GI Flashcards
What is meconium?
thick, green, black stool in newborns/infants
how long is swallowing an automatic reflex until
Six weeks
At what age can an infant begin to control swallowing
Six months
what weight percentile is considered failure to thrive?
Less than 5%
what are the priorities of treatment for failure to thrive patients
Feeding – timer, assistant programs
Daily weight , I/O
Follow routine and rhythm of eating
for failure to thrive patients should you allow the TV or other distractions to occur during feeding time?
No
Quiet, non-stimulating environment
can cleft palate/lip be unilateral?
Yes, or bilateral
causes of cleft palate/lip
Multifactorial inheritance
Teratogens – alcohol, Accutane, radiation
Maternal smoking
what kind of breathers are cleft palate patients?
Mouth breathers
Dry, mucous membranes
treatment for cleft palate/lip
Surgical correction – Z-plasty
T/F a surgical correction of a cleft palette can be done within the first few weeks of life
False, cleft lip
when can surgical correction be done for a cleft palate?
12 to 18 months
Breast-feeding, with cleft palette/lip
Upright
Special nipples – Harborman/pigeon
Pump
Burp frequently
Stimulate sucking reflex
what should the positioning of the infant be after a cleft palate operation?
On belly
can a cleft lip patient be placed on their belly?
No
esophageal atresia and trach fistula
Failure of esophagus to develop as continuous passage
Failure of trach and esophagus to separate
what are the signs and symptoms of TEF
choking, coughing, cyanosis
Frothy saliva
dx TEF
X-ray
passage of radiopaque catheter until obstruction
Ano rectal malformation treatment
Anal stenosis – manual dilations
Perineal fistulas – anoplasty
Extensive defects – colostomy
Imperforate anus – surgery in stages
omphalocele
herniation of abdominal contents through umbilical ring
Intact peroneal sack
gastroschisis
herniation of abdominal contents
No perineal sac
what type of covering should be placed over the abdominal wall defects?
Loose covering with saline, soaked pads and plastic drape
Silo patch – compression
how to monitor for an ileus post abdominal wall defects
Listen for bowel sounds
gastroenteritis
Stool excess, diarrhea
Three or more watery stools per day
Increased in frequency
Decreased in consistency
cause of gastroenteritis
1 viral- rotavirus, Nora virus
Bacterial
Protozoan
bacterial signs and symptoms
Bloody diarrhea
Severe cramps
Malaise
how is bacterial gastroenteritis caused?
fecal – oral transmission
Contaminated food
Cause of constipation
structural disorder
Hypothyroidism
Hypercalcemia
Lead poisoning
Spinal cord lesions
fiber formula
Age +5 = fiber needed in grams
Older than three years old
How to stimulate motility for an infant with bottlefeeding
Add Karo syrup to bottle
encopresis
Chronic constipation with soiling stool leaking around impaction
cause of encopresis
Psychological trauma
Voluntary withholding
management of encopresis
Bowel prep
MiraLAX – 6 to 12 months
bowel training
what should be present when an infant uses the toilet?
Stool in front to relax sphincters
hirschsprung disease
Congenital aganglionic megacolon
Patho of HD
Absence of autonomic peristalsis in segments of the colon
Enlargement of bowel, proximal to defect
Mechanical obstruction from inadequate motility
what is the most serious complication of HD?
Enterocolitis
General sx HD
ischemia
Bloody diarrhea
Fever
Lethargy
newborn sx HD
Failure to pass meconium within 48 hours
Food refusal
Bilious, vomiting
Abdominal distention
infant sx HD
Poor weight gain
Constipation, diarrhea, vomiting
Abdominal distention
older child sx HD
constipation
Ribbon like
Foul smell
Palpable fecal mass
Poor appetite
Abdominal distention
dx HD
barium enema
Rectal biopsy
Anal rectal manometry
Surgery options for HD
temporary colostomy
Soave Endorectal pull through
Pre-op HD surgery
Measure abdominal girth daily
Note 1st BM
Bowel prep, anbx
Monitor hydration, f/e imbalance
What type of enemas should be avoided pre-op?
Tap water enemas
Post-op HD surgery
NG-LWS
NPO
I/0-losses
Abdominal assessment
Ostomy care
