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Module 5 > GI Dysfunction of the Child > Flashcards

GI Dysfunction of the Child Flashcards

1
Q

deficit of lyses AND water

A

isotonic dehydration

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2
Q

deficit of lytes with more water

A

hypotonic dehydration

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3
Q

deficit of water with more lytes

A

hypertonic dehydration

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4
Q

what is the most important determinant of fluid loss in children

A

weight

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5
Q

what is usually the earliest sign of dehydration

A

tachycardia

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6
Q

what is a late sign of dehydration

A

LOW BP- when this happens we arent getting blood to our tissues causing tissue hypoxia

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7
Q

in the tx of dehydration what should NEVER be done

A

give rapid bolus to hypertonic dehydration because it could lead to cerebral edema

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8
Q

this is given to provide AT LEAST minimum fluid requirements

A

enteral (PO) rehydration- for mild to mod dehydration.

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9
Q

when child is unable to digest lytes to meet daily physiological needs, replace previous deficit needs with

A

parenteral (IV) rehydration- severe dehydration and child is unable to keep enough fluids and lytes down

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10
Q

acute diarrhea=

A

less than 14 days and self limiting;

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11
Q

chronic diarrhea=

A

more than 14 days

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12
Q

protozoa that is ingested and eventually excreted in stool, transmitted person to person, improper prepared food
contaminated water and animals

A

giardiasis

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13
Q

s/s of giardiasis=

A

abd cramping, mal odorous floating stool, diarrhea and vomiting

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14
Q

who is giardiasis confirmed and treated

A

stool sample

metrinozole or tinidazole

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15
Q

transmitted- fecal oral mouth or by object, shed through poop and by contaminated hands/food/water

A

rotavirus

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16
Q

when a person is infected with rotavirus does this mean immunity

A

NO! reinfection can occur at any age but subsequent infections are usually less severe

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17
Q

what should you NOT give to a person with rotavirus

A

antidiarrheal because this is how it gets out

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18
Q

a decrease in bowel movement frequency or trouble defecating for more than 2 weeks

A

constipation

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19
Q

congenital anomaly results in mechanical obstruction of part of the intestines from inadequate motility of part of the intestines, this is a result of absence of ganglion cells

A

hirschsprung disease

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20
Q

what are ganglion cells=

A

nerve cells in intestines that help coordinate peristalsis

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21
Q

confirmation of hirschsprung disease is only made by

A

rectal biopsy demonstrating the absence of ganglion cells

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22
Q

what is important NOT to do post op of hirschsprung

A

nothing given per rectum

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23
Q

what are CM of hirschsprung

A 
failure to pass meconium within 48 hrs
abd distention
vomiting
constipation, diarrhea and/or ribbon-like, foul smelling stool
easily palpable stool mass
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24
Q

the transfer of gastric contents into the esophagus

A

gastroesophageal reflux

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25
Q

what is the gold standard for dx GER

A

24hr intraesophageal monitoring

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26
Q

lining is replaced with tissue that is similar tot the intestinal lining but this puts the pt at risk for esophageal carcinoma

A

barrett’s esophagus

27
Q

what are tx for GER

A

thicken milk with teaspoon of rice cereal, feed in small frequent intervals if breast feeding
have them sit up for 30 minutes-1hr after feeding

28
Q

what are the 3 medication for GER

A

H2 antagonists
Proton Pump Inhibitors
Pro kinetic Agents

29
Q

what surgical treatment is done for GER

A

nissen fundoplication= funds of stomach is placed behind the esophagus, this helps strengthen the lower esophageal sphincter and help prevent regurgitation of fluids and food

30
Q

infant will have an NGT post op of nissen fundoplication, if it comes out what should you do

A

you as the nurse DO NOT replace NGT because this could disrupt the surgical incision so call the physician

31
Q

inflammation of the vermiform appendix caused from an obstruction of the lumen of the appendix

A

appendicitis (avg age is 10 yrs)

32
Q

CM of appendicitis

A 
abd pain in RIGHT LQ
rigid abd
decreased or absent BS
fever
vomiting
33
Q

when is there a sudden relief of pain in appendicitis

A

after the appendix perforates- then they will be in pain again following by tachycardia chills and fever (becoming septic)

34
Q

what should you never give to the pt who has appendicitis

A

laxatives, enemas or heat!

35
Q

what 2 diseases fall under inflammatory bowel disease

A

ulcerative colitis and crohns disease

36
Q

inflammation limited to colon and rectum

A

ulcerative colitis

37
Q

what is the most dangerous form of severe colitis

A

toxic megacolon

38
Q

what does ulcerative colitis look like inside

A

red and inflamed

39
Q

involves ANY part of the GI tract from mouth to anus (most often affects terminal ileum) involves all layers of the intestinal wall

A

crohns disease

40
Q

what does crohns disease look like inside

A

cobble stoning

41
Q

what is the biggest thing to know for ulcerative colitis

A

rectal bleeding and weightloss

42
Q

what is the biggest thing to know for crohns disease

A

more painful

43
Q

a progressive inflammatory process that results in intrahepatic and extra hepatic bile duct fibrosis, resulting in ductal obstruction

A

biliary atresia= flow of bile from liver to gallbladder is blocked (death within first 2 years of life)

44
Q

CM of biliary atresia

A

jaundice lasting beyond 2 wks of age
putty-white or clay stools (absence of bile)
tea colored urine
itching and irritability (bile salt on skin)
malnutrition

45
Q

what is the red flag of biliary atresia

A

baby 3-4 wks of age bilirubin levels start to creep up

46
Q

how is biliary atresia dx

A

US and percutaneous liver bx
ERCP

*early dx is critical
in first 60 days= 80% chance of bile flow
60-90= 50% chance
>90= 10% chance

47
Q

what is the tx for biliary atresia

A

Kasai procedure= bile drainage but sclerosis will occur so MOST children will need a liver transplant

48
Q

defect in cell migration resulting in failure of the maxillary and premaxillary processes to merge between the 4th and 10th weeks of embryonic development

A

cleft lip and cleft palate

49
Q

what are immediate problems of cleft lip/cleft palate

A

reaction of the parents

feeding

50
Q

for infants with cleft lip/cleft palate begin ______ ASAP, ________ can conform to shape of mouth

A

breastfeeding; breasts

51
Q

if breastfeeding is not possible for children of cleft lip/palate what should be done

A

large soft nipples with soft holes

52
Q

since cleft lip/palate babies get tired easier and at an increase risk for aspirating, what is the ESSR feeding technique

A

enlarge the nipple
stimulate suck reflex
swallow
rest

53
Q

for cleft lip surgical repair what is the “rule of 10s”

A

at least 10wks old
10 pounds
hemoglobin of 10

54
Q

when is cleft palate sx done and if they are not a candidate for it what could they do

A

between 6 and 12 months but preferable before their first words and if they can’t have it done yet then a prosthetic can be made until sx

55
Q

what is important when caring for a post op cleft lip/palate sx

A 
do NOT place anything in mouth 
resume feeding as tolerated
pain control
restraints (oral stage)
reduction of tension on suture line
56
Q

narrowing of the pyloric canal producing outlet obstruction

A

hypertrophic pyloric stenosis

57
Q

what are the CM of hypertrophic pyloric stenosis

A 
olive like mass in upper abd
vomiting after feedings
dehydration
met. alkalosis
growth failure
ultrasound
58
Q

what dx hypertrophic pyloric stenosis and what is the tx

A

H&P
US to confirm
tx is pyloromyotomy= incision through the muscle allows compression of the lumen to be released

59
Q

what is important to know about pre op of a pyloromyotomy

A

keep pt NPO

60
Q

who should feedings be given post op of pyloromyotomy

A

clear liquids with glucose and lytes
small volumes at frequent intervals
progress to formula in increments

61
Q

occurs when one segment of bowel telescopes into another segment

A

intussesception

62
Q

what is a red flag for intussusception

A

mucous causing jelly like stool

63
Q

what are CM of intussusception

A 
palpable mass in RUQ
empty RLQ
vomiting
lethargy
red, currant jelly like stool
tender distended abd
acute, severe, int abd pain

Module 5 (18 decks)

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