Nursing Care of a Child With Gastrointestinal Disorder

Question 1

Common diagnostic procedures include in GI

Answer 1

fiberoptic endoscopy
colonoscopy, and
barium enema.

Question 2

Fluid Balance

adult-infants-children

Answer 2

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;

Question 3

interstitial and the intravascular fluid together are often referred to as

Answer 3

extracellular fluid (ECF),

Question 4

In infants, the extracellular portion is much greater, totaling up to

Answer 4

45% of total body weight.

Question 5

ECF in n young children, this amount is

Answer 5

30%

Question 6

ECF in adolescents

Answer 6

25%

Question 7

Fluid is distributed in three body compartments:

Answer 7

intracellular (within cells), 35% to 40%
interstitial (surrounding cells and bloodstream), 20% of body weight; and
(c) intravascular (blood plasma), 5% of body weight.

Question 8

treatment for vomiting is to

Answer 8

withhold food from the stomach for a time

Question 9

To decrease vomiting, withhold food and fluid for a time (nothing by mouth [NPO]) for how many hours?

Answer 9

period of 3 to 6 hours

Question 10

World Health Organization provides a home recipe for fluid rehydration

Answer 10

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.

Question 11

most common viral pathogens that invade the GI tract include

Answer 11

rotaviruses and adenoviruses

Question 12

most common bacterial pathogens include

Answer 12

Campylobacter jejuni, Salmonella, Giardia lamblia, and Clostridium difficile

Question 13

All children with severe diarrhea or diarrhea that persists longer than 24 hours should have a

Answer 13

stool culture taken so definite antibiotic therapy can be prescribed.

Question 14

For a child who will not drink, an IV solution such as

Answer 14

normal saline or 5% glucose in normal saline is begun

Question 15

Salmonella bacteria

Incubation period:

Answer 15

6 to 72 hours for intraluminal type; 7 to 14 days for extraluminal type

Question 16

Listeria monocytogenes

Incubation period:

Answer 16

1 day to more than 3 weeks

Question 17

Bacterial infection of diarrhea (3)

Answer 17

Salmonella
Shigella
Listeria

Question 18

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.

Answer 18

Gastroesophageal Reflux in Infant

Question 19

used to measure the strength of the esophageal sphincter

Answer 19

Esophageal manometry

Question 20

traditional treatment of GI reflux is to

Answer 20

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

Question 21

Irritation to the esophagus occurs when stomach contents, including hydrochloric acid, reflux through the lower esophageal sphincter and irritate the esophageal lining.

Answer 21

Gastroesophageal reflux disease (GERD)

Question 22

the opening between the lower portion of the stomach and the beginning portion of the intestine, the duodenum.

Answer 22

pyloric sphincter

Question 23

hypertrophy or hyperplasia of the muscle surrounding the sphincter occurs, it is difficult for the stomach to empty, a condition called

Answer 23

pyloric stenosis

Question 24

The vomiting grows increasingly forceful until it is projectile, possibly projecting as much (pyloric stenosis) feet?

Answer 24

3-4 feet

Question 24

The vomiting grows increasingly forceful until it is projectile, possibly projecting as much (pyloric stenosis) feet?

Answer 24

3-4 feet

Question 25

pyloric stenosis diagnosis?

Answer 25

begins at 6 week of age Projectile vomiting Immediate after eating

Question 26

treatment for pyloric stenosis

Answer 26

surgical or laparoscopic correction (a pyloromyotomy),

Question 27

intermittent protrusion of the stomach up through the esophageal opening in the diaphragm.

Answer 27

Hiatal hernia

Question 28

Hiatal hernia is diagnosed by

Answer 28

history and an ultrasound or barium swallow.

Question 29

shallow excavation formed in the mucosal wall of the stomach, the pylorus, or the duodenum.

Answer 29

peptic ulcer

Question 30

the most reliable diagnostic test to confirm the diagnosis of peptic ulcer disease

Answer 30

Fiberoptic endoscopy

Question 31

Adolescents are prescribed an antibiotic such as for peptic ulcer

Answer 31

amoxicillin or clarithromycin (Biaxin) and a proton pump inhibitor such as omeprazole (Prilosec).

Question 32

Younger children are prescribed for pepetic ulcer?

Answer 32

cimetidine (Tagamet) because safe levels of omeprazole

Question 33

Mode of transmission: In children, of hepatitis A

Answer 33

ingestion of fecally contaminated water or shellfish; day care center spread from contaminated changing tables

Question 34

immunity for hepa A

Answer 34

HAV vaccine (recommended for all children 12 to 23 months of age and workers in day care centers)

Question 35

DNA virus, 120 days average of incubation period Mode of transmission: Transfusion of contaminated blood and plasma or semen;

Answer 35

Hepatitis B

Question 36

single-strand RNA virus. Transmission, as with HBV, is primarily by blood or blood products, IV drug use, or sexual contact.

Answer 36

Hepatitis C (HCV)

Question 37

hepatitis is enterically transmitted similarly to hepatitis A (fecally contaminated water).

Answer 37

Hepatitis E

Question 38

All hepatitis viruses cause liver cell destruction, leading to increased

Answer 38

serum aspartate amino transaminase (AST), alanine aminotransaminase (ALT), and alkaline phosphatase levels.

Question 39

Symptoms of hepatitis B are more marked. Children report generalized aching, in what location?

Answer 39

right upper quadrant pain, and headache.

Question 40

means “yellow,” or the typical color of hepatic scar tissue.

Answer 40

Cirrhosis

Question 41

a frequent complication of liver disorders such as cirrhosis

Answer 41

Esophageal varices

Question 42

Liver transplantation requires a wide

Answer 42

subcostal incision. The vena cava is temporarily clamped during the removal of the natural liver to prevent bleeding,

Question 43

Postoperative care for liver transplant

Answer 43

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

Question 44

is the most common cause of abdominal surgery in children

Answer 44

Appendix

Question 45

point of sharpest pain is often one third of the way between the anterior superior iliac crest and the umbilicus

Answer 45

McBurney’s point

Question 46

In embryonic life, the intestine is attached to the umbilicus by the omphalomesenteric (vitelline) duct.

Answer 46

Meckel’s Diverticulum

Question 47

bnormal immunologic response to protein, particularly the gluten factor of protein found in grains—wheat, rye, oats, and barley.

Answer 47

Celiac Disease (Malabsorption Syndrome; Gluten-Induced Enteropathy)

Question 48

Treatment for celiac disease

Answer 48

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.

Question 49

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

Answer 49

Inguinal hernia

Question 50

Treatment of inguinal hernia

Answer 50

laparoscopy surgery. The bowel is returned to the abdominal cavity and retained there by sealing the inguinal ring.

Question 51

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

Answer 51

Hirschsprung’s disease, or aganglionic megacolon,

Question 52

Two conditions are categorized as inflammatory bowel disease:

Answer 52

ulcerative colitis and Crohn’s disease

Question 53

inflammation of segments of the intestine; it may affect any part of the GI tract but most commonly involves the terminal ileum.

Answer 53

Crohn’s disease

Question 54

typically the colon and rectum are involved, with the distal colon and rectum most severely affected, and inflammation involves continuous segments.

Answer 54

ulcerative colitis

Question 55

disease caused by protein deficiency, occurs most frequently in children ages 1 to 3 years, because this age group requires a high protein intake.

Answer 55

Kwashiorkor,

Question 56

Edema results from? in kwashiorkor

Answer 56

hypoproteinemia,

Question 57

Because iodine is not supplemented in food except as iodized salt, a diet deficient in iodine may lead to either

Answer 57

hypothyroidism or overgrowth (goiter) of the thyroid

Question 58

What medication is needed to correct the IRon deficiency.

Answer 58

Supplemental iodine or synthetic thyroxine (Synthroid)