GI STRUCTURAL INFLAMMATORY DISORDERS

Question 1

what does a cleft lip look like?

Answer 1

visible separation from upper lip towards the nose

Question 2

what does a cleft palate look like?

Answer 2

visible or palpable opening of the palate connecting the mouth and the nasal cavity

Question 3

when is a cleft lip repair performed?

Answer 3

cleft lip surgery repair is done between 2 and 3 months of age

Question 4

when is a cleft palate repair performed?

Answer 4

cleft palate surgery repair is done between 6 and 12 months of age

Question 5

what are post op nursing care that can be performed for both cleft lip and palate?

Answer 5

1. avoid having infant suck on nipple or pacifier
2. avoid spoons, forks, or anything that infant may bring to their mouth and damage incision so NOTHING can go in the mouth!
3. observe family interaction with infant
4. apply elbow restraints and remove periodically to assess the skin

Question 6

what are nursing post operation interventions specifically for cleft lip?

Answer 6

1. position infant on back and upright or side lying during immediate post op period
2. clean incision site with NS,water, or diluted hydrogen peroxide

Question 7

what are nursing post operation interventions specifically for cleft palate?

Answer 7

1. 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

Question 8

what are nutritional interventions for a patient with cleft lip?

Answer 8

1. encourage breast feeding
2. use a wide based nipple for bottle feeding
3. squeeze infant’s cheeks together during feeding to decrease the gap

Question 9

what are nutritional interventions for a patient with cleft palate or palate +lip?

Answer 9

1. position infant upright while cradling during feeding
2. use a special bottle with a one way valve and a specially cut nipple
3. burp infant frequently
4. syringe feeding can be necessary for the infant who is unsuccessful with other methods

Question 10

what are complications to watch for with cleft lip/palate post operation?

Answer 10

ear infection, airway obstruction, hemorrhage, laryngeal spasms, and speech/language impairment

Question 11

what are clinical manifestations of GERD in infants?

Answer 11

1. spitting up or forceful vomiting
2. irritability
3. blood in vomit
4. failure to thrive
5. respiratory problems

Question 12

what are clinical manifestations of GERD in children?

Answer 12

1. heartburn
2. abdominal pain
3. noncardiac chest pain
4. acid comes back up when they lay down at night

Question 13

what foods should be avoid with a GERD patient?

Answer 13

avoid foods that cause reflux such as caffeine, citrus, peppermint, spicy, and fried foods

Question 14

what nutritional interventions should be implemented for a GERD patient?

Answer 14

1. small, frequent meals
2. thicken formula with 1 tsp-1 tbsp rice cereal per 1 oz formula
3. position patient with head elevated after meals for 30 minutes

Question 15

what medications can be given for GERD?

Answer 15

PPI or H2 antagonist ending in prazole

Question 16

what are GERD patients at high risk?

Answer 16

GERD patients are at high risk for pneumonia

Question 17

what is a big manifestation of appendicitis?

Answer 17

severe pain in the right lower quadrant

Question 18

what are nursing interventions to perform for a patient with appendicitis?

Answer 18

1. prepare for surgery
2. no heat to abdomen because vasodilation can cause rupture
3. no enemas or laxatives should be given

Question 19

what are pre op care teaching for non ruptured appendicitis surgery?

Answer 19

give IV fluids and IV antibiotics

Question 20

what are post operation teaching for non ruptured appendicitis surgery?

Answer 20

1. assess respiratory status and maintain airway
2. monitor bowel sounds
3. monitor for fracture after removal of non ruptured appendix

Question 21

what are pre operation instructions for a ruptured appendicitis surgery?

Answer 21

IV antibiotics and NG tube for decompression

Question 22

what are post operation instruction for a ruptured appendicitis surgery?

Answer 22

1. assess respiratory status and maintain airway
2. monitor bowel sounds
3. maintain NPO
4. Maintain NG tube to low continuous suction

Question 23

what are major complications of appendicitis?

Answer 23

1. rupture= pain goes away

2. peritonitis= rigid distended abdomen with rapid and shallow breathing

Question 24

what are clinical manifestations of pyloric stenosis?

Answer 24

1. projectile vomiting with blood
2. constant hunger but failure to gain weight
3. olive shaped mass in the RUQ
4. dehydration

Question 25

what is the plan of care for a patient with pyloric stenosis?

Answer 25

prep the patient for surgery