Pediatric GI dysfunction Flashcards
A parent comes into the ER with his newborn and is concerned because his baby is constantly spitting up after she eats and doesn’t understand why this would be happening. How do you educate this patient?
Newborns have a relaxed cardiac sphincter which will cause infants to have frequent regurgitation
A parent is wanting to make a routine for her child’s meals throughout the day, and she is wondering when it’s okay to start giving her child breakfast, lunch, and dinner each day. How would you respond to this patient?
By age 2 most children can tolerate up to 3 meals per day
A child is admitted to the ER due to GI issues. The nurses have been monitoring the child’s I’s and O’s for the past 24 hours and have noticed a significant imbalance in the amount of fluid that is ingested versus what is being excreted. What is being affected in this child? What may be altering this?
Water balance, which can be altered by disease states
A parent brings in her child to the doctor’s office and is worried that her child has not been having an adequate fluid intake. Her child is a 2 year old female and weighs 13kg. What would you recommend her child’s fluid intake should be?
1150 mL per day
A parent has become concerned that her child seems to be sweating a lot more than what she thinks her child should be sweating. How would you educate this patient?
Aside from urination, children’s insensible fluid loss primarily comes from sweat, so if a child is sweating a lot, this is pretty normal, (as long as the child is not experiencing any adverse symptoms and is adequately taking in fluids). Additionally, infants have 2 to 3 times higher BSA than adults, which creates more sweat as well.
Why would an infant be excreting more fluids than an adult would, given the same intake of fluid?
the BMR of an infant is higher which results in greater metabolic wastes excreted through the kidneys
Why is it important to educate parents on adequate fluid intake for an infant?
Infants have little fluid volume reserves when they become dehydrated, which makes them decompensate faster than older children and adults
What is the normal value for serum Na+? What does it mean if someone is hypotonic? And hypertonic?
130-150 mEq/L
Hypotonic means that electrolyte loss is exceeding water loss (<130)
Hypertonic means that water loss is exceeding electrolyte loss (>150)
If a patient presents to the ER with a BP of 98/67, HR of 140, absent tears and cool extremities, what would be the primary concern for this child?
dehydration
How is fluid volume restored in a child that is moderately dehydrated? And mildly dehydrated?
Mild and moderate dehydration are treated the same way, and this is with PO treatment, most likely to be done at home.
How is severe dehydration normally treated?
Potentially with PO but more likely IV fluids
A patient is presenting with uncontrollable vomiting, severe gastric distention, HR of 134 bpm and a BP of 100/70. What is the primary concern for this child? How would you treat this child?
Severe dehydration. Start an IV the be prepared to administer IV fluids
What is a leading cause of illness in children younger than 5 (usually it will resolve itself in 14 days and treatment is only required if dehydration occurs)?
Acute diarrhea
A parent brings his child into the hospital because for the past 15 days his 4 year old has been having diarrhea. What is this child experiencing?What are some topics that should be addressed to determine the cause of this?
Chronic diarrhea
Ask parent if the child has any food allergies, lactose intolerance, or an immunodeficiency.
What are some things that can cause chronic diarrhea in a child?
Food allergy, lactose intolerance, malabsorption syndromes, inflammatory bowel disease, immunodeficiency
A 4 year old patient presents to the ER because she has been having diarrhea for weeks now. Her mom doesn’t understand what is causing this. She says that her daughter has been making sure to drink lots of fluids and states that she normally drinks 5-7 cups of apple juice each day along with her water. What may the patient be presenting with? Why?
Chronic nonspecific diarrhea (CNSD) aka Toddler’s Diarrhea
It is linked to excessive intake of juices & sorbital
A patient has been diagnosed with diarrhea. What is important to educate this patient on? Why?
Hand washing
Most pathogens are spread by fecal-oral route and can come from contaminated foods/water or from person to person contact
What are two viruses that a child may have if he is experiencing diarrhea?
Rotovirus or norovirus
What are the different bacterias that may be found in the stool of a patient that is experiencing diarrhea?
E. coli
Salmonella
Shigella
Yersinia
Campylobacter
Cholerae
