GI Flashcards

1
Q

What are some clinical manifestations of gastrointestinal dysfunction?

A
  • failure to thrive
  • spitting up, regurgitation
  • nausea, vomiting
  • diarrhea, constipation
  • abdominal pain, distension, GI bleeding
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2
Q

What are some key assessment questions to ask if a child is vomiting?

A
  • how long, when?
  • how much, often?
  • color?
  • green bilious?
  • projectile?
  • fever present?
  • abdominal pain?
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3
Q

If vomiting persists it can lead to what?

A

metabolic alkalosis

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4
Q

What are some common feeding intolerances in children?

A
  • cow’s milk allergy, lactose intolerance

- food allergies= formula or something mom is eating

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5
Q

what are some manifestations and management of feeding intolerances?

A
  • reflux, colic, diarrhea
  • small, frequent feeds and change formula
  • increase Burbank (reflux)
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6
Q

what is lactose intolerance in the management for it?

A
  • genetic deficiency of lactase
  • reduce Dairy consumption, but do not cut it out completely because it helps with growth and development
  • use probiotics to help tolerate formula
  • eat hard cheese, cottage cheese, yogurt
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7
Q

true or false: Food allergies are common and can change or disappear as the child gets older.

A

true

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8
Q

what disease is caused by soy allergy?

A

celiac disease

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9
Q

what are some manifestations of gastroesophageal reflux?

A
  • happy spitters (common in preemies)
  • painless emesis
  • immature esophageal sphincter
  • no failure to thrive ( typically won’t see changes in weights)
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10
Q

what are some manifestations of gastroesophageal reflux disease (GERD)?

A
  • failure to thrive
  • aspiration pneumonia
  • greater volume of emesis
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11
Q

what are some treatment options for gastroesophageal reflux?

A
  • small, frequent feeds
  • increase burping after every ounce given
  • Elevate head at all times
  • reflux precautions
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12
Q

what is one particular thing we do when caring for a child who has gastroesophageal reflux disease (GERD)?

A

thicken feeds

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13
Q

what pharmacological interventions are used for gastroesophageal reflux disease(GERD)?

A
  • H2 receptor antagonist ( drug of choice in Pediatrics)

- proton pump inhibitors

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14
Q

what are some nursing considerations for histamine 2 antagonists when giving to patients with GERD?

A
  • interferes with skin test using allergen extracts (cannot give within two weeks of allergy test)
  • Don’t give within an hour of antacids
  • give without regard to meals but best before meals or at bedtime
  • may cause drowsiness or dizziness
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15
Q

what is a nursing consideration when administering proton pump inhibitors to patients who have GERD?

A

give with first meal of the day; ideally, administer 30 minutes before breakfast

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16
Q

If a patient who has GERD is not improving with interventions or medication which surgery will be done?

A

Nissen fundoplication

17
Q

If a patient is experiencing prolonged constipation/encopresis what are some interventions that can be done?

A
  • fluids, fiber, exercise
  • re-establish a normal bowel regimen
  • pharmacological interventions
  • Chait tube/MACE
18
Q

Chait tubes/MACE are commonly used in which type of patients to relieve constipation issues?

A

immobile patients

19
Q

What are two common symptoms of celiac crisis?

A
  • profuse watery diarrhea

- vomiting

20
Q

what are some common dietary guidelines for celiac disease?

A
  • high-calorie, high-protein, low-fat
  • allowed it to eat corn, rice, millet
  • temporary lactose free diet
  • high fiber foods initially until inflammation of bowel has subsided
  • supplement fat soluble vitamins, folic acid, iron
  • risk of developing intestinal lymphoma
21
Q

when is it common to have cleft lip repairment surgery?

22
Q

when is it common to have cleft palate repairment surgery?

A

9 to 12 months

-typically takes multiple revisions

23
Q

what are two concerns that we have if a child has a cleft lip or cleft palate?

A
  • Dental concerns

- developmental delays in speech

24
Q

risk factors are increased if a child has a cleft lip or cleft palate?

A
  • aspiration
  • otitis media
  • upper respiratory disease
25
what are some PRE-OP nursing management interventions that need to be done with a child who has a cleft lip or cleft palate?
- assessment of respiratory status - suction equipment at bedside/ Tom suctioning forms - position of right for feedings - slowly, burp frequently, you special nipples and bottles if needed - hold upright 30 min after feeding - teach family to feed in small, frequent intervals
26
what are some POST-OP nursing management interventions that need to be done but a child who has a cleft lip or cleft palate?
- assess respiratory status every 4 hours and maintain patent Airway - avoid the use of suctioning or objects in mouth (unless Allowed by MD) - restraints for at least 1 week (remove restraints every 2 hours, one at a time for ROM) - position on side or back or in a seat - try to prevent crying - suture line care per physician(cleft lip)
27
what are some POST-OP nursing interventions when it comes to feeding a child who just had cleft lip or cleft palate surgery?
- syringe with rubber tip catheter, soft-tip bottle, or free flow bottle nipple - no spoons or straws - no pacifier - soft and/or liquid diet - can you soft spout sippy cup or open cup (palate repair!) - provide good dental care
28
what is Pierre Robin Sequence?
where the lower jaw setback and smaller than the upper jaw, causing tongue displacement
29
what is the number one priority for a patient who has Pierre Robin Sequence?
positioning (prone when resting)
30
what is some monitoring that needs to be done with nasogastric/orogastric tubes?
- document accurate gastric output (change canister every shift) - watch for increase gastric output, decreased or concentrated urine, total output greater than intake - may require NG replacement fluids (usually replacement fluid (NS/LR) given 1mL:1mL) - excess output May indicate migration of tube- get a KUB x-ray - increased distention, no output may indicate clogged tube or dislodge tube (check placement)