Pediatric - GI Flashcards
Mild or severe diarrhea can lead too
Dehydration
What is acute diarrhea
Sudden increase in frequency and change in consistency of stool
What is acute diarrhea secondary to
Infectious agent in the G.I. tract, upper respiratory infection, urinary track infection, anabiotic used or laxative use
When does self resolution of diarrhea occur
Less than 14 days if dehydration does not occur
What is chronic diarrhea?
Increase in frequency and change of consistency of stools for more than 14 days
What is dehydration
Body fluid disturbance when output exceeds intake
Risk factors for diarrhea
Flag of normal elimination pattern, lack of clean water, poor hygiene, crowded, living environments, poor sanitation, nutritional definiency
What is Rotavirus
Most common cause of diarrhea in children younger than 5
What happens during rotavirus
Instead of watery stools
Diarrhea for 5 to 7 days
Vomiting for approximately two days
How do you get rotavirus?
Fecal oral transmission
What is the incubation period for Rotavirus
48 hours
What is yersinia enertcolitis
Bacterial infection
What happens when you get yersinia enertcolitis
Mucoid, possibly bloody diarrhea
Abdominal pain, fever, and vomiting
How do you get yersinia enertcolitis
Transmission through pets and food
Incubation period for yersinia enertcolitis
1-3 weeks
What is escherichia coli
Bacterial infection
What happens when you get escherichia coli
Watery diarrhea for one to two days followed by abdominal cramping in bloody diarrhea
Could lead to hemolytic uremic syndrome
Incubation period for escherichia coli
3-4 days
What is salmonella nontyphodial groups
Bacterial infection
What happens when you get salmonella nontyphodial groups
Mild to severe nausea, vomiting, abdominal cramping, bloody, diarrhea, and fever
Diarrhea can last 2 to 3 weeks
Possible, headache, confusion, seizures
Can lead to meningitis or septicemia
How do you get salmonella nontyphodial groups
Person-to-person, undercooked meat and poultry
Incubation period for salmonella nontyphodial groups
6-72 hours
What is clostridium diffiicile
Bacterial infection
Infection can occur from overgrowth of C. difficile following anabiotic therapy
What happens when you get clostridium diffiicile
Mild watery, diarrhea for a few days
Less severe and children than adults
How do you get clostridium diffiicile
Contact with colonized spores
What is clostridium botulinum
Bacterial infection
What happens when you get clostridium botulinum
Abdominal pain and cramping and diarrhea
Possible respiratory or CNS problems
How do you getclostridium botulinum
Transmission contaminated food products
Incubation period for clostridium botulinum
12 to 26 hours
What is shigella groups: Shigellosis
Bacterial infection
What happens when you get shigella groups: Shigellosis
Sick appearance
Fever, fatigue, and anorexia
Cramping abdomen, followed by watery or bloody diarrhea lasting 5 to 10 days
How do you get shigella groups: Shigellosis
Contaminated, food, or water
Incubation period for shigella groups: Shigellosis
1-7 days
What is Norwalk like organisms: caliciviruses
Viral infection
What happens when you get Norwalk like organisms: caliciviruses
Abdominal cramping, nausea, vomiting, malaise, watery, diarrhea
Last 2 to 3 days
How do you get Norwalk like organisms: caliciviruses
Contaminated water
Incubation period for Norwalk like organisms: caliciviruses
12-48 hours
What is staphylococcus?
Bacterial infection
What happens when you have staphylococcus?
Diarrhea, nausea, and vomiting
How do you get staphylococcus?
Inadequately cooked or refrigerated food
What is the incubation period for staphylococcus?
1-8 hr
What is enterobius vermicularis
Pinworm
Helminthic infection
What happens when you get pinworms?
Peroneal, itching, enuresis sleeplessness, restlessness, and irritability due to itching
What is the transmission is pinworm?
Fecal oral
What is pin worm
Enterobius vermicularis
Ingested or inhaled eggs hatch in the upper intestine in mature after mating worms migrated out of the intestine in like eggs eggs can survive 22 to 3 weeks on surfaces
What is giardia lamblia:
Parasitic pathogen
What happens when you get giardia lamblia:
Children five years or younger
Diarrhea, vomiting, anorexia
Older children
Abdominal cramps intermittent loose malodorous pale greasy stool
How do you get? giardia lamblia:
 Person-to-person food and animals
What does a tape test diagnose?
Enterobius vermicularis :pin worm
How do you perform a tape test?
Please transparent tape over the child’s anus at bedtime preferably after child is asleep
Caregiver should remove the tape just prior to the child awakening if possible prior to the child toileting her bathing
Diagnostic tools for diarrheal agents
Stool sample or stool culture
What should the nurse do if a patient has an acute infectious G.I. Issue
Daily weight
Avoid rectal temp
Monitor I & o
In what infectious G.I. issue do you administer antibiotics
Shigella
C. difficile
G lamblia
What a cute infectious G.I. issues. Should you avoid antibiotics
E. coli
Salmonella
What a cute G.I. infectious disorder should you avoid anti-motility agents
E. coli
Salmonella
Shigella
If a patient is dehydrated, what is the priority nursing action?
Start replacements with oral replacement solution
What is oral rehydration therapy and how do you use it?
Start replacement with oral replacement solution of 75 to 90 MEQ of sodium over four hours
Give ORS alternatively with intake of other liquids (breast, milk, formula)
Replace each diarrheal store with 10 mL per kilogram of ORS
What do you use Metronidazole for
C. difficile and g lamblia
What do you use mebendazole for
Enterobius vermicularis : pin worms
It’s a patient has pinworms. How should the family go about preventing them?
Entire family should be treated at the same time
If patient has a cute infectious G.I. issue, what should you educate them on?
Informing child school
Child should stay home during incubation. Period.
Fruits, carbonated, sodas, caffeine, chicken, or beef broth should be avoided
Provide skin care to print skin breakdown
If a patient in your house has acute G.I. infectious disorder. What should you be doing?
Change bed linens, and underwear daily for several days
Avoid shaking linens
Cleanse, toys
Avoid undercooked or under refrigerated food
Proper hand, hygiene
Do not share dishes and utensils,
Clip nails and discouraged, nailbiting 
What is isotonic dehydration?
Water and sodium are lost in nearly equal amounts
Result in hypovolemic shock
What is hypotonic dehydration?
Electrolyte loss is greater than water loss
Water changes from extra cellular fluid to intracellular fluid
What is hypertonic dehydration?
Water loss is greater than electrolyte loss
Fluid shifts from intracellular to extracellular
Check for neurological changes
What are manifestations of severe dehydration?
Weight loss greater than 10%
Capillary refill greater than four seconds
Dry, mucous membranes, tented skin
No tearing
Sunken anterior fontanelle
What is contraindicated in hypertonic dehydration
Rapid fluid replacement is contraindicated because of risk of cerebral edema
A nurse is caring for a child who has had watery diarrhea for the past three days which of the following is an action for the nurse to take
Offer chicken broth
Initiate oral rehydration therapy
Start hypertonic IV solution
Keep NPO until diarrhea subsides
Initiate oral rehydration therapy
A nurse is caring for a child who is suspected to have enterobius vermicularis which of the following action, should the nurse take?
Perform a tape test
Collect a stool specimen for culture
Tess the store for occulut blood 
Initiate IV fluids
Perform a tape test
The nurse is assessing a child who has rotavirus infection, which of the following are expected findings (select)
Fever
Vomiting
Watery stools
Bloody stools
Confusion
Fever
Vomiting
Watery stools
A nurse is teaching a group of parents about Salmonella, which of the following information should the nurse include in the teaching( select)
Incubation period is non-specific
It is a bacterial infection
Bloody diarrhea is common
Transmission can be from house pets
Antibiotics are used for treatment
It is a bacterial infection
Bloody diarrhea is common
Transmission can be from house pets
A nurse is teaching a group of caregivers about E. coli which of the following information should the nurse include in the teaching(select)
Severe abdominal cramping occurs
Watery diarrhea is present for more than five days
It can lead to hemolytic uremic syndrome
It is a foodborne pathogen
Antibiotics are given for treatment
Severe abdominal cramping occurs
It can lead to hemolytic uremic syndrome
It is a foodborne pathogen
What is a cleft lip?
Results from the incomplete fusion of the oral cavity during intrauterine life
What is a cleft palate?
Result from incomplete fusion of the pallets during interuterine life
Risk factor for cleft lip or palate
Other syndromes
History,
Exposure to alcohol, cigarette smoke, anticonvulsants, retinoids, or steroids during pregnancy
Folate deficiency during pregnancy 
Expected findings in a cleft lip
Visible separation from the upper lip towards the nose
Expected findings in a cleft palate
Physical or palpable opening of the pallet connecting the mouth in the nasal cavity
When does a cleft lip repair typically get done
Between 2 to 3 months of age
When does a cleft palate repair typically get done
Between 6 to 12 months of age
Most require second surgery
What are pre-operative nursing actions for a cleft lip or pallet repair
Inspect the lip and palate palpate using Gloved to palpate pellet
 Assess ability to suck
Observe interaction between Family 🏠 and infant
Assess ability to feed
For isolated cleft lip what strategies do you give for successful feeding
Encourage breast-feeding
Use white bass nipple for bottlefeeding
Squeezy infants cheeks together during the feeding to decrease the gap
For cleft palate or cleft lip and palate strategies for successful feeding
Possession in the infant upright, well cradling the head during the feeding
You specialize bottle with a one-way valve and especially cut nipple
Burp the infant frequently
Syringe feeding’s can be necessary
Post operative, nursing actions of a cleft lip or pallet repair
Keep infant pain-free to decrease crying and stress on repair
Assess site for manifestations of crusting bleeding an infection
Avoid having the infant suck on a nipple or pacifier
Avoid spoons and forks
Postoperative nursing actions for just a cleft lip
Monitor integrity of protective device to ensure proper positioning
Position the infant on the back and upright
Apply elbow restrains to keep the infant from entering the repair site
Use water or diluted hydrogen peroxide to clean incision site
Postoperative actions for just a cleft palate
Change the infants position frequently to facilitate drainage in breathing
Please infant inside lane position
Infant usually NPO for four hours, then allowed liquids for only the first 3 to 4 days
Avoid placing a straw tongue, depressor hard pacifier in mouth
How should you place s feeding an infant, who has ear infection or hearing loss
Feed infant an upright position
What is GER
Gastric contents reflux, back up into the esophagus, making esophageal mucosa vulnerable to injury from gastric acid
What is GERD
Tissue damage from GER
Risk factors for GER
Prematurity, neurological impairment, asthma, cystic fibrosis, cerebral palsy, scoliosis
Risk factors for Gerd
Neurological impairment, hiatal, hernia, morbid obesity
Expected findings for an infant with Gerd
Spitting up or forcefully vomiting
Excessive crying
Blood in vomit us
Arcing of back
Stiffening
Failure to thrive
Expected findings with a child with Gerd
Heartburn
Abdominal pain
Difficulty swallowing
Chronic cough
Chest pain
Diagnostic procedure for Gerd
Upper G.I. endoscopy
Nursing care for Gerd
Small, frequent meals
Thicken infant formula,
Avoid foods that cause reflux
Position the child with head elevated after meals
Place child supine to sleep rather than prone
Administer protein pump, inhibitor, or H2 receptor 
What is a Nissan fundoplication
Laparoscopic surgical procedure, that reps the fundus of the stomach around the distal, esophagus to decrease reflux
What is hypertrophic pyloric stenosis?
Thickening of the pyloric sphincter, which creates an obstruction
Usually occurs in the first few weeks of life
Expected, finding in hypertrophic pyloric stenosis
Vomiting that occurs following a feeding, but can occur after several hours after feeding
Projectile vomiting as obstruction worsens
Constant hunger
Olive shaped mass in right upper quadrant
Failure to gain weight
A patient with hypertrophic pyloric stenosis requires what to get rid of it
Surgery
What is a pyloromyotomy
Laparoscopic surgery for hyper trophic pyloric stenosis
Preoperative nursing actions for hypertropic pyloric stenosis
NG tube for decompression
NPO
Daily weight
Postoperative nursing actions for hypertrophic pyloric stenosis
Start clear liquids 4 to 6 hours after surgery advanced breastmilk or formula is tolerate a 24 hours after surgery
What is Hirschsprung’s disease
Congenital a ganglionic megacolon
Structural anomaly of the G.I. tract caused by lack of ganglionic cells in segments of the colon resulting in decrease motility in mechanical obstruction
Expected findings in a newborn with Hirschsprung’s disease
Failure to pass meconium with 24 to 48 hours after birth
Vomiting bile
Refusal to eat
Abdominal distention
Expected findings in an infant with Hirschsprung’s disease
Failure to thrive
Constipation
Vomiting
Episodes of diarrhea
Expected findings in a child with Hirschsprung’s disease
Under nourished anemic appearance
Abdominal distention
Visible peristalsis
Palpable fecal mass
Foul smelling ribbon like stool
Diagnostic procedure Hirschsprung’s disease
Recto biopsy to confirm the absence of ganglion cells
What would the nurse do caring for a patient who has Hirschsprung’s disease
Prepare Family 🏠 for surgery
High protein, high, calorie, low fiber, diet
What happens in surgery of? Hirschsprung’s disease
Removal of the aganglionic section of the bowel
Temporary colostomy can be required
Preoperative nursing actions for Hirschsprung’s disease
Administer electrolyte in fluid replacement
Monitor for enterocolitis
Bowel prep with saline enema
Postoperative, nursing action Hirschsprung’s disease
Provide Foley catheter care
Assess bowel sounds
Provide ostomy care
Observer manifestation of dehydration
What is entrocolitis
Inflammation of the bowel
What do you do if your patient has entercolitis
Excessive abdominal girth
Prevent bowel perforation
Resolve inflammation
What is intussusception?
Proximal segment of the Paul telescopes into a more distal segment, resulting in lymphatic and Venus obstruction, causing edema in the area
With progression is, she gave me up and increase mucus into intestine will occur
What would you find with a patient who has intussusception
Sudden episodic, abdominal pain
Screaming, with drawing needs to chest
Abdominal mass sausage shaped
Stools mixed with blood and mucus that resemble the consistency of red currant jelly
What do you do for a patient who has intussusception?
NG tube for decompression
Air enema
Surgery is required for reoccurring cases
What is appendicitis?
Inflammation of the appendix
Caused from an obstruction of the lumen
What do you find in a patient who has appendicitis?
Pain in the right lower quadrant
Richard abdomen
Decreased or absent bowel sounds
Shallow breathing
Possible, vomiting
What will the nurse do for a patient who has purse appendicitis
Prepare for surgery
Avoid applying heat to abdomen
Avoid enemas or laxatives
What kind of surgery do you receive for a non-ruptured appendix
Laparoscopic surgery
What kind of surgery do you receive for a ruptured appendix?
Open surgery
What does it mean if you have a sudden relief from pain after perforation followed by a diffuse increase in pain
you have peritonitis your appendix burst
What is peritonitis?
Inflammation in the peritoneal cavity
What is postoperative nursing actions after appendicitis?
Maintain NPO assessed for peritonitis early ambulation
What is meckels diverticulum
Complication resulting from failure of the omphalomesentric duct to fuse during the embryonic development
What is expected finding in Meckel’s diverticulum
Rectal bleeding, usually painless
Abdominal pain
Bloody mucus tools
What is a therapeutic procedure, for Meckels diverticulum
Surgical removal of the diverticulum
What should you watch closely for in Meckel’s diverticulum after surgery
Blood loss and stools
G.I. hemorrhage in bowel obstructions can occur
A nurse is assessing an infant who has hyper trophic pyloric stenosis, which of the following manifestations with the nurse expect (select)
Projectile vomiting
Dry, mucous membranes
Currant, jelly stools
Sausage shaped abdominal mass
Constant hunger
Projectile vomiting
Dry, mucous membranes
Constant hunger
A nurse is caring for a child who has Hirschsprung’s disease which of the following action should the nurse take?
Encourage high-fiber, low protein, low calorie diet
Prepare the family for surgery
Place an NG tube for decompression
Initiate bedrest
Prepare the family for surgery
A nurse is caring for an infant who has just returned from the PACU filing a cleft lip and palate repair which of the following action should the nurse take
Remove the packing in the mouth
Place the infant in an upright position
Offer a pacifier with sucrose
Assess the mouth with the tongue blade
Place the infant in an upright position
A nurse is caring for a child who has Meckel’s diverticulum which of the following manifestations should the expect (select)
Abdominal pain
Fever
Mucus and blood in stools
Vomiting
Rapid shallow, breathing
Abdominal pain
Mucus and blood in stools
A nurse is teaching a parent of an infant about gastrointestinal reflux disease, which of the following should the nurse include in the teaching Offer frequent feedings
Thicken formula with rice cereal
Use a bottle with one-way valve
Position baby upright after feedings
Use a wide base nipple for feedings
Offer frequent feedings
Thicken formula with rice cereal
Position baby upright after feedings
