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Peds Exam 2 > GI Dysfunction > Flashcards

GI Dysfunction Flashcards

1
Q

Dehydration

A
  • Incrd risk for dehydration due to high % of water in body
  • Kidneys don’t reutake water like adults
  • Causes
    > diarrhea, N/V
    > dcrd intake
    > sweating w/ fevers
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2
Q

Dehydration - CMs

A
  • No forming tears
  • Wt loss
  • Incrd respirations
  • Incrd pulses
  • Dcrd BP
  • Limited urine output
  • Dcrd skin turgor
  • Sunken eyes
  • Sunken fontanels
    want to correct before it causes shock
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3
Q

Correcting Fluid Imbalance

A
  • IV hydration
    > not 1st option
  • Oral rehydration solution
    > pedialyte; electrolyes, low sugar
    > give small amnt
    > popsicles
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4
Q

Cleft Lip & Palate

A
  • Facial malformations tht occur during embryonic development
  • Bones & tissue fail to fuse completely at midline
    > 1st trimester
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5
Q

Cleft Lip & Palate - Risk Factors

A
  • Syndromes
  • Genetics
  • Mom has dcr in folic acid during pregnancy
  • Alcohol
  • Smoking
  • Anticonvulsants, steroids, retinols
    > incr change
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6
Q

Interprofessional Management

A
  • Can have cleft lip & palate at same time
    > can have one or the other
  • Cleft lip easier to treat
    > don’t usually need more than 1 surgery
  • Cleft palate more difficult
    > can be a couple of surgeries, around 12-18 months
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7
Q

Cleft Lip & Palate - Nursing Interventions

A
  • Feeding
    > difficulty suctioning
    > want longer nipple, Haberman
  • Pre & post op care
  • Long-term care
    > monitor palate as they grow
  • At higher risk for ear infections
    > tubes may be placed during correction surgeries
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8
Q

Esophageal Atresia & Tracheoesophageal Fistual (TEF)

A
  • Esophageal Atresia: Failure of esophagus to develop as a continuous passage
    > esophagus doesn’t attach to stomach or anything, or attaches to trachea
  • TEF: Failure of trachea to separate into a distinct structure
  • Seen on ultrasound
  • **Fluid going to lungs or straight back out
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9
Q

Esophageal Atresia & Tracheoesophageal Fistual (TEF) - Manifs

A
  • Coughing
  • Choking
  • Cyanosis
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10
Q

Esophageal Atresia & Tracheoesophageal Fistual (TEF) - Nursing Interventions

A
  • Have continuous suction set up
  • Prepared for surgery
    > pretty quickly after birth
    > goal: reattach esophagus to stomach & separate from trachea
  • Maintain airway
  • Feedings through IV
    > NOT NG until after surgery
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11
Q

Pyloric Stenosis

A
  • Constiction of pyloric sphincter w/ obstruction of gastric outlet
    > result of the thickening of pyloric sphincter which leads to obstruction
  • Not always present at delivery, happens w/in 1st few wks
  • Not usually seen on ultrasound before brith
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12
Q

Pyloric Stenosis - Manifs

A
  • Vomit after feedings
    > projectile; entire feeding
  • Act very hungry
  • Dehydration
  • Failure to thrive
  • Peristaltic waves
    > left to right
  • Oval shaped mass
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13
Q

Pyloric Stenosis - Treatment

A

Surgery

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14
Q

Pyloric Stenosis - Nursing Interventions

A
  • Gain IV access to correct hydration
  • Postop, kids usually progress great
    > usually no long term effects
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15
Q

Hirschsprung’s

A
  • AKA “congenital aganglionic megacolon”
    > congenital anomaly
    > usually seen after they are born
  • Mechanical obstruction from inadequate motility (peristalsis) of intestine
    > absence of ganglion cells in colon
    > leads to a blockage above area
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16
Q

Hirschsprung’s - CMs

A
  • Red Flag: newborn hasn’t pooped or delayed passage of meconium
    > severe case
  • Not formed stool
  • Chronic constipation since birth
  • Poor wt gain
    > failure to thrive
  • Abdominal pain & distention
17
Q

Hirschsprung’s - Treatment

A
  • X-ray for diagnosis
  • Biopsy for confirmation
    > shows absence of ganglionic cells
  • Clear obstruction
  • Remove section of colon tht does not have ganglion cells
  • Long term usually no issues
    > maybe digestive issues & continence
18
Q

Appendicitis

A
  • Inflamation of ther veriform appendix
    > inflammation and obstruction of the blind sac at the end of the cecum
  • Most common major surgical disease in the school age
    > peaks at 10-12yrs
  • No known function
  • Lumen becomes obstructured (fecal matter, calcium buildup, tumors, trauma, infection)
    > inflammation can lead to infection, necrosis, perforation
  • Infected contents spill into abdominal cavity if ruptures
    > causes peritonitis
19
Q

Appendicitis - CMs

A
  • Mid abdomen cramps
  • Abdominal tenderness
  • Localizes into RLQ
    > McBurney point
  • Gaurding
  • Rebound tenderness
  • N/V
  • Low grade fever
  • Lethargy, irritability, constipation, diarrhea
  • Normal bowel sounds
  • Pain w/ deep breathing
20
Q

Appendicitis - Nursing Interventions

A
  • Worried abt ruptured appendix
    > peritonitis
  • Suddenly no pain
    > red flag, appendix bursts
  • CT scan for diagnosis
    > shows inflammation
  • Parents present when waking up from surgery
  • IV & NG after surgery
  • Right-side lying position w/ knees bent
  • IV fluids
    > NPO until bowel sounds/flatus
  • Prevent infection
  • Manage wound
  • Antibiotics & pain meds
21
Q

Appendicitis - Treatment

A

Surgery
laparoscopic if hasn’t bursts yet
usually emergent

Peds Exam 2 (23 decks)

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