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328 Pediatrics Exam 2 > GI Diseases > Flashcards

GI Diseases Flashcards

1
Q

List the agents that cause Infectious Diarrhea.

A
  • Rotavirus
  • Escherichia coli (E. coli)
  • Salmonella
  • Clostridium Difficilie (C. diff)
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2
Q

What is the etiology of each Infectious Diarrhea agent?

A
  • Rotavirus = virus
  • E. coli = bacteria
  • Salmonella = bacteria
  • C. diff = bacteria
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3
Q

What are some unique characteristics of Rotavirus?

A
  • Most common cause of diarrhea < 5 yrs
  • Vaccine preventable (e.g. Rotarix)
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4
Q

What are some unique characteristics of E. coli?

A
  • undercooked beef, lettuce, petting zoos
  • produce. E. coli OH157:H7 linked with acute renal failure.
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5
Q

What are some unique characteristics of Salmonella?

A
  • turtles
  • bloody diarrhea
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6
Q

What are some unique characteristics of C. diff?

A
  • C. difficile spores are not killed by alcohol, and the most effective way to remove them from hands is through handwashing
  • WASH HANDS / Probiotics
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7
Q

What is Meconium?

A
  • Meconium – First stool
    • Sticky, greenish-black stool
    • Amniotic fluid and cells swallowed in utero
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8
Q

When should Meconium be passed? What do you assess for if it is not passed within that time period?

A

Should be passed within 24 hours of life; if not, assess for:

  1. Hirschsprung disease – lack of ganglion cells
  2. Hypothyroidism – metabolism slow
  3. Cystic Fibrosis – thick mucous
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9
Q

Describe the pathophysiology of Hirschsprung Disease.

A
  • Absence of ganglion (nerve) cells in colon and rectum
  • Colon expands - accumulation of stool with distention
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10
Q

Hirschsprung Disease manifestations?

A

Delayed meconium passing, bilious vomiting, large stools (older children)

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11
Q

How is Hirschsprung Disease diagnosed?

A
  • X-ray
  • barium enema
  • Confirm diagnosis with rectal biopsy
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12
Q

GER (Gastroesophageal Reflux) manifestations?

A

Regurgitation of gastric contents into the esophagus

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13
Q

GERD (Gastroesphageal Reflux Disease) manifestations?

A

Tissue damage to esophagus

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14
Q

What concerns are there regarding GERD?

A

Concern when Failure to Thrive (FTT) – decreased growth (height/weight) or dysphagia develop

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15
Q

How is GER/GERD managed?

A
  1. Feeding alterations in infant
    • Thickening feedings (rice)
    • Upright positioning
    • Frequent burping during feeds
  2. Pharmacologic : H2 receptor antagonists (Cimetidine, Pepcid)-reduce gastric hydrochloric acid secretion.
  3. Surgical intervention—Nissen fundoplication
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16
Q

Acute Appendicitis manifestations?

A
  • 1st - intermittent periumbilical crampy pain
  • 2nd - Moves to McBurney’s point (RLQ)
  • Fever, decreased appetite, nausea, vomiting, diarrhea
  • Suspect appendix has ruptured if patient has a sudden relief of pain
17
Q

How is Acute Appendicitis diagnosed?

A
  • Ultrasound
  • CT Scan
18
Q

How do you treat a child with a non-ruptured appendix?

A

Non-Ruptured - laparoscopy surgery, IV antibiotics, can go home same day

19
Q

How do you treat a child with a ruptured appendix?

A

Can result in peritonitis – open abdominal surgery - substantial IV antibiotics, longer hospitalization

20
Q

Crohn’s Disease manifestations?

A
  • Chronic gastrointestinal inflammation of any part of the GI tract (Mouth to the anus).
  • Skip lesions - regions of inflammation separated by healthy bowel
  • RLQ Pain
  • Abdominal pain and distention
  • Bloody stools
  • Diarrhea
21
Q

Ulcerative Colitis manifestations?

A
  • Diffuse inflammation of rectal and colon mucosa
  • LLQ pain
  • Abdominal pain and distention
  • Bloody stools
  • Diarrhea
22
Q

What symptoms do Crohn’s Disease and Ulcerative Colitis share?

A
  • Abdominal pain
  • Bloody stools
  • Diarrhea
  • Weight loss
  • Fatigue
23
Q

Crohn’s Disease and Ulcerative Colitis complications?

A
  • Anemia - bloody stools
  • Fluid and electrolyte imbalance due to diarrhea
  • Weight loss and growth failure due to malabsorption of nutrients
  • Immunosuppression due to meds
  • Impact on quality of life due to frequent hospitalization
24
Q

How is Crohn’s Disease and Ulcerative Colitis treated?

A
  • Medication
    • Corticosteroids-reduce inflammation
    • Immunomodulators (suppress the immune systems abnormal response)
    • Anti-diarrheal medication
    • Probiotics
  • Pain management
  • Nutritional supplements
25
Q

Describe the pathophysiology of Cleft Lip and Palate.

A
  • Malformation occurring during fetal development
    • Cleft lip results from incomplete fusion of the oral cavity
    • Cleft palate results from incomplete fusion of the palate
  • Combination of environment and genetic factors: Smoking, alcohol, use anticonvulsants, steroids, during pregnancy
26
Q

Cleft Lip and Palate complications?

A
  • speech
  • feeding
  • dental problems
27
Q

How is Cleft Lip and Palate managed?

A
  • Special Needs Feeder (Haberman)
  • Surgical repair at 3 months
28
Q

Describe post-operative care for Cleft Lip and Palate.

A
  • Manage pain
  • Avoid pacifiers, spoons, sippy cups, and other sucking toys
  • Elbow/arm restrains to arms
29
Q

Describe the pathophysiology of Hypertrophic Pyloric Stenosis (HPS).

A
  • Constriction of the pyloric sphincter with obstruction of gastric outlet
  • Not present at birth but develops in the first few weeks of birth
30
Q

Hypertrophic Pyloric Stenosis (HPS) manifestations?

A
  • Nonbilious projectile vomiting (30 minutes to an hour after eating)
  • Infant is “always hungry”
  • Dehydration may occur
  • Metabolic alkalosis
  • Olive-like pyloric mass may be palpated in the upper abdomen
31
Q

How is Hypertrophic Pyloric Stenosis (HPS) treated?

A

Pyloromyotomy

32
Q

Describe the pathophysiology of Intussusception.

A
  • Telescoping of one portion of intestine into another (Intestine then folds into itself)
  • Etiology unknown
  • Usually involves the small bowel
33
Q

Intussusception manifestations?

A
  • Abdominal pain: intermittent episodes of pain-infant draws knees to chest, excessive irritability and crying. In between these episodes, infant appears comfortable.
  • Vomiting
  • Palpable abdominal “sausage like” mass RLQ
  • Currant jelly–like stools (mixture of blood and mucus)
  • Decreased appetite
34
Q

How is Intussusception diagnosed?

A
  • Clinical Symptoms
  • Ultrasound
35
Q

How is Intussusception managed?

A
  • Air enema with or without contrast radiologically- The air may help move the intestine back into its normal position.
  • Saline enema
  • Surgery to reduce or remove segment
36
Q

Describe the etiology of Short Bowel Syndrome (SBS).

A
  • A malabsorptive disorder
  • Portions of the bowel damaged or missing
  • Usually as result of small bowel resection often related to necrotizing enterocolitis (NEC) in premature infant.
37
Q

Short Bowel Syndrome (SBS) nursing considerations?

A
  • Nutritional support (e.g., TPN, enteral feeding)
  • Monitor for complications associated with central lines (infection) and TPN administration (liver failure)

328 Pediatrics Exam 2 (7 decks)

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