GI/GU/Endocrine Flashcards
what are major issues with children with cleft lip and palate?
Feeding and bonding w parents/family (trust vs. mistrust)
Child w cleft lip and palate have problems later in school age w
speech
Every newborn with cleft lip/palate need ________ in the oral cavity for sucking
negative pressure
babies with cleft palates need a special bottle with a one way valve
It is hard for babies with cleft l/p to ______ so the mom can pump milk and feed baby w a bottle
breast feed
babies w cleft palate need a special bottle with a _____ way valve
one
When feeding, a baby with cleft palpate the child should sit
sit up-right, burp frequently and small frequent feeds (not too much at once)– aspiration risk
Cleft lip is repaired at ______
repaired within the first 6 months of life
ATI: 10 pounds and 10 weeks
Cleft palate surgical repair is done at ________
18 months of age
- consider how child’s speech is affective
baby cleft LIP surgical repairs post-op care
- the no-no touch restraints for infants (PRN)
- Avoid prone positions (cleft palate is okay but not lip)
- Maintain the airway
- light suction only if needed
post-op cleft palate repair
Prone postion is ok
clear liquid 4 hours and then formula 3-4 days
NOOO pacifiers, NOOO straws (nothing going into the mouth other then liquid)
Child MUST use a cup for feeds (no bottle)
long term effects of cleft palate
- speech impairment
- otitis media (ear infection)– due to positioning of tubes in-ear connecting to the mouth
Hypertrophic Pyloric stenosis (HPS) is
a condition of the lower stomach in newborns, where the lower sphincter of the stomach becomes enlarged preventing food from entering the small intensities resulting in vomiting –> leading to dehydration
pyloric stenosis s/s
Projectile vomiting after feedings = pyloric stenosis (PS)
constant hunger
abdominal distension
palpable gastric olive shaped mass in the right umbilicus
poor weight fain and dehydration
–compare the current weight to birth weight
palpable gastric olive-shaped mass in the right umbilicus with vomiting is a sign of
hypertrophic pyloric stensis
HPS vomiting occurs
after feedings
infants stomachs can hold
30mL
How do you diagnose AND fix hypertrophic pyloric stenosis
Ultrasound
Laparoscopic surgery
Before a baby goes for surgery for HPS the nurse should
start IVF bolus NSS
NPO and NG tube to decompress the stomach before operation
Intussusception compare in what age group?
9 month-toddlers
Intussusception is when
one part of the intestines intestines into another part of the intestines
Intussusception s/s
- stool that is blood/mucus-streaked (currant jelly)
- sauage shaped abdominal mass
- vomiting (non-projectile)
- guarding, crying, DRAWING KNEES TO CHEST
S/S Intussusception is now peritonitis
fever
abdominal RIDIDITY
rebound tenderness
Treatment for Intussusception
Air enema !!! most effective
enema is given under imaging to reduce the defect
surgery is only needed if enema is not affective
—the goal is the passage of normal brown stool —> surgery won’t be needed
the child has currant jelly stool!!!!!!!! and the cycle of intermittent legs pulled up and the child is screaming!!! then they are relaxed and fine.. then get worst and loses LOC
what is happening?
Intussusception —> bowel ruptured (perforated) –> can lead to sepsis