GI

Question 1

FTT tm

Answer 1

catch up growth, multidiscipline, correct deficiencies, treat cause, educate caregivers

Question 2

ftt nc

Answer 2

help with feeding
- staff consistency, quiet env, calm temperament, talk and give directions to child, be persistent, face to face posture, new foods slowly, follow child’s rhythm of feeding, structured routine, sit with them, hold them
I+O, daily weight, model proper care, parent support, self respect and confidence

Question 3

cleft lip/palate tm

Answer 3

lip sx in first weeks, palate sx 12-18 mo
multidisciplinary care

Question 4

cleft lip/palate nc

Answer 4

bonding! - pictures
promote feeding: upright position, special nipples, stimulate suck reflex, appropriate swallow, rest, freq burp
postop: protect airway - belly for palate, hypothermia, prevent infection, nonos, protect suture line, pain, avoid objects in mouth, suction with caution
speech, dentition, hearing problems, ear infections, good oral care

Question 5

esophageal atresia/tracheosophageal fistula nc

Answer 5

careful suction, upright position, nonnutritive sucking, ng low suction, high humidity, prevent pna, chest care tube, nutrition, comfort and physical contact
discharge: s/s of resp distress, tracheomalacia, gerd, constriction of esophagus

Question 6

abd wall defects

Answer 6

omphalocele = less severe
born c section
loosely cover with saline soaked pads and drape, fluids, abx, sx, silo
nc: sterile, careful, monitor for ileus, fam support, d/c planning, home care
can hear bowel sounds
npo

Question 7

gastroenteritis

Answer 7

viral mostly
treat s, ORS
nc: f+e, prevent spread, skin breakdown, adequate nutrition, fear and anx, infection control, health education for prevention and home management

Question 8

constipation

Answer 8

quality not quantity
nc: teach - reg potty times, right size, stay on top of this for 6 mo
tm: diet (fiber, fluids - water and fruit juice, activity), stool softeners
no raw fruits and veggies if choking, know fiber foods

Question 9

encopresis

Answer 9

so constipated you ooze around
tm: purge, stool soften, bowel retraining
nc: no punish, teach, support, compliance, empower, + reinforcement

Question 10

hirschsprung

Answer 10

meconium w/n 48 hrs
tm: sx, treat constipation
nc: first bm, measure abd girth, enemas and abx (bowel prep), hydration, F+E, npo, teach enema
ng, npo, I+O, hydration and e balance, abd assessment ostomy care

Question 11

gerd

Answer 11

happy spitters ok, fussy and poor growth = worry
antacid, ppI, prokinetic
nc: elevate hob 30 (wedge, harness), small freq, thickened formula, avoid fatty foods (chocolate, tomato, carbonated), educate parents, freq burp, hold upright or lay flat or on side (reduce abd P), dont feed too much

Question 12

hps

Answer 12

olive shaped mass, projectile vomit, ftt, exorcist babies
tm: sx
nc: fluid therapy, npo, I+O, ng, f+e, pain, titrate po feedings - vomit ok, pedialyte

Question 13

itussussception

Answer 13

currant jelly like stools, legs up, vomit, abd tender and distended, sausage shaped mass
tm: barium or air enema - diagnose and treat, sx
nc: ng, monitor for s of shock, abx, hydration and nutrition, fam support, post op care

Question 14

celiac

Answer 14

gluten: wheat, rye, barley, oats
tm: high cal and protein, low fat, vits and iron, risk of lymphoma
nc: teach diet

Question 15

sbs

Answer 15

didnt really talk about it

Question 16

appendicitis

Answer 16

lower right side, rebound tenderness, mcburneys point
nc: assess, no enemas or heating pads, prep for sx, atc pain meds, not sent home with narcotics, get them moving