GI 1 Flashcards
1
Q
what is essential for growth
A
adequate nutrition
2
Q
what can cause an array of problems
A
obesity
3
Q
describe obesity
A
BMI above 95%
4
Q
nursing care of overweight/obese
A
- assess risk factors
- teach about activity level
- dieting is NOT suggested
5
Q
describe celiac diagnosis
A
- disease of the proximal small intestine (life long disease)
- abnormal mucosa an permanent intolerance to gluten
6
Q
what is gluten found in
A
wheat, barley, oats, rye
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)
8
Q
what are the later signs of celiac disease
A
- behavior changes (irritable and apathy)
- muscle wasting
- loss of subcut fat
9
Q
describe what can occur in a celiac crisis
A
- electrolyte imbalance
- dehydration
- severe acidosis
10
Q
celiac diagnostics
A
- 72 hr fecal fat analysis
- jejunal biopsy (reveals apathy and mucosal cells)
- serum antigliaden and antirectum antibodies
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)
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
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)
14
Q
treatment of colic
A
- supportive, no intervention
- *Simethicone (Mylican) drops can be helpful
- switch to a soy formula or elementary
15
Q
who has colic less frequently
A
breastfed babies
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
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
s/s of food allergy
- swelling of lips, mouth, uvula/glottis
- generalized urticaria
- severe cases= analphylaxis
- common: shellfish, peanuts, tree nuts, eggs, soy wheat, strawberries, cow milk
26
describe lactose intolerance
-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
infants and young children are most at risk for....
fluid, electrolyte, acid base imbalance
28
why are infants so at risk for alterations in electrolyte and fluid imbalance
- % 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
fluid deficit s/s
- 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
this is the most important determination of % of total body fluid loss in kids
weight (weigh kids EVERY day at the hospital)
31
what is important to remember when determining if dehydration
* look at the signs rather than the symptoms (3 signs)
1) abnormal cap refill
2) abnormal skin turgor
3) rapid breathing
32
describe dehydration
- loss of fluid and electrolytes
- classified according to Na
- isonatremic(most common)
- hyponatremic
- hypernatremic
- GI: V/D, pyloric stenosis, malabsorption, decreased fluid intake
33
how do you categorize dehydration
- by % of body wt lost
1) mild: 4-5%
2) moderate: 6-10%
3) severe: >10%
34
most accurate way to measure dehydration is to...
report ACUTE LOSS over <48 hrs
| *in mL per kg of body wt
35
what should be done for children suspected of failure to thrive
-weigh on SAME SCALE every day (or weigh any child that very concerned about)
36
signs of dehydration if mild
- normal VS
- fussy, restless
- thirsty
- normal mucus and skin turgor
- cap refill is < 3 sec
37
signs of dehydration if moderate
- 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
signs of dehydration if severe
- increased WEAK HR and decreased BP
- drowsy and comatose
- decreased skin turgor
- cap refill > 5 sec
- specific gravity> 1.030
39
what is important to tell parents in order to monitor dehydration in infants
-watch the urine output (should have 1 wet diaper every 4-5 hrs)
40
describe rehydration therapy
- 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
