GI

Question 1

Hirschberg disease in children is a

Answer 1

birth defect

Question 2

what happens in Hirschberg disease

Answer 2

part of lg intestine is unable to move waste properly causing blockage of lg intestine in newborn. ganglion cells either don’t reach area or don’t function.

Question 3

s/s of Hirschberg

Answer 3

infection may develop (enterocoloitits)
vomiting/failure to thrive
swelling of lg intestine/abdomen

Question 4

does Hirschberg require a surgical procedure

Answer 4

yes, laproscopicaly assisted trans-anal pull through

Question 5

what procedure is necessary until surgery can be done

Answer 5

recto-irrigations, removes gas and waste, to prevent infection

Question 6

in a laproscopicaly assisted trans-anal pull through what happens

Answer 6

loosen and remove diseased intestine; circular incision in rectum, inside of anus; pulled out through anus for removal

Question 7

s/s of pyloric stenosis

Answer 7

vomiting
constipation
green diarrhea
weight loss
stomach pain after eating

Question 8

symptoms of pyloric stenosis begin when baby is

Answer 8

3 weeks old

Question 9

how is pyloric stenosis treated

Answer 9

surgery, loosen muscle so fluid can be easily out of the stomach

Question 10

what causes pyloric stenosis

Answer 10

muscle is too big; doesn’t relax, stays tight

Question 11

how is failure to thrive classified

Answer 11

growth failure; weight below the 5th percentile on growth chart

Question 12

3 categories of failure to thrive

Answer 12

idiopathic - unknown cause
organic - r/t physical problem - look to disorders
non-organic - r/t not being fed - possible neglect

Question 13

NFTT s/s

Answer 13

behavior - apathy, interested more in toys, no fear of strangers (issues)

Question 14

goals for FTT

Answer 14

reverse malnutrition - provide calories needed
observe parent/child interactions
primary nursing - same assignment when possible

Question 15

what is primary nursing

Answer 15

same assignment to learn cues/behaviors of child

Question 16

if child is getting attention for feeding will they feed

Answer 16

no - if that is the only way I get attention - extending time

Question 17

what tools do we use for cleft palate/lip

Answer 17

haberman feeder

Question 18

mgmt. of cleft lip/palate

Answer 18

elevate child for feedings - 45 degrees (reduce risk for infections & aspiration)
encourage mom to breast feed
use teach back so parents know how to use tools

Question 19

which surgery would come first if child had both a cleft lip and palate

Answer 19

cleft lip

Question 20

when would you do the cleft lip procedure/surgery

Answer 20

10
10 weeks
10 pounds
hemoglobin = 10

Question 21

what is the name of cleft lip surgery

Answer 21

cheiloplasty

Question 22

cleft palate surgery is usually performed at what age

Answer 22

between 6-12 months

Question 23

goal for cleft palate surgery

Answer 23

normal speech development

Question 24

is cleft lip same day surgery

Answer 24

yes - discharged, same day, if child is doing okay after surgery

Question 25

mgmt. after cleft lip surgery

Answer 25

feed them - po

logan bow arm restraints - to keep hands away form incision

Question 26

complications of cleft

Answer 26

hearing problems w/recurrent otitis media infections
dental problems (missing teeth)
recurrent respiratory infections (usually unrepaired cleft)

Question 27

with cleft palate surgery what would you encourage

Answer 27

drinking for a cup

do not insert straws or pacifier

Question 28

what is esophageal atresia

Answer 28

esophagus ends in pouch

Question 29

what do we worry about with esophageal atresia

Answer 29

aspirations
respiratory issues
risk for pneumonia

Question 30

when feeding a baby with esophageal atresia what can happen (three c’s)

Answer 30

choking
coughing
cyanosis - bag baby/oxygen - critical!

Question 31

what happens when you stick an NG tube through nose with a baby with esophageal atresia

Answer 31

It stops

Question 32

goals for child with esophageal atresia

Answer 32

npo 
maintain patent airway
intubation
hob elevated
iv fluids
suction

Question 33

can esophageal atresia be repaired

Answer 33

yes, thoracotomy

end-to-end anastomosis of esophagus

Question 34

what will happen to esophagus after esophageal atresia surgery

Answer 34

flappy airway, not as sturdy

Question 35

what happens if child cries/coughs

Answer 35

esophagus can collapse/close

Question 36

after surgery goals/mgmt. for esophageal atresia

Answer 36

chest tubes
do not place tension on sutures
make sure esophagus is patent before feeding

Question 37

discharge teaching for esophageal atresia

Answer 37

go home with apnea monitor
cpr training
preventing reflux

Question 38

what is biliary atresia

Answer 38

bile ducts may not form completely, or they close; bile cannot come out of liver and go into duodenum
can be intra or extrahepatic - bile ducts didn’t form properly

Question 39

when will we see s/s of biliary atresia

Answer 39

2 weeks - prolonged jaundice (progression)
swollen abdomen
acholic stools
hepatomegaly(enlarged liver)
pruritis - intense itching from toxins and irritants building up in the body

Question 40

what happens in biliary atresia

Answer 40

cholestasis - bile stays in liver
causes damage to liver
get cirrhosis/liver damage
life threatening disease
difficulty absorbing fat soluble vitamins A,D,E,K

Question 41

ultimate treatment for biliary atresia

Answer 41

liver transplant

Question 42

cause of biliary atresia

Answer 42

unknown

Question 43

dx of biliary atresia

Answer 43

labs

liver biopsy - determines

Question 44

what is kasai procedure*

Answer 44

segment of intestine is anastomosed for bial drainage

Question 45

treatment for biliary atresia**

Answer 45

kasai procedure - supportive

liver transplant

Question 46

what age do children with biliary atresia have the best success rate

Answer 46

dx and surgically treated before 2 months of age

Question 47

mgmt. for biliary atresia

Answer 47

failure to thrive
itching - prevent secondary infections - oatmeal baths
support for parents