Pediatric GI/GU Flashcards
Nephrotic Syndrome
most common kidney disease in children
-common in toddlers 2-5 yrs
**minimal change type
nephrotic syndrome s/s
massive proteinuria
hypoalbuminemia
edema
hyperlipidemia
nephrotic syndrome dx
urinalysis : proteinuria
labs :
-fibrinogen, aPTT, d-dimer increased
-hypoalbuminemia
-hyperlipidemia
renal US
nephrotic syndrome at high risk for…
- infection
- thromboembolism
- peritonitis
what to do if infection is suspected with nephrotic syndrome…
start broad spectrum abx as soon as possible
proteinuria causes
fever
dehydration
cold temp outside
overexertion
nephrotic syndrome interventions
- give O2
- IV fluids - 20 mL / kg
- IV diuretics
- IV abx
- corticosteroid - prednisone
- fluid restriction
- low sodium
nephrotic syndrome specific labs
Coags
CMP
UA
failure to thrive
-weight for age is <5th percentile
-weight decline that crosses multiple % lines on chart
FTT causes
-inadequate energy intake
-inadequate nutrition absorption
-neglect
organic FTT
chronic disease affecting digestion and absorption
nonorganic FTT
poor growth with no underlying diagnosis
FTT management goal
- Nutrition with appropriate weight gain
- weight gain and monitor labs (PreAlbumin)
- find cause and treat it!!!
- ensure parents are feeding correctly
PreAlbumin
normal is 20-40
appropriate weight gain
4-6 months = double birth weight
0-6 months = 5-7oz / week
FTT complications
- increased risk for short stature
- increase risk for heart disease
- increase risk for childhood disease
- affects brain development
what is the #1 cause that needs to be ruled out with FTT…
ABUSE , may order x-rays to check for harm
emergent FTT
- stabilize kid - rehydrate w/ dextrose
- feed however possible
- figure out what is causing it
- get family involved
- could admit - up to 2 weeks
**want to see weight gain before going home
short bowel syndrome
inefficient length of small intestines
**congenital, illness, traumatic
congenital SBS
intestinal problem baby is born with
-intestinal atresia / stenosis
-gastroschisis
-volvulus
-Hirschsprung’s disease
illness SBS
NECROTIZING ENTEROCOLITIS
-damages the intestines leading to holes or narrowing in intestines
traumatic SBS
includes injury to small bowel that requires removal
-crohn’s disease
-radiation enteritis
-vasculitis
-etc.
SBS s/s
abd pain
weight loss
dehydration
diarrhea
vomiting
mineral / vit deficiency
necrotizing enterocolitis
immature GI tract for premature infants put them at risk
-infection and inflammation
