  • Hypertonic dehydration rapid fluid replacement is contradicted because of the risk of cerebral edema.
36
Q

assessment

A
  • Avoid potassium replacement until kidney function is verified.
  • Assess capillary refill.
  • Assess vital signs.
  • Monitor weight.
  • Maintain accurate I&O.
  • Encourage oral fluids.
  • Resume normal diet as soon as possible.
  • Monitor how many times the child voids.

pediatrics (19 decks)

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