Inflammatory Disorders

Question 1

What is appendicitis?

What is the usual cause?

Answer 1

Inflammation of the appendix

Due to obstruction usually

Question 2

Why is early dx important with appendicitis?

Why can this sometimes be hard to do?

Answer 2

Due to obstruction, a perforation can happen and the spillage goes out into the peritoneal cavity and causes the peritonitis.
It gets mistaken for other things a lot.

Question 3

What is pain like in appendicitis?

What happens if the pain just goes away after its been constant?

Answer 3

At first may just come and go in the periumbilical area.
And then, will become constant in the right lower quadrant (RLQ)

If the pain stops, that means the tissue has ruptured and now there is a possibility of peritoneal infection.

Question 4

Common symptoms of appendicitis?

Answer 4

Pain
Fever
N/V
Rovsings Sign - palpation of other quadrants caused pain in RLQ. 
Guarding of the abdomen 
Rigid

Question 5

How is appendicitis diagnosed?

Answer 5

CBC showing left shift
Rule out other issues first such as give pG test to rule out for ectopic PG
UA to rule out

Abdominal ultrasound is gold or CT scan

Question 6

Treatment of appendicitis if not perforated?

For perforation?

Answer 6

Laprascopic surgery can be done most times. It is quick .

If it has perforated then may need to go in and open w drain

Question 7

What do we need to do after surgery?

Anesthesia ?

Answer 7

Vitals
Pain control
Nutrition education

Anesthesia will slow down the GI tract and effect motility so will need the OG tube to avoid vomiting

Question 8

Why might someone be on antibiotics with an appendictis?

Answer 8

To treat infection of peritoneal

Question 9

How long will someone be on IV fluids after appendicitis surgery?

Answer 9

24-48 hrs due to GI motility absence

• note intake and output
• replace fluid and electrolytes

Question 10

What is Gastroenteritis?
Why is this common in infants?

Leading orgnaism cause of this?

Answer 10

Diarrhea due to inflammation from an organism
Infants and kids put their hands near their mouths & who knows where the hand has been

Rotavirus
- but can be caused by other viral, bacterial, and parasites

Question 11

Why is Gastroenteritis a huge concern for infants though?

What can it lead metabolic state can it lead to?

Answer 11

Bc it is causing them to lose fluid & cause imbalances & lead to shock fast

Can lead to metabolic acidosis as well

Question 12

How many wet diaper does an infant usually have?

What do infant symptoms of dehydration look like again (due to Gastroenteritis)?

Answer 12

6-8 in 24 hrs

Sunken fontanel
Mucosa is dry

Question 13

What do Gastroenteritis causing dehydration symptoms look like in older kids?

What do we need to educate parents about?

Answer 13

Thirst increase
Lethargy
Decreased urination
tinting, dryness of skin

how to get kid to drink in small frequent amounts

Question 14

What age is constipation common in?

Answer 14

School aged children

Question 15

How exactly does the patho work for constipation?

Answer 15

The fluid from the stool is reabsorbed and so then it is too dry to pass

Question 16

Reasons a kid may be constipated?

Answer 16

Not drinking enough fluids
Not eating enough fiber
Social behavior of not wanting to go & making themselves constipated

Question 17

What exactly is the social behavior that causes kids not want to go ?

What things will need to be done to fix this?

Answer 17

They are learning about privacy and the idea of stooling in public makes them too uncomfortable to go. And so then they just hold it.
But of course, that leads to the water being reabsorbed and then they end up constipated.

Bowel may need to be retrained
Change diet, attitude, and toileting schedule
or clean out regimen with Miralax

Question 18

When kid is constipated, what do we need parents to understand?

Answer 18

That this may require a lot of their time just bc it is a complicated issue.