part 6

Question 1

What can we tell parents to do in order to keep the baby from forgetting how to eat if they are NPO for months before repair of tracheoesophageal fistula or atresia?

Answer 1

using a pacifier

Question 2

• occurs when the circular areas of muscle surrounding the pylorus hypertrophy
• results in stenosis of the passage between the stomach and duodenum, partially obstructing the lumen of the stomach
• lumne becomes enflamed and edematous, which narrows the opening until the obstruction becomes complete
• cause unknown
• symptoms occur 2 to 4 weeks after birth

Answer 2

obstructive disorders: hypertrophic pyloric stenosis

Question 3

What is a prominent manifestation of obstructive disorders: hypertrophic pyloric stenosis?

Answer 3

projectile vomiting
-Other:
visible peristalsis
resp distress

Question 4

What are the diagnostic evaluations for obstructive disorders: hypertrophic pyloric stenosis?

Answer 4

ultrasound
upper GI series
labs (metabolic alkalosis, elevated pH and bicarb)
low Na, K, chloride

Question 5

What are the 2 types of surgery for obstructive disorders: hypertrophic pyloric stenosis?

Answer 5

pylorotomy: incision of the pyloric submucosa to relieve hypertrophic stenosis
or
pyloromyotomy: an incision and suture of the pyloric sphincter

Question 6

When do feedings begin post op surgery for obstructive disorders: hypertrophic pyloric stenosis?

Answer 6

• feedings begin 4-6 hours post op (water)
• document how feedings are tolerated
• if water is retained formula or breast milk for 24 hours after surgery
• some vomiting may occur up to 48 hours after surgery

Question 7

• telescoping of one portion of the intestine into another
• typically occurs from age 3 months to 3 years
• invagination of a section of the intestine into the distal bowel that causes bowel obstruction

Answer 7

intussusception

Question 8

What is a prominent manifestation of intussusception?

Answer 8

• currant jelly stool: decreased ability to pass stool causes mucous and blood with stool
• abd pain
• lethargy

Question 9

How can you attempt to reduce intussusception?

Answer 9

barium or air enema

-if unsuccessful abdominal surgery or laparoscopy

Question 10

• inadequate growth - often multifactorial

- below the 5th percentile

Answer 10

failure to thrive (FTT)

Question 11

• inadequate caloric intake
• inadequate absorption
• excessive caloric expenditure

Answer 11

failure to thrive (FTT)

Question 12

What are the clinical manifestations of failure to thrive?

Answer 12

• no fear of strangers (too exhausted)
• withdrawn
• growth failure