GI Flashcards
Hirschberg disease in children is a
birth defect
what happens in Hirschberg disease
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.
s/s of Hirschberg
infection may develop (enterocoloitits)
vomiting/failure to thrive
swelling of lg intestine/abdomen
does Hirschberg require a surgical procedure
yes, laproscopicaly assisted trans-anal pull through
what procedure is necessary until surgery can be done
recto-irrigations, removes gas and waste, to prevent infection
in a laproscopicaly assisted trans-anal pull through what happens
loosen and remove diseased intestine; circular incision in rectum, inside of anus; pulled out through anus for removal
s/s of pyloric stenosis
vomiting constipation green diarrhea weight loss stomach pain after eating
symptoms of pyloric stenosis begin when baby is
3 weeks old
how is pyloric stenosis treated
surgery, loosen muscle so fluid can be easily out of the stomach
what causes pyloric stenosis
muscle is too big; doesn’t relax, stays tight
how is failure to thrive classified
growth failure; weight below the 5th percentile on growth chart
3 categories of failure to thrive
idiopathic - unknown cause
organic - r/t physical problem - look to disorders
non-organic - r/t not being fed - possible neglect
NFTT s/s
behavior - apathy, interested more in toys, no fear of strangers (issues)
goals for FTT
reverse malnutrition - provide calories needed
observe parent/child interactions
primary nursing - same assignment when possible
what is primary nursing
same assignment to learn cues/behaviors of child
if child is getting attention for feeding will they feed
no - if that is the only way I get attention - extending time
what tools do we use for cleft palate/lip
haberman feeder
mgmt. of cleft lip/palate
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
which surgery would come first if child had both a cleft lip and palate
cleft lip
when would you do the cleft lip procedure/surgery
10
10 weeks
10 pounds
hemoglobin = 10
what is the name of cleft lip surgery
cheiloplasty
cleft palate surgery is usually performed at what age
between 6-12 months
goal for cleft palate surgery
normal speech development
is cleft lip same day surgery
yes - discharged, same day, if child is doing okay after surgery
mgmt. after cleft lip surgery
feed them - po
logan bow arm restraints - to keep hands away form incision
complications of cleft
hearing problems w/recurrent otitis media infections
dental problems (missing teeth)
recurrent respiratory infections (usually unrepaired cleft)
with cleft palate surgery what would you encourage
drinking for a cup
do not insert straws or pacifier
what is esophageal atresia
esophagus ends in pouch
what do we worry about with esophageal atresia
aspirations
respiratory issues
risk for pneumonia
when feeding a baby with esophageal atresia what can happen (three c’s)
choking
coughing
cyanosis - bag baby/oxygen - critical!
what happens when you stick an NG tube through nose with a baby with esophageal atresia
It stops
goals for child with esophageal atresia
npo maintain patent airway intubation hob elevated iv fluids suction
can esophageal atresia be repaired
yes, thoracotomy
end-to-end anastomosis of esophagus
what will happen to esophagus after esophageal atresia surgery
flappy airway, not as sturdy
what happens if child cries/coughs
esophagus can collapse/close
after surgery goals/mgmt. for esophageal atresia
chest tubes
do not place tension on sutures
make sure esophagus is patent before feeding
discharge teaching for esophageal atresia
go home with apnea monitor
cpr training
preventing reflux
what is biliary atresia
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
when will we see s/s of biliary atresia
2 weeks - prolonged jaundice (progression)
swollen abdomen
acholic stools
hepatomegaly(enlarged liver)
pruritis - intense itching from toxins and irritants building up in the body
what happens in biliary atresia
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
ultimate treatment for biliary atresia
liver transplant
cause of biliary atresia
unknown
dx of biliary atresia
labs
liver biopsy - determines
what is kasai procedure*
segment of intestine is anastomosed for bial drainage
treatment for biliary atresia**
kasai procedure - supportive
liver transplant
what age do children with biliary atresia have the best success rate
dx and surgically treated before 2 months of age
mgmt. for biliary atresia
failure to thrive
itching - prevent secondary infections - oatmeal baths
support for parents
