Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MCN > Gastrointestinal disorders > Flashcards

Gastrointestinal disorders Flashcards

1
Q

▪ Protrusion of intraabdominal contents through defect in abdominal wall lateral to umbilical ring which is
never with a peritoneal sac
▪ M. membranes covers the exposed

A

GASTROSCHISIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Incomplete fusion of the palate which results in
communication between the mouth and the nose

A

Cleft Palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when will cleft palate precede cleft lip

A

6 – 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AE/TEF: A2

A

Simple esophageal atresia with no fistula (Isolated EA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

signs of Esophageal motility disorders

A

dysphagia, GER (50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • non union of the tissue and bone of the upper lip and hard/soft palate during embryonic development
  • Distinct facial defects that occurs singly or in combination
  • Malformation of the face that may occur individually or together
  • Both occur during embryonic development
A

CLEFT LIP (HARELIP)/CLEFT PALATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type of cleft palate: occurs in midline and may involve soft
and hard palate

A

CP alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is ESSR

A

▪ Enlarge the nipple (long, soft)
▪ Stimulate the suck reflex
▪ Swallow fluid appropriately
▪ Rest =to allow child to finish what has been placed in the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

(-) air in the GIT in EA/TEF meaning

A

EA without TEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type of EA/TEF: Both upper and lower ends of esophagus open into the
trachea by a fistula

A

EA with double TEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rule of 10

A

10gms Hgb?10lbs?10wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Restraints for cleft palate

A

▪ Elbow restraint until palate healed (4-
6 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to prevent infection in Cleft lip/palate

A
  1. Assess v/s
  2. Cleanse suture line with normal saline/sterile water if ordered
  3. Cleanse cleft areas by giving 5-15 cc of water after feeding
  4. loosen crust
    aiding in removal
  5. Antibiotic cream as prescribed
  6. Careful hand washing and sterile technique
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Assessment for Transesophageal Atresia (TEF)

A

a) 3 Cs - choking, coughing, cyanosis
b) Aspiration pneumonia
c) Distended abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Preop preparation of the infant for surgery in omphalocele

A

NPO, IVF, NGT for decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Major Etiology/Causes of Cleft lip/palate

A

genetics and environmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Speech impairment in CL/CP

A

o Insufficient functioning of the muscle of the soft palate and nasopharynx
o Improper tooth alignment-orthodontics
o Hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CLINICAL MANIFESTATIONS of EA/TEF

A
  • 3 C’s of TEF = choking, coughing, cyanosis (intermittent)→due to aspiration from overflow of secretions from the blind pouch
  • copious, fine white frothy bubbles of mucus in the mouth and nose=EA
  • increased respiratory distress after feeding
  • Distended abdomen-air from trachea passes through the fistula into the stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Structural Defects

A
  1. Cleft lip/ cleft palate
  2. Esophageal Atresia with Transesophageal Fistula
  3. Omphalocele
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Protrusion of intraabdominal contents into the base of umbilicus which is covered by a translucent sac
(peritoneum without skin)→rupture→****

A

evisceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

position for maintaining patent airway in Cleft lip

A

upright/infant seat position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to maintain Airway patency in CP/CL

A

gentle aspiration (NO SUCTIONING=trauma to the site) of mouth and nasopharyngeal
secretions to prevent aspiration and respiratory complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gastrointestinal System of the Newborn

A
  1. The infant does not have voluntary control over swallowing until 6 weeks old.
  2. Stomach capacity is small and intestinal motility is greater than in older children.
  3. Relaxed cardiac sphincter.
  4. Deficiency of several enzymes until 4 to 6 months.
  5. Liver junctions are immature until the first year of life.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to optimize nutrition in Cleft lip

A

Rubber tipped syringe on the side of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

incidence of cleft palate

A

1:2000 live births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

week of Fusion of palatal processes

A

7 – 12th wk AOG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

stomach capacity of 2-3 weeks

A

75-100 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

postop preparation of the infant for surgery in omphalocele

A

measures to control pain, prevent infection, fluid and electrolyte balance,
adequate nutritional intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Gastrostomy tube feedings are elevated and secured to a point above the level of the stomach in how many inches to prevent reflux to the healing esophagus; allows gastric secretions to pass duodenum and swallowed air to escape through open tube

A

4”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Type of cleft lip: small notch; maybe a little
more than a notching of the vermillion border of the lip and may extend to the nostril

A

Incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

management of EA/TEF

A
  1. Prevention of aspiration pneumonia through drug therapy
    * →inevitable and appear early
    * Broad spectrum antibiotic
  2. Surgery
    ▪ to repair anomaly→ emergency; closing the fistula and anastomosing esophageal
    segments (NGT for feeding until esophagus heals; chest tube)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

diagnosis of cleft lip

A

apparent at birth – detected by Sonogram (while in Utero)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How to protect sac from trauma and infection in omphalocele

A

▪ Monitor sac and make sure that it is covered with sterile gauze soaked in NSS to prevent drying of abdominal contents
▪ Place dried sterile gauze over sterile moist gauze and cover with plastic wrap to provide additional protection from heat and moisture loss
▪ Monitor vital signs especially temperature because the infant easily loses heat through sac
▪ Monitor for s/s of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Pediatric Nursing Gastrointestinal Disorders

A

A. Structural Defects
B. Disorders of Motility
C. Obstructive Disorders
D. Malabsorption Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

development of larynx, trachea, beginning lung tissue, esophageal
lumen

A

4th – 8th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

corrective surgeries for EA/TEF

A

▪ End-to-end anastomosis
▪ Colon transplants for defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

why infant with cleft palate have difficulty feeding

A

infant is unable to generate a negative pressure and create suction in the oral cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

incidence of cleft lip

A

1:800 live births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

how to provide adequate nutrition in CL/CP

A

a. ESSR
b. Upright position when feeding to facilitate swallowing and discourage aspiration
c. Burp frequently because more air is swallowed which can cause regurgitation/vomiting
d. NGT feeding as ordered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

▪ Protrusion of intraabdominal contents into the base of umbilicus which is covered by a translucent sac
(peritoneum without skin)→rupture→evisceration
▪ Herniated organs

A

OMPHALOCELE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Type of cleft lip: extends into the base of the nose and even the gums in which upper teeth are set may also be deformed

A

Complete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Characteristics of cleft lip

A

Associated with deformed dental structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

NURSING DIAGNOSIS
Preoperative of CL/CP

A
  • High risk for aspiration (breastmilk, formula or mucus) related to anatomic defect
  • High risk for aspiration (breastmilk, formula or mucus) related to anatomic defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

stomach capacity of 3 months

A

150-200 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

intestines which include stomach and liver covered by psa

A

Herniated organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

NURSING CARE of omphalocele

A
  1. Protect sac from trauma and infection
  2. Prepare the infant for surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

stomach capacity of 2 years

A

500 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Type of EA/TEF: most common

A

EA with distal TEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

stomach capacity of 1 month

A

90-150 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Pre-op nursing care for EA/TEF

A
  1. Maintain open airway
  2. NPO
  3. Administer IVF as ordered
  4. Oxygen to relieve respiratory distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Other defects associated with cleft lip/palate

A

omphalocele, TEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

3Cs of TEF

A

choking, coughing, cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

purposes of cheiloplasty

A
  • early repair avoids oral deprivation, prevents trauma and difficulty for the parents
  • its difficult to bond with an infant with deformed face
  • Help infant experience the pleasure in sucking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Palliative surgery for EA/TEF:
* Provision of constant drainage of the esophageal
pouch=tube in the mouth to upper pouch

o Esophageal replacement

A

Esophagostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Types of cleft palate

A
  • CP alone
  • With CL
56
Q

Palliative surgery for EA/TEF:
* Several stages – indicated for premature, multiple
anomalies/in poor condition LIGATION OF TEF + PALLIATIVE
MEASURES
* for gastric decompression (placement of a feeding tube,
left open to drain by gravity to keep stomach empty of
secretion and prevent reflux into lung) and jejunostomy
feeding

A

Gastrostomy

57
Q

how to observe for bleeding in CL/CP

A

check for frequent swallowing, increased PR and restlessness

58
Q

ethnicity where cleft lip/palate is most common

A

Asians

59
Q

gender at risk for cleft palate

A

Females

60
Q

Palliative surgeries for EA/TEF

A

▪ Gastrostomy
▪ Esophagostomy

61
Q

Management of cleft palate

A

URANOPLASTY

62
Q

chest tube care (thoracotomy) in EA/TEF

A
  • Check clots
  • Keep lower than chest
  • Check amount, color, drainage
  • Vaselinized gauze at bedside
  • Don’t clamp unless ordered
    d. Semi-Fowler’s position or right side to prevent gastric juice from flowing to the fistula
63
Q

Type of cleft lip: generally below the center of one nostril

A

Unilateral

64
Q

In CL/CP, why cleanse cleft areas by giving 5-15 cc of water after feeding

A

to prevent accumulation of carbohydrates
which encourage bacterial growth

65
Q

How to help parent cope with the impact of the defect in CL/CP

A

o Encourage them to hold and cuddle the infant
o Explain surgical procedure and expected outcome
o Show pictures before and after surgery

66
Q

Types of EA/TEF

A
  • Simple esophageal atresia with no fistula (Isolated EA)
  • EA with proximal TEF
  • EA with distal TEF
  • EA with double TEF
  • Isolated TEF
67
Q

postop nursing care for EA/TE

A
  1. Promote respiratory function
  2. Provide optimum nutrition
68
Q

an alternative to gastrostomy if the 2nd step surgery will be much later

A

Cervical esophagostomy

69
Q

risk for EA/TEF

A
  • low birth weight
  • prematurity
  • occurs with other congenital disorders (VACTERL)
70
Q

Type of EA/TEF: Upper end of esophagus is blind, lower end
connects into the trachea

A

EA with distal TEF

71
Q

when can cheiloplasty be done

A

on or before 2nd month

72
Q

nursing responsibilities in oral feeding of postop EA/TEF

A
  • Carefully observe to make sure that infant is able to swallow without choking
  • Start with sterile water, followed by small feedings of formula
  • May be supplemented with gastrostomy/parenteral nutrition if unable to take sufficient amount by mouth
  • Discharged if able to take oral fluids well and gastrostomy tube removed but for palliative surgery,
    discharged with gastrostomy tube (EDUCATION)
73
Q

stomach capacity of NB

A

10-20ml

74
Q

cause of EA/TEF

A

unknown

75
Q

failure of the maxillary and median
nasal processes to fuse (incomplete
fusion of the lip)

A

Cleft Lip

76
Q

AE/TEF: B4

A

EA with proximal TEF

77
Q

management of speech impairment

A

speech therapy

78
Q

Characteristics of cleft palate

A

❖ Although these are also through with CL, it is
more with CP
* Difficulty feeding
* Prone to recurrent otitis
media

79
Q

evidence that cleft lip/palate is inherited

A

increased incidence in relatives

80
Q

diagnosis of Cleft lip/palate

A

physical assessment

81
Q

what covers omphalocele

A

peritoneal sac

82
Q

sex incidence of EA/TEF

A

equal

83
Q

How to optimize nutrition in Cleft palate

A

Paper cup/large hole nipple

84
Q

How to promote respiratory function in EA/TEF

A

a. Assessment of respiratory difficulties
b. Suction PRN
c. Provide chest tube care (thoracotomy)
d. Semi-Fowler’s position or right side to prevent gastric juice from flowing to the fistula
e. Gastrostomy returned to gravity drainage

85
Q

Care for patients in restraint

A

→ Check site for s/s of irritation
→ Release one at a time at frequent intervals to provide opportunity to exercise arms and for cuddling

86
Q

position for maintaining patent airway in Cleft palate

A

lie on abdomen

87
Q

abnormal connection between the esophagus and the trachea

A

Tracheoesophageal fistula (TEF)

88
Q

Nursing Care for Cleft lip/palate

A
  1. Help parent cope with the impact of the defect
  2. Provide adequate nutrition
  3. Prepare for surgery
  4. Postoperative care
89
Q

Type of cleft lip: beneath
both nostril

A

Bilateral

90
Q

Obstructive Disorders

A
  1. Intususception
  2. Pyloric Stenosis
91
Q
  • failure of the esophagus to develop a continuous passage
  • esophagus ends in a blind pouch with no entry to the stomach
A

Esophageal atresia (EA)

92
Q

associated with other congenital anomalies of omphalocele

A

heart, genitourinary, TEF and imperforate anus

93
Q

ethnicity where cleft lip/palate is least common

A

Blacks

94
Q

congenital disorders associated with EA/TEF

A

(VACTERL)=vertebral,
anorectal, cardiovascular, tracheoesophageal, renal, limb
abnormalities

95
Q

Malabsorption Syndrome

A

Celiac Disease

96
Q

DIAGNOSTIC TESTS for EA/TEF: (to confirm placement , aspirate stomach contents)

A

Inability to pass NGT

97
Q

MANAGEMENT of omphalocele

A

immediate surgical repair to replace abdominal contents and close abdominal wall

98
Q

how to loosen crust in CL/CP surgery

A

use cotton swab to apply a half-strength peroxide solution

99
Q

Avoid trauma to the operative site in CL/CP

A

▪ Logan’s bow/butterfly adhesive after surgery to hold in close approximation the suture line
▪ Restraints (elbow pinned to the infant’s clothing) to avoid rubbing the incision with hands
▪ Minimize crying – anticipate needs (produces tension on the suture line)
▪ No to sucking – no pacifiers
▪ No tongue depressor, thermometer, spoons, straws, toothbrushing, hard food items

100
Q

AE/TEF: E3

A

Isolated TEF

101
Q

Type of cleft palate: midline of the soft palate and one orboth sides of the hard palate

A

With CL

102
Q

repair for cleft lip (cheiloplasty) is until what age

A

age 2

103
Q

Pacifier and NPO purpose is to

A

prevent food aversion

104
Q

signs of stricture due to tension

A

dilatation

105
Q

DIAGNOSTIC TESTS for EA/TEF

A
  1. History (polyhydramnios=EA) and clinical manifestations
  2. Inability to pass NGT
  3. Radiography
106
Q

Management of cleft lip

A

CHEILOPLASTY

107
Q

gender at risk for cleft lip

A

Males

108
Q

diagnosis of cleft palate

A

may not be detected without thorough assessment of the mouth (palpate with the finger)

109
Q

results of otitis media

A

→fluid can get in the middle ear
→tympanic membrane scarring
→hearing loss

110
Q

NURSING DIAGNOSIS
Postoperative of CL/CP

A
  • Ineffective breathing pattern related to anesthetic and increased secretions
  • Impaired tissue integrity related to surgical correction of cleft
  • Knowledge deficit (parent) related to diagnosis, treatment, prognosis and home care needs
  • Altered nutrition: less than body requirements related to surgery and feeding difficulties
111
Q

diagnostic sign of EA without TEF

A

(-) air in the GIT

112
Q

Etiology/Causes of Cleft lip/palate

A

o Genetics
o Environmental
o Family History
o Exposure to certain drugs during pregnancy
o Nutritional deficiencies
o Certain Medical Conditions

113
Q

Cause of omphalocele

A

Abdominal contents fail to return when abdominal wall closes by 10th week.

114
Q

How to Provide optimum nutrition in EA/TEF

A

a. Gastrostomy tube feedings
b. Oral feeding when anastomosis site healed
c. Maintain IVF
d. Pacifier
e. NPO or no oral stimulation

115
Q

when can uranoplasty be done

A

12 – 18 months

116
Q

COMPLICATIONS OF SURGERY in EA/TEF

A
  • Anastomostic leak
  • Stricture due to tension
  • Esophageal motility disorders
117
Q

Assessment for Esophageal Atresia (EA)

A

a) History of polyhydramnios in mother
b) Inability to pass NG tube
c) Increased drooling & salivation
d) Immediate regurgitation of undigested formula/milk when fed
e) copious, fine white frothy bubbles of mucus in the mouth and nose

118
Q

signs of anastomostic leak

A

purulent chest tube drainage, temperature instability and increased WBC

119
Q
  • to take advantage of palatal changes that take place with normal growth and before child develops faulty speech in anticipation of speech development, it is done before the child develops faulty speech habits
A

URANOPLASTY

120
Q

on what day will you give gastrostomy tube feedings in postop care for EA/TEF

A

5th-7th day-post-op feedings

121
Q

Restraints for cleft lip

A

▪ Elbow restraint
▪ Jacket restraint for older children to prevent rubbing of site

122
Q

Type of EA/TEF: Upper end of the esophagus ends into the trachea

A

EA with proximal TEF

123
Q

Type of EA/TEF: Upper and lower ends of esophagus are blind, no connection to the trachea

A

Simple esophageal atresia with no
fistula (Isolated EA)

124
Q

stomach capacity of 1 week

A

30-90 ml

125
Q

Alternative to nipple feeding

A

rubber tipped medicine dropper or aseptosyringe,

Breck feeder
(large syringe with soft rubber tubing) deposited at the back of the mouth

126
Q

Cleft lip/palate has higher incidence in

A

Caucasians

127
Q

Type of EA/TEF: No Esophageal atresia but with fistula between
normal esophagus and trachea

A

Isolated TEF

128
Q

what covers gastroschisis

A

mucus membranes

129
Q

Types of cleft lip

A
  1. Complete
  2. Incomplete
  3. Unilateral
  4. Bilateral
130
Q

How to maintain patent airway in EA/TEAF

A
  • Continuous/low intermittent suction to remove secretions from blind pouch
  • TEF=supine with HOB elevated on an inclined plane for at least 30 degrees→minimizes reflux of gastric secretions up the distal esophagus into the trachea and bronchi
131
Q

Disorders of Motility

A
  1. Gastrointestinal Reflux Disease
  2. Hirschprung’s Disease
  3. Colic
132
Q

on what day will you give oral feeding in postop care for EA/TEF

A

when anastomosis site healed (10th day-2nd week)

133
Q

Postoperative care for cleft lip/palate

A

a. Maintain Airway patency
b. Observe for Bleeding
c. Avoid trauma to the operative site
d. Minimize pain
e. Optimize nutrition
f. Prevent infection

134
Q

week of Fusion of maxillary and premaxillary processes

A

7 – 8th wk AOG

135
Q

AE/TEF: C1

A

EA with distal TEF

136
Q

o may appear alone with cleft lip
o midline of hard & soft palate
o midline of soft palate & one or both
side of hard palate

A

Cleft Palate

137
Q

AE/TEF: D4

A

EA with distal TEF

MCN (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions