GI Disorders Flashcards

1
Q

What does vitamin A deficiency cause?

A

Diarrhea, dehydration, blindness.

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2
Q

What are some sources of vitamin A?

A

Carrots, liver, eggs, cabbage, artichokes

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3
Q

What can vitamin D deficiency cause?

A

Rickets- mostly in 3rd world countries.

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4
Q

What are some sources of vitamin D?

A

Sun

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5
Q

What is Kwashiorkor?

A

Associated with protein, mineral, vitamin A deficiency; “Older child sickness”, thin extremities, ascities, blindness, diarrhea, circulatory failure.

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6
Q

What is Maramus?

A

Protein and caolorie malnutrition; atrophy of subQ fat, wrinkly, edema

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7
Q

What is treatment of Maramus?

A

Replace fluids, nutritional supplements, anti diarrhea and antibiotics

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8
Q

What are some general symptoms of GI dysfunction?

A

Failure to thrive, spitting up, N/V, diarrhea, jaundice, fever, weight gain from fluid.

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9
Q

What is encopresis?

A

overflow of feces; staining on pants.

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10
Q

What is hematemesis?

A

Bright red blood in vomit or spit up; Acute

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11
Q

What is coffee ground emesis?

A

Old blood in emesis and throw up; sign of upper GI bleeding; chronic.

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12
Q

What is hematochezia?

A

Bright red blood in stools; acute

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13
Q

What is melena?

A

Black tarry stool; upper GI bleed. Slow/chronic.

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14
Q

What is dehydration?

A

When fluid output exceeds intake.

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15
Q

What does isotonic dehydration mean?

A

Even dehydration and Na is normal.

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16
Q

What is hypotonic dehydration?

A

When the cells increase; use bolus; hyponatremic.

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17
Q

What is hypertonic dehydration?

A

Dangerous; hypernatremic, causes cerebral complications; give back slowly.

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18
Q

What percent of water is in a full term infant?

A

75-80%

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19
Q

What degree of water loss is life threatening?

A

15%

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20
Q

What are classic symptoms of dehydration?

A

Change in LOC, Increase HR, temp, Decrease skin turgor, sunken eyes and fontanels, irritable.

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21
Q

What are the goals of treatment for dehydration?

A

Rehydrate, maintain fluid therapy, and reintroduce normal diet.

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22
Q

What is the treatment for rehydration?

A

40-50 ml/kg of fluid per 4 hours, do not exceed 150ml/kg/day, no caffeine or soup or bland diet.

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23
Q

What is diarrhea?

A

Abnormal transport of intestinal water and electrolytes.

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24
Q

What are the types of diarrhea?

A

Acute or chronic, or acute infectious.

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25
Q

What is the treatment of diarrhea?

A

Strict I&O, IV replacement for electrolytes, salt, antiinfectives, antiparasitic, daily weights.

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26
Q

What is occurring with diarrhea metabolically?

A

Metabolic acidosis because it is depleting alkaline.

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27
Q

What are allergies? (r/t GI problems)

A

Severe reactions with the GI system

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28
Q

What are some common allergies that effect the GI system?

A

Cows milk, eggs, legumes, peanuts, shellfish, wheat, chocolate, fruit.

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29
Q

What is GERD?

A

Transfer of gastric contents into the esophagus

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30
Q

What is the cause of GERD?

A

Lower esophageal sphincter dysfunction with a delay of gastric emptying- food backs up.

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31
Q

What is the treatment of GERD?

A

Meds- Reglan, Proton pump inhibitors, or surgery

32
Q

What are signs and symptoms of GERD?

A

Regurgitation, vomitting, weight loss, dysphagia, nocturnal asthma

33
Q

What is Hirschsprung disease?

A

Congenital Aganglionic megacolon- a decrease in nerve intervention to bowel causing decrease mobility and mechanical obstruction.

34
Q

What are the symptoms of Hirschsprung disease?

A

No stool, especially at birth, megacolon (protruding), obstruction, ischemic bowel, entercolitis.

35
Q

How does entercolitis lead to death?

A

The bowel is inflamed, then perforates, then causes shock and death.

36
Q

What are symptoms of Hirschsprung disease in infants?

A

No meconium, bilious vomitting, abdominal distention, explosive stools.

37
Q

What are symptoms of Hirschsprung disease in older children?

A

Constipation, ribbon like stool, foul smell, abdominal distention, palpable fecal mass

38
Q

What is the diagnosis of Hirschsprung disease?

A

Assessment of s/s and bowel function, small caliber emptying of rectum, x-ray to confirm.

39
Q

What is the treatment of Hirschsprung disease?

A

Pull through, colostomy, ileostomy, replace fluids, enemas, low fiber/high calorie and protein diet.

40
Q

What is the nursing care of clients with Hirschsprung disease?

A

Educate parents, post op care, colostomy care, nutritional education, home health care.

41
Q

What is an acute inflammatory disease of the bowel?

A

Acute Appendicitis- inflammation of the appendix; danger of perforation.

42
Q

What are the symptoms of acute appendicitis?

A

Right lower quadrant pain (might start at belly button), fever, rigid abdomen, vomitting or diarrhea OR constipation, anorexia, tachy, pallor

43
Q

What is the diagnosis of acute appendicitis?

A

Assess McBurney point, CT, ultrasound, increase in WBCs and Bands, increase in C reactive protin

44
Q

What is the McBurney Point?

A

Between the iliac creast and umbilicus there is rebound pain when palpated.

45
Q

What is the treatment of acute appendicitis?

A

Appendectomy- can be lap or open (usually open when bowel effected)

46
Q

What is a complication of appendicitis?

A

Rupture and peritonitis

47
Q

What are the inflammatory bowel diseases?

A

Ulcerative colitis and Crohn’s

48
Q

What is ulcerative colitis?

A

Inflammation limited to colon and rectum; can be mild/mod/severe

49
Q

What are symptoms of UC?

A

Diarrhea, rectal bleeding, abdominal pain, colicky

50
Q

What is Crohn’s disease?

A

Chronic inflammation involving any part of the GI tract from mouth to anus- most often terminal ileum & layers of bowel wall. Occurs in discontinuous fashion. (Skip lesions)

51
Q

What are symptoms of Crohn’s disease?

A

Abdominal pain, diarrhea, decrease in appetite, weight loss, growth delay and development.

52
Q

What is the diagnosis of UC and Crohns?

A

Patient history, PE, lab studies, CT, ultrasound.

53
Q

What are the goals of treatment for inflammatory bowel diseases?

A

To control inflammatory process, obtain long term remission, promote normal growth

54
Q

What is the treatment for inflammatory bowel diseases?

A

Individualied, managed according to type, severity, location, and response to therapy.

55
Q

What are structural defects?

A

Cleft lip and palate.

56
Q

What is cleft lip and palate?

A

Malformation during embryonic stage 7/8th week

57
Q

What is a cleft lip?

A

failure of maxillary and median nasal process to fuse.

58
Q

What is a cleft palate?

A

Midline fissure of palate from failure of both sides to fuse.

59
Q

What is the cause of structural defects?

A

Teratogen exposure prenatally (alcohol), associated with other syndromes, genetic

60
Q

How are structural defects diagnosed?

A

Ultrasound

61
Q

What is the treatment for structural defects?

A

Cleft lip=early surgery, cleft palate=later surgery

62
Q

What are some nursing care techniques for children with structural defects?

A

Parent support, long term care,follow up, assist with feeding, post of care, analgesic, antibiotic ointment

63
Q

What are some obstructive disorders?

A

Hypertrophic pyloric stenosis and intussusception.

64
Q

What is hypertrophic pyloric stenosis?

A

Circular muscle of pylorus thickens and causes an increase in mass, narrowing pyloric canal. (where the stomach and duodenum meet) (narrows at sphinctor, liquid accumulates)

65
Q

What are clinical manifestations of hypertrophic pyloric stenosis?

A

Projectile vomitting, weight loss, distended abdomen, palpated olive shaped tumor, visible peristaltic waves

66
Q

What is the treatment of hypertrophic pyloric stenosis?

A

Surgical- pyloromyotomy, small frequent feedings.

67
Q

What is Intussusception?

A

An obstruction before 3 years, promiximal segment of bowel telescopes into the distal segment pulling the mesentary with it, leading to obstruction. Causes decreased blood flow, increase muscous and bleeding

68
Q

What is a common site of intussusception?

A

Ileocecal valve

69
Q

What are symptoms of intussusception?

A

Severe colicky pain, abdominal pain, vomit, jelly stools, diarrhea

70
Q

How is intussusception diagnosed?

A

Barium enema, x ray, rectal exam

71
Q

What is the treatment for intusception?

A

Usually barium enema helps, surgical

72
Q

What is an Omphalocele?

A

A covered defect of umbilical ring where organs herniate- thin peritoneal sac covers it. Can rupture

73
Q

What is an open omphalocele?

A

Gastroschiasis- bowel herniates through defect in abdominal wall. Cover with moist gauze and surgery

74
Q

What is short bowel syndrome?

A

Decreased mucosal surface resulting from extensive resection of small intestine; from anomalies, ischemia, trauma

75
Q

What is the therapeutic goal of congenital abnormalities of the GI system?

A

Preserve bowel, maintain nutrition, stimulate feedings, minimize complications.

76
Q

What is the care and management of patients with congenital bowel abnormalities?

A

Parental and caretaker support, educate, NGT, Long term treatment of vitamins and TPN

77
Q

What is celiac disease?

A

Gluten sensitivity to “BROW”