GI

Question 1

What is meconium?

Answer 1

thick, green, black stool in newborns/infants

Question 2

how long is swallowing an automatic reflex until

Answer 2

Six weeks

Question 3

At what age can an infant begin to control swallowing

Answer 3

Six months

Question 4

what weight percentile is considered failure to thrive?

Answer 4

Less than 5%

Question 5

what are the priorities of treatment for failure to thrive patients

Answer 5

Feeding – timer, assistant programs
Daily weight , I/O
Follow routine and rhythm of eating

Question 6

for failure to thrive patients should you allow the TV or other distractions to occur during feeding time?

Answer 6

No
Quiet, non-stimulating environment

Question 7

can cleft palate/lip be unilateral?

Answer 7

Yes, or bilateral

Question 8

causes of cleft palate/lip

Answer 8

Multifactorial inheritance
Teratogens – alcohol, Accutane, radiation
Maternal smoking

Question 9

what kind of breathers are cleft palate patients?

Answer 9

Mouth breathers
Dry, mucous membranes

Question 10

treatment for cleft palate/lip

Answer 10

Surgical correction – Z-plasty

Question 11

T/F a surgical correction of a cleft palette can be done within the first few weeks of life

Answer 11

False, cleft lip

Question 12

when can surgical correction be done for a cleft palate?

Answer 12

12 to 18 months

Question 13

Breast-feeding, with cleft palette/lip

Answer 13

Upright
Special nipples – Harborman/pigeon
Pump
Burp frequently
Stimulate sucking reflex

Question 14

what should the positioning of the infant be after a cleft palate operation?

Answer 14

On belly

Question 15

can a cleft lip patient be placed on their belly?

Answer 15

No

Question 16

esophageal atresia and trach fistula

Answer 16

Failure of esophagus to develop as continuous passage

Failure of trach and esophagus to separate

Question 17

what are the signs and symptoms of TEF

Answer 17

choking, coughing, cyanosis

Frothy saliva

Question 18

dx TEF

Answer 18

X-ray
passage of radiopaque catheter until obstruction

Question 19

Ano rectal malformation treatment

Answer 19

Anal stenosis – manual dilations
Perineal fistulas – anoplasty
Extensive defects – colostomy
Imperforate anus – surgery in stages

Question 20

omphalocele

Answer 20

herniation of abdominal contents through umbilical ring
Intact peroneal sack

Question 21

gastroschisis

Answer 21

herniation of abdominal contents
No perineal sac

Question 22

what type of covering should be placed over the abdominal wall defects?

Answer 22

Loose covering with saline, soaked pads and plastic drape

Silo patch – compression

Question 23

how to monitor for an ileus post abdominal wall defects

Answer 23

Listen for bowel sounds

Question 24

gastroenteritis

Answer 24

Stool excess, diarrhea
Three or more watery stools per day
Increased in frequency
Decreased in consistency

Question 25

cause of gastroenteritis

Answer 25

#1 viral- rotavirus, Nora virus Bacterial Protozoan

Question 26

bacterial signs and symptoms

Answer 26

Bloody diarrhea Severe cramps Malaise

Question 27

how is bacterial gastroenteritis caused?

Answer 27

fecal – oral transmission Contaminated food

Question 28

Cause of constipation

Answer 28

structural disorder Hypothyroidism Hypercalcemia Lead poisoning Spinal cord lesions

Question 29

fiber formula

Answer 29

Age +5 = fiber needed in grams Older than three years old

Question 30

How to stimulate motility for an infant with bottlefeeding

Answer 30

Add Karo syrup to bottle

Question 31

encopresis

Answer 31

Chronic constipation with soiling stool leaking around impaction

Question 32

cause of encopresis

Answer 32

Psychological trauma Voluntary withholding

Question 33

management of encopresis

Answer 33

Bowel prep MiraLAX – 6 to 12 months bowel training

Question 34

what should be present when an infant uses the toilet?

Answer 34

Stool in front to relax sphincters

Question 35

hirschsprung disease

Answer 35

Congenital aganglionic megacolon

Question 36

Patho of HD

Answer 36

Absence of autonomic peristalsis in segments of the colon Enlargement of bowel, proximal to defect Mechanical obstruction from inadequate motility

Question 37

what is the most serious complication of HD?

Answer 37

Enterocolitis

Question 38

General sx HD

Answer 38

ischemia Bloody diarrhea Fever Lethargy

Question 39

newborn sx HD

Answer 39

Failure to pass meconium within 48 hours Food refusal Bilious, vomiting Abdominal distention

Question 40

infant sx HD

Answer 40

Poor weight gain Constipation, diarrhea, vomiting Abdominal distention

Question 41

older child sx HD

Answer 41

constipation Ribbon like Foul smell Palpable fecal mass Poor appetite Abdominal distention

Question 42

dx HD

Answer 42

barium enema Rectal biopsy Anal rectal manometry

Question 43

Surgery options for HD

Answer 43

temporary colostomy Soave Endorectal pull through

Question 44

Pre-op HD surgery

Answer 44

Measure abdominal girth daily Note 1st BM Bowel prep, anbx Monitor hydration, f/e imbalance

Question 45

What type of enemas should be avoided pre-op?

Answer 45

Tap water enemas

Question 46

Post-op HD surgery

Answer 46

NG-LWS NPO I/0-losses Abdominal assessment Ostomy care