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NCLEX: Pediatric > Gastrointestinal System > Flashcards

Gastrointestinal System Flashcards

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1
Q

Birth defect characterized by incomplete formation of the lip

A

Cleft lip

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2
Q

Birth defect characterized by incomplete formation of the roof of the mouth

A

Cleft palate

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3
Q

Treatment of cleft lip

A

Surgical repair between 3-5 months of age

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4
Q

Treatment of cleft palate

A

Surgical repair between 9-12 months of age

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5
Q

Bottle feeding a baby with cleft lip

A

Use bottle that has a nipple with a wide base, squeezing baby’s cheeks together while feeding can help get a good lip seal

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6
Q

Bottle feeding a baby with cleft palate

A

Position baby in upright position, use bottle with one-way flow valve and a specialty nipple that increases the flow of liquid, burp the baby frequently

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7
Q

Cleft lip or palate post-op precautions

A
  • protect site!
  • petroleum jelly along suture line to keep area moist and promote wound healing
  • elbow immobilizes used to prevent baby from touching and damaging site
  • avoid pacifiers
  • feed baby with syringe or dropper (bc sucking disrupts suture line)
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8
Q

Birth defect by which the upper part of the esophagus is not attached to lower esophagus

A

Esophageal atresia

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9
Q

Birth defect characterized by an abnormal connection between the esophagus and the trachea

A

Tracheoesophageal fistula

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10
Q

Signs of esophageal atresia and tracheoesophageal fistula

A
  • prenatal: ultrasound reveals presence of polyhydramnios (baby cannot swallow amniotic fluid d/t defect)
  • after birth: choking, respiratory distress during feeding, cyanosis, abdominal distention
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11
Q

Post-op nursing care for esophageal atresia and tracheoesophageal fistula

A

Maintain patent airway, suction upper esophageal pouch to prevent aspiration, NPO, administer IV fluids and antibiotics

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12
Q

Esophageal atresia and tracheoesopageal fistula place infants at risk for

A

Aspiration pneumonia and respiratory distress

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13
Q

Factors that contribute to GER in children

A

Underdeveloped lower esophageal sphincter, consumption of primarily liquid diet, spending a lot of time on back

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14
Q

S/S of GER in infants

A

Spitting up, crying, arching back, FTT, respiratory difficulties

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15
Q

S/S of GER in children

A

Dyspepsia, regurgitation, chest pain, Dysphagia, chronic cough

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16
Q

GER is self-resolving for most children by age ___

A

1

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17
Q

Family teaching for infants with GER

A

Feeding infants in upright position and kept in upright position for 20-30 min after feeding, recommend thickening infant formula

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18
Q

Family teaching for children with GER

A

Avoid fatty, fried, citrus, or spicy foods. Eat smaller meals rather than large meals, remain upright after meals, elevate HOB to prevent regurgitation

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19
Q

Thickening of the pyloric sphincter that blocks the movement of food from the stomach into duodenum

A

Hypertrophic pyloric stenosis

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20
Q

S/S of hypertrophic pyloric stenosis

A

Projectile vomiting, palpable olive-shaped mass in RUQ, visible peristaltic waves, signs of dehydration

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21
Q

Labs associated with hypertrophic pyloric stenosis

A

Hypokalemia, metabolic alkalosis

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22
Q

Treatment for hypertrophic pyloric stenosis

A

IV fluids and electrolytes, pyloromyotomy (surgery to enlarge opening at pylorus)

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23
Q

Congenital defect characterized by a diverticulum or pouch in the lower part of the small intestine

A

Meckel’s diverticulum

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24
Q

Signs of Meckel’s diverticulum

A

Painless rectal bleeding, red currant jelly stool, abdominal pain, anemia

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25
Q

Treatment of Meckel’s diverticulum

A

Surgical removal

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26
Q

Meckel’s diverticulum nursing care

A

Monitor for rectal bleeding and signs of hypovolemic shock such as hypotension, tachycardia, and pallor

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27
Q

Condition that causes part of the intestine to fold into the section next to it resulting in obstruction, impaired blood flow, and ischemia

A

Intussusception

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28
Q

S/S of intussusception

A

Sudden, severe abdominal pain which may cause child to draw knees up to chest, vomiting, lethargy, weight loss, sausage-shaped mass in RUQ, currant jelly stool, fever

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29
Q

Diagnosis of intussusception

A

Ultrasound reveals bullseye or target sign, air enema provides diagnosis and treatment

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30
Q

Intussusception treatment

A

Air or barium enema, surgery

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31
Q

Intussusception nursing care

A

NG tube placement, IV fluids, monitor stool for blood

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32
Q

Decrease in the length of the small intestine, typically resulting from surgery that required resection of the intestine

A

Short bowel syndrome

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33
Q

Key complication of short bowel syndrome

A

Malabsorption (d/t decreased surface area)

34
Q

Signs of short bowel syndrome

A

Malnutrition, weight loss, diarrhea, steatorrhea, dehydration

35
Q

Treatment for short bowel syndrome

A

Nutritional support: parenteral or enteral nutrition, oral rehydration, dietary modifications

36
Q

Autoimmune disorder where ingestion of gluten causes damage to the villi in the small intestine

A

Celiac disease

37
Q

S/S of celiac disease

A

Lethargy, abdominal pain and distention, diarrhea, steatorrhea, vomiting, constipation, FTT, anemia (d/t impaired absorption of iron, folate, B12)

38
Q

Treatment for celiac disease

A

Strict-gluten free diet (avoid barley, rye, oats, wheat)

39
Q

Congenital defects of the abdominal wall that allow for herniation of abdominal organs

A

Omphalocele and gastroschisis

40
Q

_________ defect occurs through the umbilical ring with herniation of abdominal organs that are covered with peritoneum

A

Omphalocele

41
Q

_________ defect occurs to the right of the umbilicus with herniation of the bowel that is NOT covered with peritoneum

A

Gastroschisis

42
Q

Diagnosis of Omphalocele and gastroschisis

A

Prenatal ultrasound, elevated MSAFP during pregnancy

43
Q

Omphalocele and gastroschisis treatment

A

Surgical closure of defect, administration of IV fluids, electrolytes and antibiotics

44
Q

Omphalocele and gastroschisis nursing care

A

Place orogastric tube to decompress stomach, protect exposed bowel prior to surgery — place protective non-adherent dressing over area, place lower have of infant in sterile, clear plastic bowel bag (gastroschisis)

45
Q

Birth defect characterized by missing ganglion cells in segments of the colon

A

Hirschsprung disease

46
Q

S/S of Hirschsprung disease

A

Failure to pass meconium in the first 48 hrs of life, abdominal distention, constipation, ribbon-like stool, vomiting that contains biles, palpable fecal mass, FTT

47
Q

Treatment of Hirschsprung disease

A

Surgical removal of the part of the colon that is missing ganglion cells, ostomy in some cases

48
Q

Hirschsprung disease nursing care

A

Monitor for complications such as enterocolitis (inflammation and infection of intestines)

49
Q

S/S of enterocolitis

A

Fever, bloody diarrhea, abdominal pain

50
Q

Inadequate weight gain in a pediatric patient that may be due to insufficient calories intake or absorption, or excess calories expenditure

A

Failure to thrive (FTT)

51
Q

Risk factors for FTT

A

Low socioeconomic status, increased psychosocial stress in home

52
Q

S/S of FTT

A

Weight below 5th percentile, developmental delays, decreased levels of prealbumin

53
Q

Focus of FTT treatment

A

Increasing calorie intake, addressing issues with feeding behaviors

54
Q

Increasing calorie intake for infants/children with FTT

A

Concentrate formula for infants, replace whole milk with high-calorie milk drinks for toddlers, tube feeding or parenteral nutrition may be required for severe case

55
Q

FTT family teaching

A

Establish regular meals times and routines, limit juice and empty calorie consumption

56
Q

Inconsolable infant crying and screaming without an obvious cause

A

Colic

57
Q

S/S of colic

A

Continual infant crying and screaming unrelieved by soothing, red-faced with legs drawn up

58
Q

Colic diagnosis

A

Rule of 3’s: episodes that last more than 3 hrs/day, 3 times/week, for over 3 weeks; symptoms usually start around 3 weeks of age

59
Q

Colic treatment

A

Supportive: swaddling, massage, providing quiet, dark environment. In breastfed infants, probiotics and strict maternal hypoallergenic diet may reduce symptoms

60
Q

Colic nursing care

A

Educate family that colic usually resolves by 4 months of age. Teach family coping strategies: DO NOT shake baby (can lead to brain damage and death), lay crying infant safely in crib and walk away

61
Q

Virus that is transmitted through the fecal-oral route, and is the most common cause of diarrhea under five

A

Rotavirus

62
Q

Bacteria transmitted through the fecal-oral route and contaminated food

A

E.Coli

63
Q

Strain of E.Coli that can cause blood diarrhea and hemolytic uremic syndrome

A

Shiga toxin producing E. Coli

64
Q

Bacteria transmitted through contaminated food such as undercooked meat

A

Salmonella

65
Q

Protozoan infection that is transmitted through contact with infected people or animals or unfiltered water

A

Giardia

66
Q

Risk factors for infectious diarrhea

A

Recent travel, recent antibiotic use, poor hygiene, crowded living conditions, poor sanitation, lack of clean water, consuming raw, undercooked and contaminated foods

67
Q

Labs associated with diarrhea

A

Hypokalemia, hyponatremia, metabolic acidosis, increased urine specific gravity

68
Q

Treatment of infectious diarrhea in children

A

Oral rehydration solution, IV fluids and electrolytes, antiemetics

69
Q

Infectious diarrhea nursing care

A

Monitor weight, I&O, educate family about prevention

70
Q

Weight loss associated with mild, moderate, and severe dehydration

A
  • mild: 3-5%
  • moderate: 6-10%
  • severe: >10%
71
Q

LOC associated with mild, moderate, and severe dehydration

A
  • mild: alert, thirsty
  • moderate: irritable
  • severe: lethargic or coma
72
Q

Capillary refill associated with mild, moderate, and severe dehydration

A
  • mild: </= 2 sec
  • moderate: 2-4 sec
  • severe: > 4 sec
73
Q

Urine output associated with mild, moderate, and severe dehydration

A
  • mild: normal
  • moderate: decreased
  • severe: oliguric or anuric
74
Q

Eyes associated with mild, moderate, and severe dehydration

A
  • mild: normal
  • moderate: slightly sunken, decreased tears
  • severe: deeply sunken, no tears
75
Q

S/S of dehydration

A

Poor skin turgor, dry mucous membranes, sunken fontanelles, hypotension, tachycardia, tachypnea

76
Q

Prevention of infectious diarrhea

A

Hand hygiene before eating, handling food, and after using restroom. Cook foods thoroughly, refrigerate perishable items within 2 hours of purchasing or cooking, unsafe water should be avoided, super absorbent diapers should be used to prevent leaking and contamination, gloves should be worn when handling diapers or stool of an infected child, sandboxes should be covered when not in use to prevent animals using them as a litter box

77
Q

Infectious diarrhea family education

A

Provide oral rehydration in small, frequent intervals. Avoid fruit juices, caffeine, soda, gelatin and broth. Monitor hydration by counting the number of wet diapers per day (normal is 6-8)

78
Q

Helminthic infection caused by E. Vermicularis transmitted through fecal-oral route

A

Enterobiasis (Pinworm)

79
Q

Enterobiasis risk factors

A

Poor hygiene, crowded environments (daycare)

80
Q

S/S of pinworm infection

A

Intense perinatal itching that is worse at night, poor sleep, irritability

81
Q

Diagnosis of pinworms

A

Tape test — press tape against skin surrounding child’s anus first thing in the morning before using the bathroom, cleaning up, or getting dressed, repeat for 3 consecutive mornings

82
Q

Treatment for pinworms

A

Anthelminthic agent such as albendazole, treat ALL household members, perform meticulous hand hygiene, take daily showers, and wash pajamas, underwear, and bedding in hot water to prevent reinfestation

NCLEX: Pediatric (11 decks)

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