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Critical Care Pediatics > Pediatric GI/GU > Flashcards

Pediatric GI/GU Flashcards

1
Q

Nephrotic Syndrome

A

most common kidney disease in children
-common in toddlers 2-5 yrs

**minimal change type

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2
Q

nephrotic syndrome s/s

A

massive proteinuria
hypoalbuminemia
edema
hyperlipidemia

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3
Q

nephrotic syndrome dx

A

urinalysis : proteinuria
labs :
-fibrinogen, aPTT, d-dimer increased
-hypoalbuminemia
-hyperlipidemia
renal US

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4
Q

nephrotic syndrome at high risk for…

A
  1. infection
  2. thromboembolism
  3. peritonitis
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5
Q

what to do if infection is suspected with nephrotic syndrome…

A

start broad spectrum abx as soon as possible

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6
Q

proteinuria causes

A

fever
dehydration
cold temp outside
overexertion

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7
Q

nephrotic syndrome interventions

A
  1. give O2
  2. IV fluids - 20 mL / kg
  3. IV diuretics
  4. IV abx
  5. corticosteroid - prednisone
  6. fluid restriction
  7. low sodium
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8
Q

nephrotic syndrome specific labs

A

Coags
CMP
UA

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9
Q

failure to thrive

A

-weight for age is <5th percentile
-weight decline that crosses multiple % lines on chart

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10
Q

FTT causes

A

-inadequate energy intake
-inadequate nutrition absorption
-neglect

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11
Q

organic FTT

A

chronic disease affecting digestion and absorption

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12
Q

nonorganic FTT

A

poor growth with no underlying diagnosis

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13
Q

FTT management goal

A
  1. Nutrition with appropriate weight gain
  2. weight gain and monitor labs (PreAlbumin)
  3. find cause and treat it!!!
  4. ensure parents are feeding correctly
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14
Q

PreAlbumin

A

normal is 20-40

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15
Q

appropriate weight gain

A

4-6 months = double birth weight

0-6 months = 5-7oz / week

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16
Q

FTT complications

A
  1. increased risk for short stature
  2. increase risk for heart disease
  3. increase risk for childhood disease
  4. affects brain development
17
Q

what is the #1 cause that needs to be ruled out with FTT…

A

ABUSE , may order x-rays to check for harm

18
Q

emergent FTT

A
  1. stabilize kid - rehydrate w/ dextrose
  2. feed however possible
  3. figure out what is causing it
  4. get family involved
  5. could admit - up to 2 weeks

**want to see weight gain before going home

19
Q

short bowel syndrome

A

inefficient length of small intestines

**congenital, illness, traumatic

20
Q

congenital SBS

A

intestinal problem baby is born with

-intestinal atresia / stenosis
-gastroschisis
-volvulus
-Hirschsprung’s disease

21
Q

illness SBS

A

NECROTIZING ENTEROCOLITIS
-damages the intestines leading to holes or narrowing in intestines

22
Q

traumatic SBS

A

includes injury to small bowel that requires removal

-crohn’s disease
-radiation enteritis
-vasculitis
-etc.

23
Q

SBS s/s

A

abd pain
weight loss
dehydration
diarrhea
vomiting
mineral / vit deficiency

24
Q

necrotizing enterocolitis

A

immature GI tract for premature infants put them at risk

-infection and inflammation

25
Q

immature gut factors

A
  1. decrease blood circulation
  2. decrease digestion
  3. lack of adequate structural barrier to bacteria
  4. decrease secretion of biochemical defenses
26
Q

NEC / SBS dx

A

abdominal x-ray
endoscopy / colonoscopy
barium swallow

27
Q

parenteral feeding

A

via IV / CVC
-TPN and lipids

28
Q

enteral feeding

A

via NG / OG / J tube
-formula

29
Q

celiac disease

A

gluten activates an immune response attacking small intestine

30
Q

celiac foods to avoid…

A

barely
oats
rye
wheat
maltodextran
gluten!!!

31
Q

celiac physical presentation

A

thin extremities
weight loss
foul smelling stool
dental impairments
short stature
delayed puberty

32
Q

celiac dx

A

endoscopy / labs / diet change

**HAVE endoscopy done BEOFRE diet changes

33
Q

celiac crisis

A

IV rehydration
endoscopy : NPO , consent, IV
-family teaching
-dietician referral

34
Q

obesity risk for…

A

heart disease
-uncontrolled HTN and development of diabetes

35
Q

obesity family support

A

role models of healthy eating
medication management
-peer influence
-healthy snacks

36
Q

good eating habits

A

-no eating in front of TV
-decrease screen time –> promotes movement
-no skipping meals
-provide choices
-nutrition referral –> creates plan together

Critical Care Pediatics (4 decks)

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