nutrition and elimination Flashcards
pediatric anatomy of GI
weaker esophageal sphincter
immature digestion
high risk infection via mouth
shorter esophagus
20 teeth - affects ability to break down food
absorption
slower in children - need more nutrients
organs in charge of absorption
large and small intestines
small intestines - bigger+longer/wider
liver
produces bile, digestion of fats
GER
regurgitation of gastric contents into esophagus
s/s of GER
spitting up
vomiting
heartburn
abdominal pain
dysphagia
recurrent pneumonia
weight loss
excessive crying
GERD
esophageal tissue damage due to low pH of gastric acid
s/s GERD
failure to gain weight
irritable
nausea
chest pain
tooth erosion
respiratory complications: bronchospasm
pneumonia
wheezing
nursing interventions of GER
thicken feedings
elevate HOB
smaller more frequent feedings
burp frequently
histamine blockers and PPI - lowers amount of stomach acid
nursing interventions of GERD
surgical intervention
gastric fundus wrapped around distal esophagus structure to create anti- reflex
cleft lip and palate pre op
clean mouth and nose after feeding
keep chin tucked to inhibit swallowing
keep suction equipment available
promote family child bonding and attachment
cleft lip and palate post op
elbow restraints
positioning - never on abd.
weigh daily
pain management - acetaminophen
elevate HOB
reposition q2hrs
prevent crying and sucking
Hirschsprung disease
lack of nerve cells in lower part of colon, blockage of stools
s/s Hirschsprung disease
monitor for first stool
(ribbon-like foul smelling stool)
poor feedings
poor weight gain
constipation
abdominal distention
management of hirschsprung disease
X-ray
usually involves surgery procedure or temporary colostomy
NG suction
measure I/Os, IVFs
assess bowel function
ostomy care
appendicitis
inflammation of appendix in RLQ
emergent surgery
sudden symptoms
pregnancy test to rule out ectopic pregnancy
s/s appendicitis
sudden symptoms
abdominal pain
rebound tenderness right side of belly button
rapid shallow breathing/ tachycardia
rigid abdomen, guarding
constipation
pyloric stenosis
stomach is blocked and food doesnt empty into duodenum
s/s pyloric stenosis
projectile nonbilious vomiting
dehydration
metabolic alkalosis
no evidence of pain
pt seems hungry - never gets full
hyperactive bowel sounds
pyloric stenosis management
fixed surgically
transition feedings
daily weights
restore hydration
NPO
small frequent feedings (pedialyte w/in 4-6hrs)
intussusception
intestinal obstruction
part of bowel is moving back into intestines
can cause severe edema and cut off blood supply- ischemia and tissue death in bowel
management of intussusception
ultrasound
air enema - pneumoenema
surgery
s/s intussusception
acute sudden abdominal pain
edema
bloody stools
dehydration
tachycardia/respiratory distress
cycles of sudden pain
red currant jellylike stool(no feces)
vomiting (billious)
hypotonic dehydration
greater loss of sodium than water
manifestations of dehydration
dry oral mucosa and skin
poor skin turgor
decreased urine output
sunken fontanelles
hypertonic dehydration
greater loss of water than sodium
isotonic dehydration
equal loss of water and sodium
calculate % of dehydration
preillness wt * sick wt /healthy wt *100 = ___%
severe dehydration clinical signs
increased pulses
deep and rapid RR
hyperirritable
intense thirst
moderate dehydration clinical signs
slight increased pulse
slight tachypnea RR
dry mucosa
decreased urine
oral rehydration
replaces fluid loss from vomiting an diarrhea in mild to moderate dehydration
pedialyte type fluids-
no jello, no caffeine, no broth
no BRAT diet- banana, rice, apple, tea/toast
daily maintenance fluid requirements math
100mL * 1st 10kg wt
50mL * 2nd 10kg wt
20mL * remaining wt
