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PEDS > GI 1 > Flashcards

GI 1 Flashcards

1
Q

what is essential for growth

A

adequate nutrition

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2
Q

what can cause an array of problems

A

obesity

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3
Q

describe obesity

A

BMI above 95%

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4
Q

nursing care of overweight/obese

A
  • assess risk factors
  • teach about activity level
  • dieting is NOT suggested
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5
Q

describe celiac diagnosis

A
  • disease of the proximal small intestine (life long disease)
  • abnormal mucosa an permanent intolerance to gluten
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6
Q

what is gluten found in

A

wheat, barley, oats, rye

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7
Q

what are the early signs of celiac disease

A
  • D/V
  • failure to gain wt d/t D
  • constipation
  • abdominal pain
  • steatorrhea (pale fatty stool)
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8
Q

what are the later signs of celiac disease

A
  • behavior changes (irritable and apathy)
  • muscle wasting
  • loss of subcut fat
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9
Q

describe what can occur in a celiac crisis

A
  • electrolyte imbalance
  • dehydration
  • severe acidosis
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10
Q

celiac diagnostics

A
  • 72 hr fecal fat analysis
  • jejunal biopsy (reveals apathy and mucosal cells)
  • serum antigliaden and antirectum antibodies
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11
Q

treatment of celiac

A
  • *gluten free diet
  • eleiminate wheat, rye, oats, barley
  • can have rice, corn or millet for grain
  • *need a high calorie diet and protein with simple carbs and fruits/veggies (decreased fats)
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12
Q

what is originally avoided following celiac diagnosis

A
  • *high fiber foods
  • originally avoided d/t inflammation of the bowel
  • ie/ nuts, raisins, raw veggies, fruit with skin
  • CAN have once original inflammation decreased
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13
Q

describe colic

A
  • feeding disorder characterized by paroxysmal abdominal pain and severe crying
  • crying can last up to 3 hrs (may be 3x a week)
  • etiology unknown
  • episodes peak around 6 wks (resolves by 3-4 mos of age)
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14
Q

treatment of colic

A
  • supportive, no intervention
  • *Simethicone (Mylican) drops can be helpful
  • switch to a soy formula or elementary
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15
Q

who has colic less frequently

A

breastfed babies

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16
Q

describe failure to thrive

A
  • infants and young children are not eating enough nutrients
  • look at growth charts to determine if not wt for age
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17
Q

nursing diagnoses for failure to thrive

A
  • imbalanced nutrition
  • delayed growth/development
  • risk for impaired parenting
  • fatigue r/t malnutrition
18
Q

eating disorder types

A

-anorexia nervosa
-bulima nervosa
binge eating disorder
-eating disorder otherwise not specified

19
Q

s/s of eating disorders

A
  • inordinate concern with body image and wt
  • hiding behaviors r/t food and caloric intake
  • co occurring mental health and family problems
  • lose up to 85% of body wt
  • amenorrhea, weakness, fatigue
  • can be life threatening
20
Q

nursing care of pt with eating disorder

A
  • communicate to family that treatment involves contacting a physician
  • inform family that hospitalization may occur
  • administer antidepressant and atypical anti psychotic meds
  • support adolescent and family
  • dental care
  • family therapy
21
Q

describe anorexia nervosa

A
  • potentially life threatening
  • eating disorder
  • primarily teen girls and young women (sometimes men)
  • drink lots of water
  • look like “skin and bones” and have thin hair
22
Q

describe bulimia nervosa

A
  • binge eating
  • compulsion to consume large quantities followed by self induced vomiting, laxatives or diuretics
  • look at oral cavity (d/t V)
  • maintain adequate wt (do not appear skinny)
  • teen girls to young women
23
Q

describe food intolerance

A

-most common food reaction
-abnormal response to a food that is not IgE mediated
-indigestion/flatulence after eating certain foods
-sweating d/t some spices
-rhinitis
-hives and urticaria
(milk and grain are common causes)

24
Q

describe food allergy

A
  • most serious food reaction

- an IgE mediated raction that is potentially systemic and characterized by sudden in onset (ie/ peanut)

25
Q

s/s of food allergy

A
  • swelling of lips, mouth, uvula/glottis
  • generalized urticaria
  • severe cases= analphylaxis
  • common: shellfish, peanuts, tree nuts, eggs, soy wheat, strawberries, cow milk
26
Q

describe lactose intolerance

A

-inability to digest milk and some diary products
s/s: bloating, cramping, abdominal pain, flatulence
**pain and D occur withing 30 min of ingesting lactose products

27
Q

infants and young children are most at risk for….

A

fluid, electrolyte, acid base imbalance

28
Q

why are infants so at risk for alterations in electrolyte and fluid imbalance

A
  • % of body wt that is compose of water is highest at birth and decreases with age (higher in premature infants)
  • high daily fluid replacement with little fluid reserve during infancy (vulnerable to dehydration)
29
Q

fluid deficit s/s

A
  • HR is rapid, weak, thready
  • BP decreased
  • skin is poor elasticity, pallor, cool to touch, poor cap refill, anterior fontanel sunken
  • mucus membrane is dry
  • salivation and tearing decreased
  • lethargy and irritability
  • thirst
30
Q

this is the most important determination of % of total body fluid loss in kids

A

weight (weigh kids EVERY day at the hospital)

31
Q

what is important to remember when determining if dehydration

A
  • look at the signs rather than the symptoms (3 signs)
    1) abnormal cap refill
    2) abnormal skin turgor
    3) rapid breathing
32
Q

describe dehydration

A
  • loss of fluid and electrolytes
  • classified according to Na
  • isonatremic(most common)
  • hyponatremic
  • hypernatremic
  • GI: V/D, pyloric stenosis, malabsorption, decreased fluid intake
33
Q

how do you categorize dehydration

A
  • by % of body wt lost
    1) mild: 4-5%
    2) moderate: 6-10%
    3) severe: >10%
34
Q

most accurate way to measure dehydration is to…

A

report ACUTE LOSS over <48 hrs

*in mL per kg of body wt

35
Q

what should be done for children suspected of failure to thrive

A

-weigh on SAME SCALE every day (or weigh any child that very concerned about)

36
Q

signs of dehydration if mild

A
  • normal VS
  • fussy, restless
  • thirsty
  • normal mucus and skin turgor
  • cap refill is < 3 sec
37
Q

signs of dehydration if moderate

A
  • increased HR and decreased BP
  • lethargic
  • dry mucus membrane and decreased skin turgor
  • eyes sunken
  • cap refill increased (3-5 sec)
  • specific gravity: 1.020-1.030
38
Q

signs of dehydration if severe

A
  • increased WEAK HR and decreased BP
  • drowsy and comatose
  • decreased skin turgor
  • cap refill > 5 sec
  • specific gravity> 1.030
39
Q

what is important to tell parents in order to monitor dehydration in infants

A

-watch the urine output (should have 1 wet diaper every 4-5 hrs)

40
Q

describe rehydration therapy

A
  • mild to moderate dehydration give oral rehydration fluids
  • 5-15 mLs of fluid every 10-15 min to START
  • *small amounts at frequent intervals to START

PEDS (24 decks)

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