Nursing Care of a Child With Gastrointestinal Disorder Flashcards
Common diagnostic procedures include in GI
fiberoptic endoscopy
colonoscopy, and
barium enema.
Fluid Balance
adult-infants-children
adults, body water accounts for approximately 60% of total weight. in children, it averages approximately 65% to 70%. In infants, it accounts for as much as 75% to 80% of total weight;
interstitial and the intravascular fluid together are often referred to as
extracellular fluid (ECF),
In infants, the extracellular portion is much greater, totaling up to
45% of total body weight.
ECF in n young children, this amount is
30%
ECF in adolescents
25%
Fluid is distributed in three body compartments:
intracellular (within cells), 35% to 40%
interstitial (surrounding cells and bloodstream), 20% of body weight; and
(c) intravascular (blood plasma), 5% of body weight.
treatment for vomiting is to
withhold food from the stomach for a time
To decrease vomiting, withhold food and fluid for a time (nothing by mouth [NPO]) for how many hours?
period of 3 to 6 hours
World Health Organization provides a home recipe for fluid rehydration
2 tablespoons of sugar (or honey) with 1 ⁄4 teaspoon of table salt and 1 ⁄4 teaspoon of baking soda dissolved in 1 liter (1 qt) of water.
most common viral pathogens that invade the GI tract include
rotaviruses and adenoviruses
most common bacterial pathogens include
Campylobacter jejuni, Salmonella, Giardia lamblia, and Clostridium difficile
All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a
stool culture taken so definite antibiotic therapy can be prescribed.
For a child who will not drink, an IV solution such as
normal saline or 5% glucose in normal saline is begun
Salmonella bacteria
Incubation period:
6 to 72 hours for intraluminal type; 7 to 14 days for extraluminal type
Listeria monocytogenes
Incubation period:
1 day to more than 3 weeks
Bacterial infection of diarrhea (3)
Salmonella
Shigella
Listeria
occurs from a neuromuscular disturbance in which the gastroesophageal (cardiac) sphincter and the lower portion of the esophagus spasm and allow easy regurgitation of gastric contents into the esophagus.
Gastroesophageal Reflux in Infant
used to measure the strength of the esophageal sphincter
Esophageal manometry
traditional treatment of GI reflux is to
feed infants a formula thickened with rice cereal (1 tbsp of cereal per 1 oz of formula or breast milk) while holding them in an upright position
Irritation to the esophagus occurs when stomach contents, including hydrochloric acid, reflux through the lower esophageal sphincter and irritate the esophageal lining.
Gastroesophageal reflux disease (GERD)
the opening between the lower portion of the stomach and the beginning portion of the intestine, the duodenum.
pyloric sphincter
hypertrophy or hyperplasia of the muscle surrounding the sphincter occurs, it is difficult for the stomach to empty, a condition called
pyloric stenosis
The vomiting grows increasingly forceful until it is projectile, possibly projecting as much (pyloric stenosis) feet?
3-4 feet
The vomiting grows increasingly forceful until it is projectile, possibly projecting as much (pyloric stenosis) feet?
3-4 feet
pyloric stenosis diagnosis?
begins at 6 week of age
Projectile vomiting
Immediate after eating
treatment for pyloric stenosis
surgical or laparoscopic correction (a pyloromyotomy),
intermittent protrusion of the stomach up through the esophageal opening in the diaphragm.
Hiatal hernia
Hiatal hernia is diagnosed by
history and an ultrasound or barium swallow.
shallow excavation formed in the mucosal wall of the stomach, the pylorus, or the duodenum.
peptic ulcer
the most reliable diagnostic test to confirm the diagnosis of peptic ulcer disease
Fiberoptic endoscopy
Adolescents are prescribed an antibiotic such as for peptic ulcer
amoxicillin or clarithromycin (Biaxin) and a proton pump inhibitor such as omeprazole (Prilosec).
Younger children are prescribed for pepetic ulcer?
cimetidine (Tagamet) because safe levels of omeprazole
Mode of transmission: In children, of hepatitis A
ingestion of fecally contaminated water or shellfish; day care center spread from contaminated changing tables
immunity for hepa A
HAV vaccine (recommended for all children 12 to 23 months of age and workers in day care centers)
DNA virus, 120 days average of incubation period Mode of transmission: Transfusion of contaminated blood and plasma or semen;
Hepatitis B
single-strand RNA virus. Transmission, as with HBV, is primarily by blood or blood products, IV drug use, or sexual contact.
Hepatitis C (HCV)
hepatitis is enterically transmitted similarly to hepatitis A (fecally contaminated water).
Hepatitis E
All hepatitis viruses cause liver cell destruction, leading to increased
serum aspartate amino transaminase (AST), alanine aminotransaminase (ALT), and alkaline phosphatase levels.
Symptoms of hepatitis B are more marked. Children report generalized aching, in what location?
right upper quadrant pain, and headache.
means “yellow,” or the typical color of hepatic scar tissue.
Cirrhosis
a frequent complication of liver disorders such as cirrhosis
Esophageal varices
Liver transplantation requires a wide
subcostal incision. The vena cava is temporarily clamped during the removal of the natural liver to prevent bleeding,
Postoperative care for liver transplant
child is positioned flat for the first 24 hours to prevent cerebral air emboli, which may result from any air remaining in the transplanted liver. Typically, children have a nasogastric tube inserted during surgery attached
is the most common cause of abdominal surgery in children
Appendix
point of sharpest pain is often one third of the way between the anterior superior iliac crest and the umbilicus
McBurney’s point
In embryonic life, the intestine is attached to the umbilicus by the omphalomesenteric (vitelline) duct.
Meckel’s Diverticulum
bnormal immunologic response to protein, particularly the gluten factor of protein found in grains—wheat, rye, oats, and barley.
Celiac Disease (Malabsorption Syndrome; Gluten-Induced Enteropathy)
Treatment for celiac disease
gluten-free diet for life, because there is some suggestion that these children are more prone to GI carcinoma later in life if they do not continue the diet into adulthood.
protrusion of a section of the bowel into the inguinal ring. It occurs usually in boys (9:1) because, as the testes descend from the abdomina
Inguinal hernia
Treatment of inguinal hernia
laparoscopy surgery. The bowel is returned to the abdominal cavity and retained there by sealing the inguinal ring.
is absence of ganglionic innervation to the muscle of a section of the bowel—in most instances, the lower portion of the sigmoid colon just above the anus
Hirschsprung’s disease, or aganglionic megacolon,
Two conditions are categorized as inflammatory bowel disease:
ulcerative colitis and Crohn’s disease
inflammation of segments of the intestine; it may affect any part of the GI tract but most commonly involves the terminal ileum.
Crohn’s disease
typically the colon and rectum are involved, with the distal colon and rectum most severely affected, and inflammation involves continuous segments.
ulcerative colitis
disease caused by protein deficiency, occurs most frequently in children ages 1 to 3 years, because this age group requires a high protein intake.
Kwashiorkor,
Edema results from? in kwashiorkor
hypoproteinemia,
Because iodine is not supplemented in food except as iodized salt, a diet deficient in iodine may lead to either
hypothyroidism or overgrowth (goiter) of the thyroid
What medication is needed to correct the IRon deficiency.
Supplemental iodine or synthetic thyroxine (Synthroid)
