Module 2 G.I. and G.U. disorders Flashcards
Tx for Cleft lip
Surgery Cheiloplasty
Tx for Cleft palate
Surgery Palatoplasty
Tx for Tracheoesphageal Fistula
Surgery
Tx for Pyloric Stenosis
Pyloroplasy
Tx for Celiac Disease (spruce)
Gluten free diet
Tx for Hirshprungs (Agaglionic megacolon)
Bowel resection Temp colostomy
Tx for Intersusseption
Barium enema
Tx for Meckles divirticulum
Surgery
Tx for Hernia
Herniorraphy
Tx for Gastroenteritis
Prevent dehydration Isolate child
Tx for Appendicitis
Appendectomy
Tx for Colic
Slow feed/ Burping
Tx for Gerd
Thickened feeds
Fundoplication (Severe)
Tx for Lactose intolerance
Lacoste free diet
Tx for Cystic fibrosis
Pancrease with meals
Tx for Pin worms
Antihelmetics Short fingernails
Tx for Lead poisoning
Chelation therapy
Symptoms of Cleft lip
Open fissures in upper lip
Symptoms of Cleft palate
Inability to suck
Symptoms of Tracheaesophageal Fistula
Coughing choking cyanosis
Symptoms of Pyloric stenosis
Projectile non bilious vomiting Olive like mass Visible peristalsis
Symptoms of Celiac disease Spruce
.
Symptoms of Hirshrungs Agaglionic megacon
Ribbon like stools
Symptoms of Intesusseption
Mucousy bloody stools
Symptoms of Meckles divirticulum
Bleeding after 2 years if age
Symptoms of Hernia
Painless mass at site
Symptoms of Gastroenteritis
NVD
Symptoms of Appendicitis
Rebound tenderness
Symptoms of Colic
Infant pulling up arms and legs
Symptoms of GERD
Vomiting
Symptoms of Lactose intolerance
NVF after feeds
Symptoms of Cystic fibrosis
Failure to they’ve Stetorrhea
Symptoms of Pinworms
Anal itching
Symptoms of Lead poisoning
Low cognitive functioning
Pyloric sphincter is located at the _____ of the stomach
bottom
Congenital means your
born with it
Cleft lip usually happens in the _____ week of gestation
7-8th week
Disorder where baby has difficulty sucking because seal is not created
cleft lip
how do we feed babies with cleft lip
little rubber syringe to back of throat slowly
what can the baby lose with cleft lip when it goes untreated
sucking reflex
When is it ok to perform a Chieloplasty
When baby has stable weight
How do we position baby post op Cheiloplasty
Side or back
What do we use so we can have support going across suture line (Cheiloplasty)
Logans bar
After feeding in cleft lip babies what should we do
wipe mouth with water, cleanse incision
How long should we be feeding baby with rubber tip syringe after Cheiloplasty
7-10 days
What is a major cause of Cleft palate
Low folic acid during pregnancy
When does cleft palate usually incur during gestation
7th to 12th week
Congenital defect where nasopharynx and nose combine
Cleft palate
What is the baby at risk for in Cleft palate
Failure to thrive
Frequent ear and respiratory infections, unable to suck, are common S&S of
Cleft palate
When should a Palatoplasty be done (Cleft palate)
before 18 months
What are 3 parent teaching in cleft palate
Child may need speech therapy
Hold child upright with burping frequently
limit feeding time to 20-30 min
Pre-op for cleft palate what may we fit for feeding
Obdurator
For post-op care of (Palatoplasty) cleft palate what are 3 things we must do
No sucking for 7-10 days
avoid disrupting suture line
feed by spoon
Diet for Post op cleft palate Palatoplasty
Clear liquids –> Full liquids –> Soft diet
Abnormal opening of trachea usually smaller is called
Tracheo-esophageal fistula
What are 3 S&S of Tracheo-esophageal fistula
Coughing
Choking
Cyanosis
3 nursing for Tracheo-esophageal fistula
Keep NPO
HOB 30 degress +
prevent aspiration
how can surgery go for Tracheo-esophageal fistula
Piece of colon may be transferred to close it up because it can produce peristalsis
3 nursing post op Tracheo-esophageal fistula
Pacifier
Elevate HOB
Gradually increase feeding
symptoms dont occur for pyloric stenosis until
3rd week of life
3 S&S of pyloric stenosis
Projectile vomiting
Hunger
Small Round Mass in RUQ
How might the small round mass in pyloric stenosis look like
Olive like
What kind of tube do we use for pyloric stenosis
JJ tube
3 pre op care for pyloric stenosis
NGT for decompression
thickened formula
I/O
How do we position baby post op pyloric stenosis
Right side with HOB elevated
How do we feed baby post op pyloric stenosis
small amounts of water 3-4x –> 1/4 formula –> 1/2 formula
Also known as a food virus
Gastroenteritis
2 S&S of Gastroenteritis
Water stools
Abdominal cramps and pain
3 diagnostic tests for Gastroenteritis
Stool analysis
Serum IgA
Pt. interview
What are 2 things that we must avoid giving to pt. with Gastroenteritis
milk products
OTC meds
How do we feed babies with Gastroenteritis
5-15 cc every 30 min until vomiting halts, then 30cc / 30min
along with clear liquids what diet can we implement for a patient with Gastroenteritis
BRAT diet
BRAT diet stands for
Bread
Rice
Apple sauce
Tea
If weight is under 10% we diagnose it with
Failure to thrive
Colic in babies usually happens within
1st year
Abdominal pain caused by spasm of the intestines
Colic
3 S&S of Colic
Loud cry High pitch
Pull up of arms and legs
Spitting up mucus and undigested formula
Kids with Shaking baby syndrome are usually diagnosed with
Colic
How should we feed pt. with Colic (3)
Slowly
frequent burping
rocking gently
GERD stands for
Gastroesophageal Reflux
Relaxation of cardiac sphincter allows gastric contents to return to esophagus
GERD
3 S&S of GERD
Vomiting
Weight loss
irritability
In Severe GERD what surgery is done
Fundoplication
Anchoring the esophagus is called
Fundoplication
3 Nursing for mild GERD
thickened formula
upright position
Meds to reduce acid
What should we teach parents with babies who have GERD (2)
how to use GT
Aspiration precautions
Lactose intolerance can lead to
Failure to thrive
3 S&S of Lactose intolerance
Abdominal distention
Cramps
Diarrhea
What can mom take to help with Lactose intolerance
Lactate pill
Lack of pancrease enzyme, thick secretions, decreased motility are s&s of
Cystic fibrosis
What are 3 things we might see in a patient with Cystic fibrosis
Steatorrhea (Bulky stools)
Meconium ileus
Prolapsed rectum
What can we tell family to do, that might help with baby complying to diet
Eat at sametime
What can we give for Cystic fibrosis pre-meal
Pancrease
Allergy to gluten is called
Celiac Disease (Gluten Enteropathy or Sprue)
When can Celiac Disease present itself
6mo-2years
3 S&S of Celiac Disease
Frequent Large bulky stools
FTT
Anorexia
What are 3 Diagnostic tests for Celiac Disease
Stool analysis
Serum IgA
Small bowel biopsy
What diet may we put baby on for Celiac Disease
Mediterranean diet (Poultry+Fish)
Can cause partial or complete bowel obstruction, absence of ganglion cells in bowel
Hirschsprung’s Disease
No nerve endings and risk for vomiting stool
Hirschsprung’s Disease
3 S&S of Hirschsprung’s Disease
Meconium ileus
Ribbon like stools
Potential for Enterocolitis
Inflammation of small intestine, malabsorption of nutrients and water
Enterocolitis
Hirschsprung’s Disease puts child at risk for
Sepsis
How do we diagnose Hirschsprung’s Disease
Rectal biopsy
Too many enemas can cause
Brain damage, intoxication
What is the tx. for Hirschsprung’s Disease
Abdominal resection colostomy
3 nursing post op Hirschsprung’s Disease
NGT
Strict I/O
IV fluids
Severe abdominal pain, vomiting bile, and currant jelly stools are S&S of
Intussusception
Babies with Intussusception have a potential for
Shock
What are 5 S&S of Shock
Increased pulse Rigid Abdomen Pallor Diaphoresis Hypotension
Rigid abdomens happen when there is
internal abdominal bleeding
How do we diagnose Intussusception
Barium enema
How can we tx. Intussusception
Exploratory laparotomy with resection
Protrusion of organ through the peritoneum
Hernia
When stomach and muscles are coming up through diaphragm this is a
Severe case of a Hernia
What must we avoid or tell kid to avoid with a Hernia
Pressure, straining
If Incarcerated (Strangulated hernia) what may occur
Necrosis (blood flow)
colicky babies tend to have
Umbilical hernias
What is the diet for Hernias
Clear liquids
What are 3 S&S of Appendicitis
Elevated WBC
Elevated temp 103+
abdominal pain and rebound tenderness at McBurney’s point
Pain in RLQ is a classic sign of
Appendicitis
if appendix ruptures what might it lead to
Peritonitis
What are 3 nursing for Hernia post op
Early ambulation
No laxatives
NPO
3 S&S of lead poisoning
Lower cognitive functioning
Hearing impairments
Growth delays
What therapy may be used for Lead poisoning
Chelation therapy (absorb the lead)
How do we implement Chelation therapy
3 weeks then 2 weeks off then 3 weeks on again
What must we not do if child has been poisoned
induce vomiting
Secondary drowning is also known as
Aspiration Pneumonia
When do kidneys start to work
30-32 week gestation
When we suspect a fever what can we do
First line test
What might a fever cause
UTI
How do we perform a first line test
Get a sterile specimen doing clean catch
Patient must sit still for what 2 diagnostic procedures
IVP, VCUG
Cysto is another word for
Bladder
VCUG stands for
Voiding Cystourethrography
How is a Voiding Cystourethrography (VCUG) done
injection of dye to fill bladder and observe emptying
4 telltale signs of UTI
Dysuria
Nocturia
Polyuria / Oliguria
Enuresis
What is the major cause of UTI 2-6 years
Holding of urine
What can we drink to keep tract acidic
Cranberry juice
10+ diapers is a sign of
UTI
How might the urine smell and look in UTI’s
Ammonia smell, mucousy discharge
Classic sign of UTI is when child develops
Enuresis
What can we use to diagnose if baby is diapered
U bag
What is a common med used in UTI
Bactrim
SG decreased with increased Protein is a sign of
UTI
Micturition is
the passing of urine
what is the minimum time to hospitalize a infant under 1 year with a diagnosis of UTI and why
72 hours, so we don’t run the risk of it becoming nephritis
What are 2 common side effects of Bactrim
SJS, photosensitivity
What is the proper cleaning direction after Micturition
Front to back
What is the ideal frequency for urination
3-4 hours
Why must we avoid bubble baths
kills normal flora
Presence of marked amounts of protein in the urine, edema, and hypoalbuminemia is
Nephrotic Syndrome (Nephrosis)
Nephrosis may be related to
thymus T-cell dysfunction
Nephrosis is seen in males usually in what age
2-7
4 S&S of Nephrosis
Edema (anasarca)
Ascites
Weight gain
Listless
A telltale sign in males of Nephrosis is
Enlarged scrotum
What will a urine exam reveal for Nephrosis
Albumin high, Few RBC’s
What is a major nursing intervention for Nephrosis
Turn and position frequently
Prednisone may cause
weight gain
Nephrosis puts child at great risk for developing
Pneumonia
What must we avoid in diet if edema is present (Nephrosis)
Salt
What is one thing we must document frequently (daily) for Nephrosis
Abdominal Girth
How do we measure Abdominal Girth
Lay child flat, same place each day
Steroids (prednisone) causes decreased ______ which cause decreased _______
protein
edema
Because of prednisone what must we not perform during acute phase
Vaccinations or immunizations
Allergic reaction to group A beta-hemolytic strep infection
Acute Glomerulonephritis
What is the peak age for Acute Glomerulonephritis
6-7 years
Dehydration in Acute Glomerulonephritis will lead to
Hypokalemia (increased creatinine)
What are 3 S&S of Acute Glomerulonephritis
Edema in AM in periorbital area
Oliguria
Increased Temp
How might the Urine be in Acute Glomerulonephritis
Smoky brown or bloody, high in all lab levels
Nitrogen can cause toxicity and a
change in mental status
Excessive amounts of nitrogen due to kidney failure
Azotemia
3 nursing for Acute Glomerulonephritis
Bed rest
Fluid RESTRICTION
prophylactic abx. to prevent sleep
Diet for Acute Glomerulonephritis
Low salt
Nephroblastoma (one of the most common malignancies in early life)
Wilms tumor
When does Wilms tumor usually occur
in utero
Surgery must occur within ___ for Wilms tumor
48 hours
How do we diagnose Wilms tumor
IVP
What must we avoid for pt. with Wilms tumor
Pressure on abdomen
Excessive amount of fluid in the sac that surrounds the testicle and causes scrotum to swell, sometimes confused with Hernia
Hydrocele
Undescended testicle
Cryptorchidism
In Cryptorchidism sperm cells ______ because more warm
Deteriorate
If both testes are involved in Cryptorchidism what can happen
sterility
When must surgery occur for Cryptorchidism
Before 6 years of age
Orchiopexy improves what condition
Cryptorchidism
Congential defect where urinary meatus is located on the lower portion of the shaft
Hypospadias/Epispadias
When is surgery usually performed for Hypospadias/Epispadias
before 18mo for potty training purposes
Enuresis is defined by
Urinary incontinence after continence has been attained
When should parent seek tx. for Enuresis by
6-7 years
Which diagnostic test permits visualization of the upper GI tract
Endoscopy
FTT is below what percentile
3rd
What is the best support for caring for FTT
encourage mother to participate in childcare
3 s&s of pinworms
itching
irritability
restlessness
Intussusception Stools are
Currant jelly
What % of body is H20
77
What should we do before we add potassium to diet
Check if voiding properly
greatest threat to life in isotonic dehydration is
hypovolemic shock
If a child has pinworms what will happen
any family member with S&S will be treated
How should we place infant after feeding with GERD
prone with head elevated
earliest sign of Hirschsprung’s disease is
Meconium ileus
First feeding coughing and choking usually means
Tracheo Esophageal atresia
Used to reduce edema in nephrotic syndrome
Steroids
Child with Nephrotic syndrome is at risk for
skin breakdown
What statement shows parents understanding of hypospadias
surgery should be done before 18mo
What instructions will we give parents for babies with acute glomerulonephritis
Bed rest 2 weeks
In acute glomerulonephritis what can we expect
Hypertension
Wilms tumor is usually diagnosed when
routine physical is given
urinary output looks like what for acute glomerulonephritis
smoky brown
Children receiving steroids should be
monitored closely for signs of infection
When weighing diapers 1gm is = to
1ml
Child with nephrotic syndrome should not be receiving
Immunizations
