GI STRUCTURAL INFLAMMATORY DISORDERS Flashcards
what does a cleft lip look like?
visible separation from upper lip towards the nose
what does a cleft palate look like?
visible or palpable opening of the palate connecting the mouth and the nasal cavity
when is a cleft lip repair performed?
cleft lip surgery repair is done between 2 and 3 months of age
when is a cleft palate repair performed?
cleft palate surgery repair is done between 6 and 12 months of age
what are post op nursing care that can be performed for both cleft lip and palate?
- avoid having infant suck on nipple or pacifier
- avoid spoons, forks, or anything that infant may bring to their mouth and damage incision so NOTHING can go in the mouth!
- observe family interaction with infant
- apply elbow restraints and remove periodically to assess the skin
what are nursing post operation interventions specifically for cleft lip?
- position infant on back and upright or side lying during immediate post op period
- clean incision site with NS,water, or diluted hydrogen peroxide
what are nursing post operation interventions specifically for cleft palate?
- can be placed on abdomen in immediate postop period
2. no straw, tongue depressor, hard pacifier, rigid utensils, hard tipped sippy cups, or suction catheters
what are nutritional interventions for a patient with cleft lip?
- encourage breast feeding
- use a wide based nipple for bottle feeding
- squeeze infant’s cheeks together during feeding to decrease the gap
what are nutritional interventions for a patient with cleft palate or palate +lip?
- position infant upright while cradling during feeding
- use a special bottle with a one way valve and a specially cut nipple
- burp infant frequently
- syringe feeding can be necessary for the infant who is unsuccessful with other methods
what are complications to watch for with cleft lip/palate post operation?
ear infection, airway obstruction, hemorrhage, laryngeal spasms, and speech/language impairment
what are clinical manifestations of GERD in infants?
- spitting up or forceful vomiting
- irritability
- blood in vomit
- failure to thrive
- respiratory problems
what are clinical manifestations of GERD in children?
- heartburn
- abdominal pain
- noncardiac chest pain
- acid comes back up when they lay down at night
what foods should be avoid with a GERD patient?
avoid foods that cause reflux such as caffeine, citrus, peppermint, spicy, and fried foods
what nutritional interventions should be implemented for a GERD patient?
- small, frequent meals
- thicken formula with 1 tsp-1 tbsp rice cereal per 1 oz formula
- position patient with head elevated after meals for 30 minutes
what medications can be given for GERD?
PPI or H2 antagonist ending in prazole
what are GERD patients at high risk?
GERD patients are at high risk for pneumonia
what is a big manifestation of appendicitis?
severe pain in the right lower quadrant
what are nursing interventions to perform for a patient with appendicitis?
- prepare for surgery
- no heat to abdomen because vasodilation can cause rupture
- no enemas or laxatives should be given
what are pre op care teaching for non ruptured appendicitis surgery?
give IV fluids and IV antibiotics
what are post operation teaching for non ruptured appendicitis surgery?
- assess respiratory status and maintain airway
- monitor bowel sounds
- monitor for fracture after removal of non ruptured appendix
what are pre operation instructions for a ruptured appendicitis surgery?
IV antibiotics and NG tube for decompression
what are post operation instruction for a ruptured appendicitis surgery?
- assess respiratory status and maintain airway
- monitor bowel sounds
- maintain NPO
- Maintain NG tube to low continuous suction
what are major complications of appendicitis?
- rupture= pain goes away
2. peritonitis= rigid distended abdomen with rapid and shallow breathing
what are clinical manifestations of pyloric stenosis?
- projectile vomiting with blood
- constant hunger but failure to gain weight
- olive shaped mass in the RUQ
- dehydration
what is the plan of care for a patient with pyloric stenosis?
prep the patient for surgery