GI Flashcards
Atresia
Absent or abnormal narrowing
Stenosis
Narrowing
Fistula
Abnormal connection between two body parts
Malposition
Not in the right spot
Hyperplasia/Hypertrophy
Overgrown
-itis
Inflammation
-cele
Swelling
-schisis
Cleft or split
Cleft Lip and Palate Definition
Incomplete fusion of the lip and/or palate in utero
Cleft Lip and Palate Assessment
-Severity?
-Unilateral or bilateral lips?
-Involves hard or soft palate or both?
Cleft Lip and Palate Treatment
-Correct at appropriate times d/t feeding/speech interference
-Close lip first (3-5m) by plastic surgery
-Close palate next (6-12m)
Cleft Lip and Palate Education/Care
-Feeding/nutrition: they can breastfeed, upright position, burp frequently, get good seal on nipple to let less air in, LAMB nipple, maybe G tube or syringe, have suction ready
-Promote bonding
-Respiratory assessment
-Interdisciplinary care: ENT
-Post OP: elbow restraints, manage pain, look at suture site, no nipple/paci/straw/spoon/fork for a bit, need IV fluids, clear liquid diet, no hard toys, no objects in mouth
Cleft Lip and Palate Complications
-otitis media
-respiration distress r/t aspiration
-infection
-dental
-speech delays
-self-esteem
Esophageal Atresia (EA) & Tracheoesophageal Fistula (TEF) Definition
-EA: blind pouch
-TEF: opening from trachea by fistula
Esophageal Atresia & Tracheoesophageal Fistula Assessment
-3 C’s -cyanosis, choking, coughing
-Excessive drooling and salivation
-Respiratory status
-Other congenital anomalies
-Food comes right back out of the nose or into trachea (w/ TEF)
-NG tubes can’t go down to stomach
Esophageal Atresia & Tracheoesophageal Fistula Treatment
-Medical emergency
-Surgical repair
-Bronchoscoopy
Esophageal Atresia & Tracheoesophageal Fistula Education/Care
-Respiratory status: have suction available,
-Nutrition: TPN/Lipids, G-tube, strict I/Os, daily weights
-Emotional support
-Introduce food back slowly after repair
Esophageal Atresia & Tracheoesophageal Fistula Complications
-GERD
-Aspiration
-Stricture formation
-Leak
-Tracheomalacia
Pyloric Stenosis Definition
-Thickening and tightening of the pyloric sphincter (at base of stomach)
-2-8 weeks after birth
Pyloric Stenosis Assessment
-Projectile vomiting
-Constant hunger
-Weight loss
-Olive shaped mass in RUQ
-Peristatic wave
-Dehydration
-Dx: ABD US
Pyloric Stenosis Treatment
-Medical emergency
-Surgical repair - pylorotomy
Pyloric Stenosis Education/Care
-Nutrition: pyloric protocol (small amt of Pedialyte until formula), strict I/Os, daily weights
-Emotional support
Pyloric Stenosis Complications
-Surgical site infection
-Dehydration
-Feeding intolerance
GERD Definiton
-Backflow of stomach contents to esophagus
GERD Assessment
-Regurgitation
-Hunger
-Irritability
-Monitor feeding patterns
-Dx: Upper GI, pH probe monitoring
GERD Treatment
-Feeding modification: small meals, thicken formula, slow-flow nipple, avoid spicy/fried foods
-Positioning: upright
-Meds: PPI, H2 receptor agonists
-Surgery or G-tube for severe cases
GERD Education/Care
-Suction ready
-Monitor respiratory status
-Strict I/Os, daily weights
-Feeding education
GERD Complications
-Aspiration
-Poor weight gain
-Sleep difficulties
Omphalocele & Gastroschisis Definition
-OC: through umbilical cord, covered w/ a membrane
-GS: no sac/membrane covering organs, usually right side
Omphalocele & Gastroschisis Assessment
-Location
-Presence of membrane
-Color of ABD contents, moistness
Omphalocele & Gastroschisis Treatment
-Surgical repair to correct defect
-GS: silo mesh device allows organs to slowly go back in body as child grows
Omphalocele & Gastroschisis Education/Care
-Protect protruding ABD organs
-Prevent complications
-Promote bonding
-Emotional support
-NPO and on TPN
Omphalocele & Gastroschisis Complications
-Hypothermia
-Infection
-Injury
Intussusception Definition
-Telescoping or invagination of bowel segment into itself
Intussusception Assessment
-Family Hx
-Red currant jelly stool
-Sudden severe pain
-Vomiting
-Periods of comfort then acute pain
-Palpable sausage shaped ABD mass
-Dx: US
Intussusception Treatment
-Medical emergent
-Barium enema or air enema to get bowel back out
-Surgery
Intussusception Education/Care
-Pain control
-NG tube to decompress ABD
-Hydration: on IV fluids
-Monitor for return of bowel function
Intussusception Complication
-Bowel obstruction
-Bowel necrosis
-Post-op infections
-Dehydration
Volvulus Definition
-Malrotation of intestine
Volvulus Assessment
-Bilious vomiting
-Firm ABD w/ distention
-Irritability
-Passage of bloody stools
Volvulus Treatment
-Medical emergency
-Surgical repair
-Maybe colostomy
Volvulus Education/Care
-Pain control
-NPO
-IV fluids
-Pre/Post op teaching
Volvulus Complications
-Bowel obstruction
-Bowel necrosis
-Short bowel syndrome
-death
-Ostomy
Anorectal Malformation Definition
Anomalies of rectum, urinary, and reproductive system
-Imperforate anus
-Anal stenosis
-Fistula
Anorectal Malformation Assessment
-Other congenital anomalies
-Failure to pass meconium
-Stool in urine
Dx: US
Anorectal Malformation Treatment
-Surgery
-Dilations
Anorectal Malformation Education/Care
-Assess anatomy at birth
-IV fluids, NG tube
-NPR: no meds or temps
-Colostomy care
-Emotional support
-Colostomy reversal
-Pain meds
-Skin care
Anorectal Malformation Complications
-Infection
-Bowel obstruction
-Colostomy
-Difficulties w/ toilet training
Congenital Diaphragmatic Hernia Definition
-ABD contents protrude into thoracic cavity through opening in diaphragm
Congenital Diaphragmatic Hernia Assessment
-Respiratory distress
-Cyanosis
-Dyspnea
-Shape of chest and ABD
Congenital Diaphragmatic Hernia Treatment
-Life threatening
-Surgery
Congenital Diaphragmatic Hernia Education/Care
-Immediate respiratory support in NICU: intubation, vent, ecmo
-Positioning
-NG tube to decompress ABD
-Decrease simulation
-Emotional support
-Observe for respiratory compromise
-Post op: positioning, pain meds
Congenital Diaphragmatic Hernia Complications
-Death from RDS
-Post-op infections
-Reoccurence
Umbilical Hernia Definition
-Weak or imperfectly closed umbilical ring
Umbilical Hernia Assessment
-Soft swelling covered by skin
-Easily reduced by pushing back through fibrous ring
-May increase in size when bear down, coughing or crying
-Usually not painful
Umbilical Hernia Treatment
-Surgery if strangulation or doesn’t resolve by 3-5 years or grows larger by 1-2 years
Umbilical Hernia Education/Care
-Reducible vs. strangulation
Umbilical Hernia Complications
-Strangulation
-Need for surgical repair
Acute Diarrhea
- <14 days
-Secondary to GI infection, URI, UTI, ABX, laxatives, gastroenteritis, Rotavirus
Chronic Diarrhea
- > 14 days
-Short gut syndrome, malabsorption, food allergies, inflammatory bowel disease
Diarrhea Assessment
-Bristol stool scale
-Home treatments
-Food intake
-Sick contacts
-S/Sx of dehydration
-Stool culture
-Vomiting
Diarrhea Treatment
-Hydration
-Oral rehydration
-Possible medications
-IV fluids if needed
-Electrolyte management
-Barrier cream
Diarrhea Education/Care
-Hydration
-Strict I&O, including stool
-Daily weight
-Hand hygiene
-Diet
Diarrhea Complications
-Dehydration
-Severe, electrolyte imbalances
-Skin breakdown
Functional Constipation Definition
-Absence of structural, endocrine or metabolic conditions that cause hard stools
Functional Constipation Assessment
-Bristol Stool Scale
-Review diet
-Toileting habits
Functional Constipation Treatment
-Dietary management
-Bathroom privileges at school
-Behavior management
-Pharmacologic management
-Decompaction
-Maintenance therapy
-Fiber/Fluids
Functional Constipation Education/Care
-Diet
-Activity
-Infants- 2 oz. apple or pear juice daily
-Bathroom routines
Functional Constipation Complications
-Fecal impaction
-Psychological stress
Encopresis Definition
-Recurrent soiling or at inappropriate times
-Voluntary or involuntary retention of stool leads to constipation, dilation of lower bowel and incompetence of inner sphincter
Encopresis Assessment
-Bristol Stool Scale
-Review diet
-Toileting habits
-Painful BM
Encopresis Treatment
-Encourage regular bathroom times
-Emotional support
-Positive reinforcement
-Diet
-Toilet-training techniques
Encopresis Complications
-Fecal impaction
-Constipation
-Bowel incontinence
-Psychological stress
Colic Definition
-Severe abdominal pain 3 hours and occurs at least 3 days per week.
Colic Assessment
-Crying loudly and continuously
-Face may become flushed
-ABD distended and tense
-Episodes occur at the same time each day
-Legs draw up, tense, clench hands
Colic Treatment
-Supportive care
-Gas drops- Mylicon
-Formula changes
Colic Education/Care
-Rule out other causes
-Support parents
Colic Complications
-Psychological stress
-Fatigue
Hirschsprung’s Disease Definition
-Congenital aganglionic megacolon
that starts at the anus and progresses proximally
-Paralyzing
Hirschsprung’s Disease Assessment
-Failure to pass meconium in 1st 48hrs
-ABD distention
-Dx: biopsy
Hirschsprung’s Disease Treatment
-Surgical removal of the non-functioning colon
-Maybe colostomy
-TPN/Lipids
Hirschsprung’s Disease Education/Care
-Monitor I&O, fluid and electrolyte balance
-Teach parents TPN or feeding regimen
Appendicitis Definition
-Inflammation of the appendix caused by an obstruction
Appendicitis Assessment
-Periumbilical cramps
-ABD tenderness
-Fever
-Pain in RLQ most intense at McBurney’s point
-Progressive
-Dx: CT
Appendicitis Complications
-Rupture
-Peritonitis
Crohn’s Disease Definition
-Inflammation and ulceration of GI tract
-Patchy and anywhere from mouth to anus
Crohn’s Disease Assessment
-More subtle: steady/colicky pain RLQ
-Diarrhea
-Flatulence
-Excess fat in stool
-Malaise
-Joint pain
-Weight loss
-Delayed growth
Ulcerative Colitis Definition
-Inflammation of large intestine and rectal mucosa
-Continuous and limited
Ulcerative Colitis Assessment
-1st sign: diarrhea
-Cramping during and after BM
-Blood and mucus in stool
-Joint pain
-Weight loss
Delayed growth
Crohn Disease & Ulcerative Colitis Treatment
Dx: colonoscopy w/ biopsy
-Crohn’s: ulcers reoccur
-UC: Can remove diseased bowel
-Temporary colostomy
-Medication
Crohn Disease & Ulcerative Colitis Education/Care
-Monitor for Sx of anemia
-I&O, daily weight, fluid status
-Support patient and family
-Nutrition
-Pain Management
Crohn Disease & Ulcerative Colitis Complications
-Psychological stress
-Increased risk of cancer with Crohn
-Colostomy temporary or permanent
Celiac Disease Definition
-Immunologic disorder characterized by intolerance for gluten (found in wheat, barley, rye, and oats)
Celiac Disease Assessment
-Steatorrhea: increased fat in stool
-ABD Pain
-ABD distention
-Lack of energy
-Muscle wasting
-Chronic diarrhea
-Malabsorption of Fat-Soluble Vitamins
-Dx: Colonoscopy w/ biopsy
Celiac Disease Treatment
-Eliminate gluten
Celiac Disease Education/Care
-Multi-disciplinary care
-Support family and pt
Lactose Intolerance Definition
-Inability to digest lactose
Lactose Intolerance Assessment
-ABD pain
-Flatulence
-Diarrhea
-Hx
-Dx: hydrogen breath test
Lactose Intolerance Treatment
-Eliminate lactose
-Lactose tablets
Lactose Intolerance Education/Care
-Nutrition education
-Support parent and pt
Short Bowel Syndrome Definition
-Decreased ability to absorb nutrients bc of a shortened intestine
-Congenital bowel anomaly or from a surgery (bowel resection)
Short Bowel Syndrome Assessment
-Diarrhea: quickly after eating
Short Bowel Syndrome Treatment
-Nutrition consult
-Possible TPN/Lipids
Short Bowel Syndrome Education/Care
-Monitor I&O, fluid and electrolyte balance
-Teach parents TPN or feeding regimen