GI Function

Question 1

Pediatric differences

Answer 1

• smaller stomachs
• relaxed lower esophageal sphincter
• less digestive enzymes ( until 4-6 years old )
• immature liver function
• 18 months: aware of rectum ( start potty train )
• Age 2 digestive process complete

Question 2

What is cleft lip + cleft palate

Answer 2

failure of maxillary process to fuse w/ frontal prominence ( occurs during first trimester )

Question 3

S/Sx of cleft lip + cleft palate

Answer 3

• poor speech
• poor feeding
• prone to ear infections

Question 4

Dx and Tx of cleft lip + cleft palate

Answer 4

DX: Ultrasound
TX: surgical repair

Question 5

Nursing interventions for cleft lip + cleft palate

Answer 5

For surgery:
- elbow restraints for 2 weeks
- pain control, supine position
- no pacifiers, utensils, straws- use dropper or special feeder
- incision care: rinse w/ water after each feeding

Question 6

What is GER

Answer 6

acid reflux, the lower esophageal sphincter is relaxed ( gastric contents goes into esophagus

Question 7

S/Sx and Cause of GER

Answer 7

• happy spitter, not irritable
• frequent spit ups
• able to gain weight
  Cause: over feeding

Question 8

Tx for GER

Answer 8

• thicken formula with rice cereal
• smaller frequent feedings
• formula change
• keep upright for 20-30 mins
• DONT PLACE IN CARSEAT AFTER FEEDINGS

Question 9

S/Sx of GERD

Answer 9

• poor weight gain
• irritable: arching back during feeds
• refusal of feedings
• aspiration symptoms

Question 10

TX of GERD

Answer 10

• H2 receptor antagonist ( FAMOTIDINE )
• proton pump inhibitors ( LANSOPRAZOLE, OMEPRAZOLE )
• surgery: Nissen fundoplication ( wraps stomach around lower esophagus )

Question 11

What is pyloric stenosis

Answer 11

hypertonic obstruction of the muscle between the stomach and sm. intestine

Question 12

S/Sx of pyloric stenosis

Answer 12

• olive shaped mass in RUQ
• projectile vomiting
• metabolic alkalosis ( not enough acid in the body )

Question 13

Dx and Tx of pyloric stenosis

Answer 13

Dx: ultrasound
Tx: surgery = pyloromyotomy ( slice the muscle open )

Question 14

nursing intervention of pyloric stenosis of surgery

Answer 14

• NPO preop
• post op care

Question 15

What is intussusception

Answer 15

telescoping intestine - walls of intestine rubs together

Question 16

S/Sx of intussusception

Answer 16

• pain + crying w/ periods of calm
• billious vomit
• currants jelly stools ( later sign )

Question 17

Dx and Tx of intussusception

Answer 17

Dx: ultrasound
Tx: air enema or surgical repair

Question 18

What is Hirschsprung Disease

Answer 18

congenital aganglionic mega-colon ( prevents peristalsis )

Question 19

newborn s/sx of Hirschsprung Disease

Answer 19

• no meconium passed by 48 hrs
• abd. distention
• billious vomit
• explosive diarrhea

Question 20

children s/sx of Hirschsprung Disease

Answer 20

• failure to gain weight
• chronic constipation
• fecal impaction
• ribbon like stool

Question 21

Tx of Hirschsprung Disease

Answer 21

surgery to remove the affected part of the colon –> colostomy

Question 22

What is appendicitis

Answer 22

inflammation of the appendix
-** most common cause of emergency surgery in children **

Question 23

S/Sx of appendicitis

Answer 23

• RLQ pain ( periumbilical pain )
• nausea/ fever/ guarding/ tenderness
• anorexia

Question 24

Dx and Tx of appendicitis

Answer 24

DX: jump test ( if they jump and have a lot of pain = appendicitis ), elevated WBC and c-reactive protein, ultrasound, CT

TX: surgical removal

Question 25

Nursing intervention of appendicitis

Answer 25

** SUDDEN RELIEF OF PAIN = APPENDIX RUPTURE**

Question 26

what is chrons disease

Answer 26

chronic inflammation process, fistula

Question 27

S/Sx of chrons disease

Answer 27

- abd. distention - pain, diarrhea, fever - growth failure, malaise

Question 28

Dx and Tx of chrons disease

Answer 28

Dx: upper/lower GI series, lab work, biopsy Tx: nutrition monitoring, surgery, aminosalicylates, steroids, immunosuppresants, MAB

Question 29

What is gatroenteritis

Answer 29

inflammation of the stomach and intestines

Question 30

Cause, S/sx, Tx of gastroenteritis

Answer 30

cause: rotavirus ( most common ), was hands, vaccinate S/Sx: vomiting, diarrhea, dehydration Tx: PO challenge, odansterone, rehydration, determine cause and tx if possible

Question 31

what is hyperbilirubinemia

Answer 31

increased RBC destruction + immature liver = jaundice ( the baby need to poop it out )

Question 32

physiologic jaundice

Answer 32

all kids get it, it happens at 24 hours old

Question 33

pathologic jaundice

Answer 33

occurs before 24 hours old, ABO or RH incompatibility

Question 34

Dx and Tx of hyperbilirubinemia

Answer 34

Dx: blood work, total serum bili (TSB), color Tx: phototherapy- breaks down billi, helps baby excrete it

Question 35

Nursing interventions with hyperbilirubinemia

Answer 35

- monitors babys weight, I/O, feeding - Kernicterus: if left untreated billi builds up in CNS = non reversible mental delays