GI Disorders Flashcards
Mouth, esophagus, stomach
Responsible for nutrient intake and ingestion
Upper GI tract
Small & large intestines
Handles remainder of digestion, absorption, and metabolism
Elimination
Lower GI tract
Built-in safeguard to prevent choking while sucking and swallowing
Quicker gastric emptying time
Liver and pancreas not fully mature until 6 months of age
Pancreatic lipase not adequately secreted until 1 year – problem with digesting fats until then
Infants
Reduced caloric needs from infancy
Sporadic appetites
Toddlers
Appetite fluctuations continue
GI tract mature
Preschool
Most common type of hernia in children
5x more likely in males
Inguinal Hernia
Signs & symptoms
Swelling/bulging in inguinal area
May be worse with straining
Inguinal Hernia
Nursing Care for Inguinal Hernia
Surgery (ante operative care)
Most common type of hernia in infants
Umbilical Hernia
Signs & Symptoms
Swelling on umbilical area
Reducible
Umbilical Hernia
Nursing Care for Umbilical Hernia
Most resolve spontaneously by 3-5 yrs of age
Surgery – if persist past age 5y
Caused by abnormal or arrested development
Range from simple to complex
S/S
Generally apparent at birth
Anorectal Malformations
Nursing Care for anorectal malformations
Depends on the extent of the malformation
Structural GI disorders
Inguinal Hernia
Umbilical Hernia
Anorectal Malformations
Cause unknown Males > females Signs & Symptoms: Projectile vomiting Olive-shaped mass in abdomen
Hypertrophic Pyloric Stenosis
Diagnosis for Hypertrophic Pyloric Stenosis
Upper GI, Ultrasound
Nursing Care for Hypertrophic Pyloric Stenosis
Post surgical, Education for parents
Intestine telescopes into itself
Males > females
Intussesception
S&S of Intussesception
Currant jelly stools
Acute onset abdominal pain
Sausage-shaped mass in RUQ
Diagnosis of Intussesception
Abdominal US
Barium/air enema
Nursing Care for Intussesception
Post surgical
Education and reassurance to parents
Signs & Symptoms
Most common during first month of life: intermittent bilious vomit, abdominal distention, recurrent pain, palpable epigastric mass, dehydration & lethargy
Malrotation & Volvulus
Diagnosis of Malrotation & Volvulus
Barium enema or Upper GI
Will show corkscrew, coiled, or bird’s beak appearance
Complications of Malrotation & Volvulus
Intestinal necrosis, peritonitis, perforation, short bowel, death
Nursing Care of Malrotation & Volvulus
Surgical
Obstructive GI Disorders
Hypertrophic Pyloric Stenosis
Intussesception
Malrotation & Volvulus
Most common in school-age/adolescence
Cause is motor, autonomic, psychological
Irritable Bowel Syndrome
S/S
Abd pain, gas, bloating, constipation, diarrhea
Irritable Bowel Syndrome
Diagnosis of Irritable Bowel Syndrome
based on H/P
Nursing Care for Irritable Bowel Syndrome
Dietary, Stress reduction, Education
Chronic inflammatory disease with periods of exacerbations and remissions. “Skip lesions” in the bowel
Crohn’s Disease
S&S of Crohn’s Disease
Abdominal pain
Diarrhea
Anorexia/weight loss
Nursing Care for Crohn’s Disease
Corticosteriods
Flagyl
Surgery
Emotional support
Acute or chronic inflammation of a continuous segment of the colon
Ulcerative Colitis
S&S of Ulcerative Colitis
Recurrent bloody diarrhea
Urgency
Tenesmus (painful spasms)
Systemic Symptoms
Nursing Care for Ulcerative Colitis
Immunomodulatory agents
Steroids
Nutrition
Surgical
Inflammation of the appendix
Appendicitis
What percent of appendix’s with appendicitis will perforate within 48hours
80%
S&S of Appendicitis
Periumbilical pain followed by RLQ pain
Vomiting, anorexia, fever
Nursing Care for Appendicitis
Surgical
Antibiotics if perforation
Infection of umbilical stump
Omphalitis
S&S of Omphalitis
Redness and edema of soft tissue around umbilical stump
Nursing Care for Omphalitis
Parental education
IV antibiotics
Inflammatory GI Disorders
IBS Crohn's Ulcerative Colitis Appendicitis Omphalitis
What is the cause of Infantile Colic?
unknown
S&S of Infantile Colic:
Persistent, unexplained crying or fussing in infants younger than 3 MONTHS
Crying episodes last 3 hours per DAY, >3 days per WEEK, and >3 WEEKS
Infant pulls both legs and arms to a FLEXED position
Nursing Care for Infantile Colic requires Education on what topics?
Education Over or underfeeding Inadequate burping Maternal anxiety Cigarette smoke
Excessive loss of fluids and electrolytes in the stools
Acute Diarrhea
Causes of Acute Diarrhea
Infection
Diet
Medications
Toxins
4Types of Acute Diarrhea
Osmotic
Secretory
Motility disorders
Inflammatory Disorders
Nursing Care for Acute Diarrhea
Most Cases are Self-limiting
Oral rehydration
IV rehydration
1 or more liquid to semiliquid stools passed per day for 14 days or longer
Usually associated with a chronic disease
Chronic Diarrhea
Common Cause of Shaken Baby Syndrome
Infantile Colic
Diagnosis of Chronic Diarrhea
Stool cultures, O/P, Occult blood, fats
Nursing Care for Chronic Diarrhea
Treat underlying cause
Similar to treatment of acute diarrhea
Difficult or infrequent passage of hard stool
Constipation
Hard, palpable stool on abdomen
Poor appetite, straining with stools
Constipation
Nursing Care for Constipation
Bowel retraining
Education
Nutrition
Stool incontinence beyond age 4y
Encopresis
Involuntary Encopresis
with constipation
Voluntary Encopresis
without constipation
S&S of Encopresis
Stained underwear, constipation symptoms, anorexia, abdominal pain
Nursing Care for Encopresis
Bowel retraining
Education
Nutrition
What percent of infants <2months of age have symptoms?
50%
S&S of GERD
Vomiting & Regurgitation
Fussiness
Refusal to eat
Choking, Coughing, Wheezing, Apnea
Diagnosis of GERD
H/P
pH study or swallow study
When do most cases of GERD improve/resolve?
by 9months of age
Nursing Care for GERD
Elevate HOB
Nissen fundoplication - worst cases
Congenital absence of Meissner’s and Auerbach’s autonomic plexus in the bowel wall
Hirschsprung Disease
S&S of Hirschsprung Disease
Failure to pass meconium within the first 48 hours of life, failure to thrive, poor feeding, enterocolitis
Nursing Care for Hirschsprung Disease
Surgical resection
May or may not have a colostomy
Neorectum
Functional GI Conditions
Infantile Colic Acute Diarrhea Chronic Diarrhea Constipation Encopresis GERD Hirschsprung Disease
Inability to digest milk and dairy – deficient in lactase
Lactose Intolerance
S/S Lactose Intolerance
Bloating, Cramping, Diarrhea, Vomiting
Diagnosis of Lactose Intolerance
H/P, Dietary Elimination Trial
Nursing Care for Lactose Intolerance
Nutrition, Education
Gluten-induced enteropathy and gluten-sensitive enteropathy causing damage to small bowel mucosa
Celiac Disease
S&S of Celiac Disease
Weight loss
anorexia
Listlessness
Diarrhea
Nursing Care for Celiac Disease
Gluten-free diet, Support
Usually caused by surgical resection of small bowel
Signs & Symptoms:
Malnutrition & diarrhea
Steatorrhea & carbohydrate malabsorption result in diarrhea and FTT
Short Bowel Syndrome
Nursing Care for Short Bowel Syndrome
Maintain adequate nutrition & prevent complications Tube feedings (NG & GT) Total parenteral nutrition (TPN) via central line
Malabsorption GI Disorders
Lactose Intolerance
Celiac Disease
Short Bowel Syndrome
Idiopathic – causes intra and extrahepatic bile duct fibrosis and obstruction
Biliary Atresia
S&S of Biliary Atresia
Jaundice
Dark Urine
Light Stools
Nursing Care for Biliary Atresia
Kasai procedure
Nutrition support
TPN/LIPIDS
Occurs secondary to many liver and inflammatory conditions
Cirrhosis
S&S of Cirrhosis
Jaundice
FTT
Anorexia
Fatigue
Nursing Care for Cirrhosis
Prevent Complications
Liver transplant
Hepatic Disorders
Biliary Atresia
Cirrhosis
type of diarrhea that occurs when too much water is drawn into the bowels
Osmotic Diarrhea
an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage
Secretory Diarrhea
