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PEDs Exam 2 > GI > Flashcards

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?

A

3 months

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
Q

what are some PRE-OP nursing management interventions that need to be done with a child who has a cleft lip or cleft palate?

A
  • 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
Q

what are some POST-OP nursing management interventions that need to be done but a child who has a cleft lip or cleft palate?

A
  • 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
Q

what are some POST-OP nursing interventions when it comes to feeding a child who just had cleft lip or cleft palate surgery?

A
  • 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
Q

what is Pierre Robin Sequence?

A

where the lower jaw setback and smaller than the upper jaw, causing tongue displacement

29
Q

what is the number one priority for a patient who has Pierre Robin Sequence?

A

positioning (prone when resting)

30
Q

what is some monitoring that needs to be done with nasogastric/orogastric tubes?

A
  • 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)

PEDs Exam 2 (4 decks)

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