GI Flashcards
What is Cleft palate/Cleft lip ?
An orofacial defect that affects the oropharynx and increased the risk of malnutrition and aspiration
When do Cleft palate/Cleft lip occur ?
These defects occur during fetal development
In the Pre-op phase of cleft lip/cleft palate, infants must be fed how ?
Must be fed with an…
- Elongated nipple
OR - Medicine dropper down the side of the mouth to prevent aspiration
When feeding infants in the pre-op phase with cleft lip/cleft palate, what must you do frequently ?
Burp frequently because they swallow lots of air
Anytime a baby is swallowing a lot of air, it puts them at risk for ?
- Abdominal distention
- and Abdominal Distention puts them at risk for vomiting and aspiration
If a baby is born with both cleft lip and cleft palate, which problem do they correct first ?
Cleft lip
have to wait until palate is more bone than cartilage
Why is the Cleft lip fixed first ?
Because repairing the cleft lip assists with feeding and promotes parental bonding
What is the goal post-op cleft lip and (cleft palate ?) repair ?
Goal is to protect the suture line
How should you position a child following a cleft lip repair ?
Position the child supine or side-lying
What position should you NOT place a child in following a cleft lip repair ?
Prone position
With a cleft palate what do you want to avoid doing post-op ?
Avoid putting hard or rough foods or utensils in the Childs mouth
–> You do not ant to do anything that will disrupt the suture line
(elbow restraints if needed, but want to avoid restraints as much as possible!)
What kind of diet do you want a child with a cleft palate repair to have post-op ? and why ?
Soft diet (until well healed) B/c don't want anything that will disrupt the suture line
What is the best time for a cleft palate repair to be done ?
Before speech develops, usually between ages 1 to 2 years
What is GERD also known as ?
Gastroesophageal reflux Disease
What is GERD ?
A disorder characterized by a backwash or reflux of gastric contents into the esophagus
GERD is the chronic form of what ?
GE reflux
With both GERD and GE reflux you have the risk of what ? causing what ?
Risk of Aspiration of gastric contents into the lungs, which can lead to Pneumonia
What position should a client with GERD maintain while eating ?
Upright position
How long after eating should a client with GERD remain upright ?
30 minutes
Upright position, along with frequent burping during feedings compromise what ?
What’s known as reflux precautions
Can we alter feedings to help with reflux ?
Yes
- thickened formula may be better tolerated (ex: milk with rice, etc.)
What is another Tx for GERD ?
Smaller more frequent feedings
What is Pyloric stenosis ?
Disorder resulting in projectile vomiting during or after feedings
(baby wants to eat after)
Signs and symptoms of Pyloric Stenosis ?
- on assessment of the abdomen, its possible to feel an olive shaped mass in the epigastric region, near the umbilicus. (its the enlarged pylorus)
- Projectile vomiting (b/c their is pressure behind the vomiting)
Where is the Pylorus located ?
Lies between the stomach and small intestines and has a valve to keep GI content from moving backwards
How is Pyloric stenosis diagnosed ?
Abdominal ultrasound
What is the Tx for Pyloric Stenosis ?
- Hydration and electrolyte replacement
- Intak and output
- Monitor urine specific gravity
- Daily weights
- Surgery (will open sphincter so fluid can get through more easily)
What is Intussusception ?
Name for the condition where a piece of the bowel telescopes in on itself forming an obstruction
What are signs and symptoms of Intussusception ?
- Sudden onset
- Cramping & abdominal pain
- Drawing up of knees
- Inconsolability
- Episodes of pain
- Clasic symptom = Jelly stools ***
(maroon and jelly texture d/t blood and mucous)
With Intussusception, what can sometimes be done ?
and how do they work ?
An air-contrast, barium, or an ultrasound-guided saline enema
The pressure of the enema going through the bowel with these procedures will push out the telescoped area
After an enema or surgery for Intussusception, why do they still keep them in the hospital for several days after ?
Because it might reoccur
What is Hirschsprung’s disease ?
A congenital anomaly that results in a mechanical obstruction
What is Hirschsprung’s disease also known as ?
Aganglionic Mega Colon
Hirschsprung’s disease usually affects what part of the colon ?
Sigmoid colon
What is the presenting symptom of Hirschsprung’s disease ?
Constipation
- b/c no nerves or peristalsis in that section of the colon (“Aganglionic”)
What are signs and symptoms of Hirschsprung’s disease ?
- Constipation (presenting symptom)
- Abdomina distention
- Ribbon like stools that have a foul smell
What is the Tx for Hirschsprung’s disease ?
Surgery to remove the portion of the bowel that is deseased
