Pedi GI Disorders Flashcards
Acute GI Disorders
Risk Factors
Lack of clean water poor hygiene crowded living environments poor sanitation nutritional deficiency
Acute GI Disorders
Rotavirus
Manifestations
most common cause of diarrhea in children less than 5
fever
foul-smelling, watery stools, diarrhea for 5-7 days
vomiting 2 days
Acute GI Disorders
Rotavirus
Transmission/incubation
fecal-oral
48 hr
Acute GI Disorders
E-coli
Manifestations
watery diarrhea 1-2 days, then abdominal cramping and bloody diarrhea
could lead to hemolytic uremic syndrom (HUS)
Acute GI Disorders
E-coli
Transmission/incubation
depends on strain
3-4 days
Acute GI Disorders
Enterobius vermicularis
pinworm
Manifestations
perianal itching enuresis sleeplessness restlessness irritability due to itching
Acute GI Disorders
Enterobius vermicularis
pinworm
Transmission/incubation
fecal-oral
ingested/inhaled eggs hatch in upper intestine and mature, after mating worms migrate out of intestine and lay eggs
eggs can survive 2-3 weeks on surfaces
Acute GI Disorders
Rotavirus
Diagnostics
enzyme immunoassay (stool sample)
Acute GI Disorders
E-coli
Diagnostics
Sorbitol-MacConkey agar (stool sample)
Acute GI Disorders
Enterobius vermicularis
pinworm
Diagnostics
tape test
transparent tape over anus at night, removed first thing in morning
Acute GI Disorders
E. coli
Nursing Care
avoid antibiotics
avoid antimotility
Acute GI Disorders
Enterobius vermicularis
pinworm
Medications
Mebendazole (for children over 2)
albendazole
pyrantel pamoate
admin in single dose, may need to repeat in 2 weeks
treat the whole family
Acute GI Disorders
Diarrhea
Client Education - Foods to avoid
AVOID: fruit juices sodas gelatin caffeine chicken/beef broth BRAT diet
GI structural Disorders
Cleft Lip and Palate
Risk Factors
other syndromes
family hx
exposure to alcohol, cigarette smoke, anticonvulsants, steroids during pregnancy
folate deficiency during pregnancy
GI structural Disorders
Cleft Lip
Surgical
2-3 mos old
infant should be at least 10 weeks old, weight 10lb, Hgb 10g/dL
GI structural Disorders
Cleft Palate
Surgical
most require 2nd surgery
6-12 mos old
GI structural Disorders
Cleft Palate
Complications
ear infections/hearing loss
speech and language impairment
dental problems
GI Infammatory Disorders
GER
gastric contents reflux back into esophagus = GERD
GER usually resolves by 1 year of age
GI Infammatory Disorders
GER
Risk Factors
GER - prematurity, bronchopulmonary dysplasia, neurological impairments, asthma, cystic fibrosis, cerebral palsy, scoliosis
GI Infammatory Disorders
GER
Manifestations
Infants: excessive spitting up forceful vomiting irritability excessive crying blood in stool or vomitus arching of back stiffening respiratory problems failure to thrive apnea
Children: heartburn abdominal pain difficulty swallowing chronic cough chest pain
GI Infammatory Disorders
GER
Diagnostic Procedures
upper GI
24-hr intraesophageal pH study - measure amount of gastric acid reflux into esophagus
endoscopy with biopsy - detect esophagitis and strictures
scintigraphy - identify cause of gastric content aspiration
GI Infammatory Disorders
GER
Nursing Care
Offer small frequent meals
Thicken formula
Avoid caffeine, citrus, peppermint, spicy or fried food
HOB elevated 30 degrees for 1 hr after meals
GI Infammatory Disorders
GERD
Nursing Care
Offer small frequent meals
Thicken formula
Avoid caffeine, citrus, peppermint, spicy or fried food
HOB elevated 30 degrees for 1 hr after meals
AND…
administer a proton pump inhibitor such as omeprazole or H2-receptor antagonist ranitidine
GI Infammatory Disorders
GERD
Surgical
Nissen fundoplication
laparoscopic surgical procedure - wraps fundus of stomach around distal esophagus to decrease reflux
GI Disorders
Hypertrophic Pyloric Stenosis
thickening of pyloric sphincter creating obstruction
usually occurs by first 5 weeks of life
GI Disorders
Hypertrophic Pyloric Stenosis
Manifestations
vomiting after feeding
blood-tinged vomit
constant hunger
olive-shaped mass in right upper quadrant of abdomen, possible peristaltic wave that moves left-right when lying supine
failure to gain weight and signs of dehydration (dry/pale skin, cool lips, dry mucous membranes, decreased skin turgor, diminished urinary output, concentrated urine, thirst, rapid pulse, sunken eyes)
GI Disorders
Hirschsprung Disease
lack of ganglionic cells in segments of colon = decreased motility and mechanical obstruction
GI Disorders
Hirschsprung Disease
Manifestations
Newborn: failure to pass meconium within 24-48 hr after birth; episodes of vomiting bile; refusal to eat; abdominal distention
Infant: failure to thrive; abdominal distention; vomiting; episodes of constipation and watery diarrhea
Older child: failure to thrive; abdominal distention; visible peristalsis; palpable fecal mass; constipation; FOUL-SMELLING RIBBONLIKE STOOL
GI Disorders
Intussusception
Intestines telescopes into itself = lymphatic and venous obstruction = edema in area = ischemia and increased mucus into intestine
common in 3 months to 3 years
GI Disorders
Intussusception
Manifestations
sudden episodic abdominal pain screaming with drawing knees to chest abdominal mass (sausage-shaped)*** stools mixed with blood and mucous=red currant jelly vomiting fever dehydration
GI Disorders
Appendicitis
inflammation of vermiform appendix caused from obstruction of lumen of appendix
average age is 10 years
GI Disorders
Appendicitis
Diagnostics
CT scan
