GI PowerPoint Flashcards
is liver function mature at birth
no its immature
enzymes are deficient until when
4-6 mo
is abdominal distention common with infants
yes
is the stomach smaller at birth
yes
30 days ~ 90mL
1 year ~ 360mL
when do you develop control over swallowing
6 weeks
before 6 weeks swallowing is a
reflex
- suck, swallow, breathe
who has higher peristalsis infants or older child
newborn
why do newborns have higher peristalsis amounts
high metabolism
high peristalsis leads to
looser and more frequent stools
why do infants have regurgitation
cardiac sphincter is relaexed
when will the digestive process be completed
2nd year
will you always have cleft lip and palate or can it be separate
it can be separate or together
cleft lip/palate defintion
failure of the maxillary process to fuse between 5 - 12 weeks gestation
cause of cleft lip/palate
unknown
cleft lip/palate surgery
done in phases
1. lip first to help with eating
2. palate second
the palate cannot be corrected until
they are able to eat not via a bottle
since the surgery is similar to a wisdom teeth
lip defect surgery age
3-5 mo
palate defect surgery age
12 mo
rule of 10 for cleft lip/palate
over 10 weeks
over 10lbs
hemoglobin over 10
Logan bow
little cage that protects the suture line and allows to heal
what is placed during a procedure of cleft lip/palate repair
NG/OG
complications of cleft lip/cleft palate
speech defects
dental problems
nasal defects
alteration of hearing
shock/guilt from parents
cleft lip/palate risks
aspiration
URI
OM
why is surgery for the palate done by 12 mo
decrease effect on speech development
cleft lip/palate prognosis
good
ESSR
elevate/enlarge
stimulate
swallow
rest
ESSR
- elevate
sit up other wise milk goes into nose
ESSR
- stimulate
cannot form own seals so stimulate tongue, push tongue down with nipple to attempt them to suck and then swallow and then rest
what type of feeding works well for CL/P
breastfeeding
pyloric stenosis age and race and gender
6-8 wks
full tern caucasian male
pyloric stenosis defintion
partial obstruction of lumen of the stomach muscle becomes inflamed becoming edematous, narrowing of opening leading to complete obstruction
pyloric stenosis cause
unknown
- maybe immature absent ganglion cells in pylorus, genetics
pyloric stenosis occurs between
stomach and duodenum
pyloric stenosis s/s
projective vomiting
dehydration
m alk
failure to thrive
pyloric stenosis blood tests
dehydration
electrolyte imbalance
anemia
pyloric stenosis
- olive sized bulge below the
right costal margin
pyloric stenosis
- peristaltic waves
visible
pyloric stenosis
- vomiting and when
projective during or shortly after eating
pyloric stenosis
- after vomit
resumes eating
pyloric stenosis
- weight gain or weight loss
poor weight gain
weight loss
pyloric stenosis
- malnutrition s/s?
yes
pyloric stenosis
- irritible?
yes
pyloric stenosis
- treatment surgery
pyloromyotomy
pyloromyotomy
release of muscles to allow the passage of food
- laparoscopic
pyloromyotomy
- post op
PO 4-6 hr
small frequent feeding
formula 24 hr
monitor hydration
prevent infection
intussusception defintion
telescoping or invagination of one proportion of intestine into another
walls of the intestine rub together causing inflammation, edema, and decrease blood flow
intussusception
- cause
unknown
intussusception
- s/s
usually abrupt
pain
current jelly, blood and mucus, stools
intussusception
- what part of intensive
large intestine, ascending colon at ileocecal valve
intussusception
- complications
necrosis
perforation
peritonitis
intussusception
- tx
barium enema will fix the telescoping
GERD
long term effect of GER for over a year
GER
- three mechanisms
lower esophageal relaxation
incompetent lower esophageal sphinceter
anatomic disruption of esophagogastric junction
GER
- increase indcience
premies, CP, BPD
GERrisk
aspiration
resp illness
color change during feeding
GER on probe you will see
inflammation of esophageal wall
GER pH probe
PH of 4 means acid contents
GER s/s
irritability
vomiting
wt loss
recurrent pneumonia
apnea
coughing and wheezing
GER resolves by when in most infants
1 year
do we use H2 blockers
not for infant or young child
GER nursing consideration
upright 30 min after feeding
small frequent feedings ~2 1/2-3 hr
don’t bounce around after eat
change diaper before
GER surgical treatment
Nissen Fundoplication
fundus is wrapped around the esophagus
omphalocele
congectinal defect, abdominal contents herniate through the umbilical cord
where are intestines grown and when do they migrate
outside the abdomen, 10 wks
omphalocele is it covered
yes by a sac
omphalocele
- 80% have
cognetical abnormalities
difference between omphalocele and gastroschsis
- sac
- originated
- repair
- defect
omphalocele: sac
gastroschsis: no sac
omphalocele: originate in umbilical cord
gastroschsis: right of umbilicus
omphalocele:repair in 1 day
gastroschisis: repair immediately
omphalocele: congenital defect
gastroschisis: defect of abdominal wall
gastroschisis
defect of the abdominal wall
gastroschisis location
right of umbilicus
gastroschisis membrane
no
gastroschisis how delivered
c section
what one is considered a sealed defect
omphalocele
nursing care for gastroschisis
protect the defect
place in sterile, plastic bag
Hirschsprung disease/aganglionic megacolon defintion
congenital absence of ganglion cell in the distal bowel
- absence of ganglion cells = no peristalsis
Hirschsprung disease/aganglionic megacolon
- s/s
abdominal distention
vomiting
dehydration
billious vomiting
no mec passage within 24-36 hours
Hirschsprung disease/aganglionic megacolon
- ABD XRAY
dissented bowel loops at site of defect
Hirschsprung disease/aganglionic megacolon
- tx
surgery and pull defect out and attach healthy bowel to anus
intestinal parasitic disease
- common causes
camping
drinking untreated water
exposire to pets, wildlife
- uncovered sand box
intestinal parasitic disease
- tx
antihelmintic/ antiparasite
intestinal parasitic disease
- transmission
fecal oral
intestinal parasitic disease
- nursing management
good hygiene
- after tolitening and when handling food
intestinal parasitic disease
- nursing education to parent
finish the prescription as directed
- same as antibiotics
intestinal parasitic disease
- etiology
eggs hatch in upper intestine, and mature and migrate to the colon and mate, migrate up and feed on intestinal content, live up to 2 weeks outside before entering body, lay eggs in anus
intestinal parasitic disease
- s/s
itchy butt
mild fever
gastroenteritis
diarrhea
wt loss
intestinal parasitic disease
- diagnostic test
stool sample
acute appendicitis
instructive disease, inflammation which worsens obstruction
occurs where small meets large
acute appendicitis
-s/s
referred pain
mcburneys point
guarding
rigidity
rebound tenderness
acute appendicitis
- who has ruptured
less than 3
acute appendicitis
- when do we do laparoscopic
want to treat infection before surgery to recovery faster
acute appendicitis
- non rupture tx
antibiotics for 1 week and do blood work
WBC >15 and bands
acute appendicitis
- rupture tx
removal
