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Peds Exam 3 > GI > Flashcards

GI Flashcards

1
Q

When does the GI system develop?

A

At 8 weeks gestation

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2
Q

What about the GI system is immature at birth?

A

Absorption and excretion

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3
Q

What is oral aversion?

A

There is no inclination to eat. They don’t realize that the month is for food, so when you put something in their mouth they spit it out or pull it out.

After 6 weeks, loss of sucking involuntary

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4
Q

Why is it likely for an infant to get GERD?

A

The sphincter at the top of the gastric esophageal sphincter is immature (doesn’t close all the way)

Stomach lays sideways

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5
Q

What is the stomach capacity for a newborn?

A

20 mL

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6
Q

What is the stomach capacity for a 1 month old?

A

90 mL

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7
Q

What is the stomach capacity for a 1 year old?

A

360 mL

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8
Q

How much does a baby grow from birth to 6 months?

A

A baby might grow 1/2 to 1 inch (about 1.5 - 2.5 cm) a month

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9
Q

How much does a baby gain from birth to 6 months?

A

5-7 oz (about 140 - 200g) a week

Expect baby to double birth weight by about 5 months

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10
Q

How much does a baby grow from 6 to 12 months?

A

A baby might free 3/8 inch (about 1 cm) a month

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11
Q

How much does a baby gain from 6 to 12 months?

A

3 - 5 oz (about 85-140 grams) a week.

Expect baby to triple birth weight by about 1 year

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12
Q

What is the teething rule of 6?

A

1st erupt at 6 months

1 year = 6 teeth

Lose teeth at 6 years

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13
Q

What is gastroschisis and omphalocele?

A

The intestines are on the outside of the body (herniation of the intestines)

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14
Q

What is the difference between gastroschisis and omphalocele

A

Omphalocele - the intestines are encased within the umbilical wall

Gastroschisis - the intestines are lose and just hanging out

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15
Q

Which one is worse gastroschisis or omphalocele

A

Gastroscisis because intestines are outside of abdomen and not encased. Meaning they are exposed to amniotic fluid which leads to inflammation or obstruction

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16
Q

How would you treat gastroschisis pre operative?

A

Keep intestines moist, sterile and safe!

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17
Q

What are the main types of hernias

A

Umbilical

Inguinal

Incarcerated

Diaphragmatic

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18
Q

What is the most common hernia we see in kids and what is it?

A

Inguinal- these don’t close on its own. The repair is usually done at 1-2 months of age surgically. More common in males.

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19
Q

What is the most uncommon type of hernia?

A

Diaphragmatic - needs surgical correction. Barrel shaped chest and sunken abdomen.

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20
Q

What is an imperforate anus?

A

Anus and rectum do not develop properly

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21
Q

What is the nursing care for children with a cleft lip or cleft palate?

A

Develop a good seal on the nipple whether that is moms breast or the bottle

Provide adequate nutrition and prevent aspiration and infection (otitis media)

Feed slowly

Burp frequently because swallowing large amounts of air is common

22
Q

What are the 3 Cs

A

Coughing, choking, cyanosis

Seen in tracheoesophageal fistula (TEF)

23
Q

What is the normal amount of bilirubin?

A

3-5x baby weight in kg

Less than 10 is what we consider ok

24
Q

What is the danger level of bilirubin?

A

Danger is over 20

And 25 or greater is when we would start blood transfusions exchange

25
Q

What is biliary atresia?

A

Absence (never formed) or destruction of biliary ducts

Therefore bile backs up/accumulates in the liver which damages the liver and it could kill the liver

26
Q

What is hirchsprung disease?

A

Piece of the colon that does not have ganglion cells so peristalsis does not work there.

So instead of the stool going though, it just stays there and it gets bigger and bigger because it doesn’t have any way of keeping it moving down.

27
Q

When do we normally see hirschsprung disease?

A

In infancy because they never pass their meconium in the first 24-48 hours

28
Q

How does hirschsprung disease present in older children?

A

Constipation

** ribbon like and foul smelling stools

Abdominal distention

Palpable fecal masses

Poorly nourished

Lethargic, nauseated, anorexic

29
Q

What does NEC stand for?

A

Necrotizing (death) entero (intestines) colitis (inflammation of colon)

30
Q

What causes NEC?

A

Intestinal tissues are somehow weakened by too little oxygen or blood flow

Mostly occurs in neonates.. preemies especially!

31
Q

What can NEC cause?

A

Perforation (hole) in the intestines

Scarring or strictures (narrowing) of the intestines

Problems with food absorption, if large amounts of intestine must be removed

Severe, overwhelming infection

32
Q

What are symptoms of NEC?

A

Fever, foul smelling and or blood diarrhea

Abdominal distention (bloating or swelling). The abdomen is so enlarged the skin is actually shiny

33
Q

What is meckel diverticulitis

A

A small pouch in the wall of the intestine, near the junction of the small and large intestines, which produces acid

Acid irritates the intestinal lining causing ulceration which can bleed

34
Q

Signs of meckel diverticulitis

A

Passing painless large amounts of blood in their stool (brick coloured, jelly like) possibly causing anemia

35
Q

What are the symptoms of appendicitis?

A

Abdominal pain that begins around the belly button and moves to the right lower side of the abdomen. The pain typically increases when walking, jumping or coughing, and usually worsens as time goes on.

Fever which increases with perforation

N/V

Diarrhea

36
Q

What is the pain location in appendicitis?

A

McBurney point

37
Q

What causes appendicitis?

A

Blockage of the appendix caused by hard mucus or stool, a foreign body, or virus

The blockage causes the appendix to swell and become inflamed

38
Q

What could happen if the appendix swells and the infection is left untreated?

A

It can perforate, causing the contents of the appendix to be released into the abdominal cavity and develop peritonitis

39
Q

What does it mean when the pain in appendicitis goes away?

A

That it perforated

40
Q

What is pyloric stenosis?

A

Thickening of the muscle of the pylorus, causing constriction and subsequent obstruction of pyloric channel.

41
Q

How does pyloric stenosis presents?

A

Occurs in the first few weeks of life and is more common in first born males

Presents with projectile vomiting

Olive shaped mass may sometimes be palpated

May see visible peristalsis

42
Q

What is intussusception?

A

A portion of the intestine folds like a telescope, with one segment slipping inside another segment

43
Q

How does intussusception present?

A

Sudden onset of intermittent abdominal pain

Stools may resemble currant jelly

Sausage shaped mass in RUQ of abdomen

44
Q

What is malrotation

A

Malrotation is due to abnormal rotation around the superior mesenteric artery during embryonic development

Trinkas words- malrotation happens when the intestines accidentally wrap around the Ladds bands which are the bands that connect your intestines to the abdomen

45
Q

What is a volvulus

A

Occurs when intestine is twisted around itself and compromises blood supplied to intestines

May cause intestinal perforation, peritonitis, necrosis, and death

46
Q

What are the 3 types of ostomies?

A

Colostomy- stoma is formed from the large intestine

Ileostomy- a stoma is formed from the small intestine

Urostomy- stoma is formed from the urinary tract

47
Q

What is celiac disease?

A

Malabsorption disorder of proximal small intestine, consisting of abnormal mucosa, and intolerance to gluten

48
Q

What are the symptoms of celiac disease?

A

Intolerance to gluten

Individuals are unable to digest the gliadin component of gluten, causing damage to mucosal cells

49
Q

What are the big three to avoid in celiac disease?

A

Must avoid wheat, barley, rye

50
Q

What are the 2 types of malnutrition

A

Kwashiorkor- deficient in protein

Marasmus- deficient in protein and calories

Peds Exam 3 (3 decks)

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