Neonatal Gastrointestinal Disorders & Hepatitis Flashcards
______ a birth defect where the esophagus (the tube connecting the mouth to the stomach) does not fully develop, leaving it disconnected.
It often occurs with a ________, an abnormal connection between the esophagus and trachea.
Esophageal atresia (EA)
tracheoesophageal fistula (TEF)
Esophageal atresia & tracheoesophageal fistula
Excessive drooling
Cyanosis, choking, coughing
Difficulty feeding - food returns through nose / mouth - aspiration
Resp distress
Ab distension
Diagnosis….
Inability to pass NG tube to stomach
XR verify
Esophageal atresia & tracheoesophageal fistula
Nurse management
Prep for surgery/ NPO
- Posistion….
Oxygen & suction at bedside
- Tube?
Non-food sucking - pacifier
- 30 - 45°
- Orogastric tube / low - continuous suction NO INFUSION
Post op Esophageal atresia
- Double lumen NG catheter is attached to ____ drainage..
- Nutrition directly post-op…
- Oral feedings?
- Low suction/ gravity
- TPN
- Start slowly 1 week after.
Start sterlie water & advance to breastmilk / formula
Omphalocele…
Gastroschisis…
Omphalocele
Abdominal organs protrude through umbilical cord. Contained in a sac
Gastroschisis
Bowel protrude through ab wall to the right of the umbilicus. NO SAC COVERING ORGANS
Omphalocele (Sac) & Gastroschisis (No Sac)
Immediately after birth
Keep Warm
Cover with sterlie dressing & possibly plastic wrap STERLIE TECH
hydration status
Tube?….
Orogastric tube low suction
Anorectal malformation
Rectal atresia…
Rectal stenosis…
Impersonate anus…
No obvious anal opening - fistula leads from rectum to perineum / genitourinary opening
Complete obstruction- no stooling
Rectal atresia
Complete obstruction- no stooling
Rectal stenosis:
Narrowing of the rectosigmoid lumen - Ribon like stools
Impersonate anus:
No obvious anal opening - fistula leads from rectum to perineum / genitourinary opening
Diagnosis for anorectal malformation…
Imaging
XR, US, Pelvic MRI
Anorectal malformation
Surgical repair & colostomy needed for life
T or F
F
Possibly only temp colostomy
Anorectal malformation
Surgery prep…
NPO
Gastric decompression
IV
Education & Support to family
Anorectal malformation
Post op….
Pain relief
NPO
Gastric decompression- unitl normal bowel function returns
Colostomy care maybe needed
Diverticulum….
Outpouching of walls in a canal or organ
Meckel diverticulum…
Congenital sac / blind pouch in lower portion of ileum
Meckel diverticulum
Congenital sac / blind pouch in lower portion of ileum
Clinical Manifestions:
Ab pain - may resemble appendicitis
Bloody/ jelly stools
Possible Anemia/ Shock
Management….
May require Packed Red Blood Cells
Immediately report any acute abdomen to HCP?
Acute inflammatory disease where the bowel wall swells & breakdown.
Contributing factors
Preterm
Frequent Antibiotics & antacids followed by enternal feedings…
Necrotizing Enterocolitis
Reduce NEC
Hold oral feeding for _____ in infants who experienced birth Asphyxia
Breastfeeding
Avoid overuse of antibiotics & antacids
Give oral prebiotic within first 7 days and continued for 14 days
Hold feeding 24 - 48 hrs
NEC
SS
Lethargy
Apnea
Unstable temp
Hypotension
Jaundice
Vomiting
Oliguria
Specific
Distension of ab
Gastric retention
Ab erythema / induration
Blood in stool
Vomiting Bile
Management.
- Nutrition….
- NG?
- IV…
- X rays….
- TPN
- NG yes to suction
- IV antibiotics
- XR q6-8H
Inflammation of the liver caused from infection or non infection…
Hepatitis
Hep A is caused from fecal exposure
SS flu-like
Pre-icteric phase…
Icteric phase…
(Describe SS)
Pre-icteric phase. HA, Fatigue, fever, anorexia
Icteric phase. Jaundice, dark urine, RUQ pain
Hep B - transmitted Parentally, sex, drugs, and rock and roll. (Blood)
SS….
Sometime asymptomatic
Anorexia
Ab pain
Fatigue
Rash
Slightly fever
Jaundice
Enlarge liver
Hep C (like Hep B) transmitted
Perinatal, sex, drugs, blood
SS…
Asymptomatic
Fluid
Jaundice
Hepatosplenomegaly
Cirrhosis/ Cancer Liver
Hep D: Rare jn kids- must already have HBV
SS…
Same as HBV
Increased risk of chronic, active hepatitis & cirrhosis
