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Pediatrics Exam 3 > GI / GU > Flashcards

GI / GU Flashcards

1
Q

Stomach Capacity

KNOW THIS!!!!!

A

Newborn: 20 mL or ping pong ball

30 Day old: 90 mL (3 oz)

1 Year: 360 mL

Adult: 2-3 mL

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2
Q

Cleft Lip or Palate

A

Failure of the maxillary processes to fuse by 6 weeks gestation & failure of the tongue to move down at the correct time prevents the palatine process from fusing

  • unknown cause (smoking, EtOH, folate)
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3
Q

Cleft Lip

KNOW THIS!!!!!

A
  • Noticable at birth
  • unilateral or bilateral can occur alone
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4
Q

Cleft Palate

KNOW THIS!!!!!

A

Hard palate clefts from a continuous opening; may involve hard palate, soft palate, or both

  • Less obvious than cleft lip
  • may not be detectable at birth
  • unilateral or bilateral
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5
Q

Cleft Lip / Palate Tx

KNOW THE TIMING FOR EACH SURGERY!!!!!

A

Surgical repair, dental on board, increased risk of speech delay or hearing impairment

  • Lip: surgery between 3-5 months
  • Palate: before 12 months
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6
Q

Cleft Lip / Palate Post-Op

A
  • Obtain vitals
  • Monitor I&Os
  • Place upright for feedings = aspiration
  • Use special feeder / nipples
  • Cleanse sutures with NS
  • Supine to avoid rubbing face on floor
  • Avoid utensils & straws
  • Elbow immobilizers to prevent touching incision = restraints
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7
Q

GERD (Gastroesophageal Reflux Disease)

KNOW THIS!!!!!

A

Return of gastric contents into the esophagus

1.) lower esophageal relaxations
2.) incompetent lower sphincter
3.) anatomic disruption fo esophagogastric junction

Other Causes: overfeeding, prematurity, small stomach

Nursing Considerations: clear airway (suction), I&Os, nutrition, daily weight, respiratory

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8
Q

Signs & Symptoms of GERD

KNOW THIS!!!!!

A
  • Regurgitation
  • Spitting up
  • Vomiting
  • Frequently hungry
  • Irritable
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9
Q

GERD Treatment

A

Depends on severity

  • medications Ranitidine (zantac), special nipples (slow flow), formula
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10
Q

Pyloric Stenosis

KNOW THIS!!!!!

A

Hypertrophy of pyloric muscle leading to obstruction of pyloric sphincter

  • S/S: felt like an olive in the epigastric region & projectile vomiting

Tx: NPO + surgery

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11
Q

Signs & Symptoms of Pyloric Stenosis

KNOW THIS!!!!!

A

Projectile Vomiting & it feels like an olive in the epigastric region

  • hypochloremia
  • hypokalemia
  • metabolic alkalosis (pH > 7.45)
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12
Q

Pyloric Stenosis Nursing Considerations

A
  • Avoid oral feeds
  • IV rehydration
  • Education
  • I&Os
  • NG tube
  • Daily weights
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13
Q

Omphaloceale

A

Defect herniation of the abdominal contents into the umbilical cord

  • week 11 of gestation
  • sac made of Wartons Jelly
  • 50-70% additional anomaly

Rupture = emergency

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14
Q

Gastroschisis

A

A defect in the abdominal wall lateral, usually right-sided, with protrusion of the intestines

  • no sac around the intestines
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15
Q

Intussusception

A

Abdominal emergency

Telescoping of a segment of the intestine leading to inflammation, edema, & decreased blood flow

  • most common site is ileocecal valve
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16
Q

Intussusception Signs & Symptoms

A
  • Intermittent abdominal pain
  • Currant jelly stools (blood & mucus)
  • Vomiting
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17
Q

Intussusception Tx

A

Air enema, two attempts; then surgery

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18
Q

Hirschsprung Disease

KNOW THIS!!!!! (know the bold)

A

Congenital absence of ganglion cells in the wall of the colon or rectum

  • Causes colon to become a “megacolon”

S/S: Failure to pass meconium in first 48 hours of life, abdominal distention, feeding intolerance, bilious emesis

DX: hx, bowel pattern, barium enema, rectal suction biopsy

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19
Q

Intussusception

KNOW THIS!!!!!

Tutoring Notes

A

Occurs when a portion of the intestine invaginates into another leading to inflammation, edema, & decreased blood flow

Triad of Symptoms: intermittent abdominal pain, currant jelly stools (blood & mucus) & vomiting

20
Q

Enterocolitis

A

Inflammation fo the small & large intestine

  • complication fo Hirschsprung disease

S/S: fever, foul smelling stool, bloody diarrhea

TX: antibiotics

21
Q

Enterocolitis is a complication fo what disease?

KNOW THIS!!!!!

A

Hirschsprung disease

22
Q

What is gastroenteritis?

KNOW THIS!!!!!

A

Inflammation of the stomach & intestines from:

  • e. coli
  • food sensitivty (gluten, dairy)
  • emotional stress
  • medications (iron, abx)
  • colon disease
23
Q

Mild Dehydration

KNOW THE BOLD!!!!!

A

Loss of < 5% of body weight

  • alert, restless
  • BP = normal
  • HR = regular
  • turgor = regular
  • moist membranes
  • normal urine output
  • sligihtly increased thirst
  • normal fontanelles
  • RR = regular
  • normal eyes
  • cap refill < 3 seconds
24
Q

Moderate Dehydration

KNOW THE BOLD!!!!!

A

Loss of 6-9% of body weight

  • lethargic, irritable, alert, restless
  • BP normal or low
  • HR = rapid
  • Turgor = poor
  • Dry membranes
  • decreased urine output
  • moderately increased thirst
  • sunken fontanelles
  • RR = regular or rapid
  • eyes slightly sunken
  • delayed cap refill > 2 seconds
25
Q

Oral Rehydration Solution (ORS)

A

Solutions containing glucose, sodium, potassium, chloride, & citrate are given orally to replace those lost in mild to moderate dehydration

26
Q

ORT (oral rehydration therapy) for mild dehydration

KNOW THIS!!!!!

A
  • If weight is less than 22 lb (10 kg) = give 60-120 mL ORS for each diarrheal stool or vomiting episode

*

  • If weight is over 22 lb (10 kg) = give 120-240 mL ORS for each diarrheal stool or vomiting episode
27
Q

ORT (oral rehydration therapy) for Moderate Dehydration

KNOW THIS!!!!!

A

Give 50 - 100 mL/kg ORS in 3-4 hours in addition to replacing fluids lost in minimal ORT

28
Q

ORT (oral rehydration therapy) for Severe dehydration

KNOW THIS!!!!!

A

Treated with IV fluids

  • When hydrated adequately or concurrently with IV rehydration, begin ORT with 100 mL/kg of fluid in 4 hours & stool replacement as described above. Recalculate fluid needs after first 4 hours & adjust as needed.
29
Q

Appendicitis

A

Inflammation of the appendix

  • ages 10-19 are most at risk for perforation

DX: ultrasound = gold standard

30
Q

Signs & Symptoms of Appendicitis

KNOW THIS!!!!!

A
  • Pain (Mcburneys, Rovsing’s, Psoas, Obturator)
  • Anorexia
  • Nausea
  • Temperature
  • increased WBC, neutrophils, C-reactive protein
31
Q

What is McBurney’s Point?

KNOW THIS!!!!!

A

RLQ pain upon palpation

  • 2/3 between umbilicus & hip bone
  • + McBurneys = appendicitis
32
Q

Rovsing’s Sign

A

RLQ pain upon LLQ palpation; referred pain

  • + Rovsing’s = appendicitis
33
Q

Obturator Sign

A

RLQ pain on internal rotation of thigh

  • + Obturator = appendicitis
34
Q

Treatment of Appendicitis

A

Surgical removal of appendix
* perforation = emergency

  • IV fluids, prophylactic antibiotics, pain medications, NPO, incision care, NG for perforation (decompresses abdomen)
35
Q

What is Hyperbilirubinemia?

KNOW THIS!!!!!

A

Elevated bilirubin level of > 5 g/dL

  • affects 84% of newborns
36
Q

Signs & Symptoms of Hyperbilirubinemia

KNOW THIS!!!!!

A
  • jaundice
  • lethargy
  • decreased PO intake
37
Q

Treatment for Hyperbilirubinemia

KNOW THIS!!!!!

A

phototherapy

38
Q

Hyperbilirubinemia Nursing Considerations

KNOW THIS!!!!!

A
  • Identify jaundice (soles, palms, sclera)
  • Obtain TSB
  • Plot TSB on normogram
  • Strict I&Os
  • IV hydration
  • Phototherapy
  • Vitals
39
Q

3 Nursing Diagnoses associated with Hyperbilirubinemia

KNOW THIS!!!!! (per tutor)

A
  • Fluid volume deficit
  • Risk for impaired attachment
  • Risk for imbalanced body temperature
40
Q

Hyperbilirubinemia

KNOW THE BOLD!!!!!

A

↑ bilirubin > 5 g/dL

S/S: jaundice, lethargy, ↓ PO intake

  • Tx = phototherapy

Nursing Diagnoses
* Fluid volume deficit
* Risk for impaired attachment
* Risk for imbalanced body temperature

41
Q

Urinary tract infection

A

Infection of the lower or upper urinary tract that can be viral, bacterial, or fungal

  • E. coli is the most common cause

Dx: urine culture, UA, CBC, CT or US

Tx: IV abx

42
Q

Acute Post-Infectious Glomerulonephritis (APG)

KNOW THIS!!!!!

A

Inflammation of the glomeruli in the kidneys

Commonly caused by group A beta-hemolytic strep

  • + protein & blood in urine
  • provide supportive care
  • common in 2-6 year old boys
  • manifests 10-21 days after strep infection recovery

do NOT need to have current infection for this to occur

43
Q

Signs & Symptoms of APG (acute post-infectious glomerulonephritis)

KNOW THE BOLD!!!!!

A
  • ↓ GFR
  • ↑ BUN / Cr
  • ↑ WBC
  • Proteinuria = ↓ serum & ↑ in urine
  • Hematuria
  • Oliguria
  • Dysuria
  • low grade fever
  • facial edema
  • flank pain
  • lethargy
  • acute hypertension
  • HA
  • N/V
  • seizures (severe)
44
Q

Hypospadias

KNOW THIS!!!!!

A

Urethral meatus (opening) located on the ventral (bottom) surface of the penis

assess every newborn male

  • Nursing Considerations: patient education, I&Os, pain management, incision care
45
Q

Epispadias

KNOW THIS!!!!!

A

Urethral opening on the dorsal (top) surface of the penis

46
Q

Nephrotic Syndrome
* What is it?
* Signs & symptoms
* Treatment

KNOW THE BOLD!!!!!

A

Clinical state of being; alteration in kidney function due to ↑ membrane permeability to proteins

  • S/S:
  • Periorbital edema
  • + proteinuria
  • hematuria & ↓ urine output
  • irritability, malaise/anorexia
  • HTN

Tx: steroids & BP meds
* prednisone = 2 mg/kg/q12 hr

47
Q

Testicular Torsion

A

Twisting of the spermatic cord causing ↓ blood flow to the testes

  • S/S: severe pain, erythema, N/V, swelling
  • Tx: surgical emerrgency untwisting (orchiopexy)

Pediatrics Exam 3 (4 decks)

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