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Pediatrics > Pediatrics Test 2: GI Disorders > Flashcards

Pediatrics Test 2: GI Disorders Flashcards

0
Q

What is dehydration

A

Output of fluids exceeds the intake of fluid

Enequal fluid balance

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1
Q

What Is the primary symptom of pyloric stenosis

A

Projectile vomiting

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2
Q

What are some causes of dehydration

A

Diane that causes insensible loss through skin and respiratory tract
Increased renal excretion: high output kidney failure
Increase loss in GI tract: vomit and diarrhea
Diabetic ketoacidosis
Extensive burns
Shock
Tachycardia
Radiant Warmers
Phototherapy
Diabetes insipidus

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3
Q

How much fluid do we need to stay healthy

A

Important for baseline data

Weight 1-10 kg there is 100mL/kg

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4
Q

Why are infants at greater risk

A

Longer GI tract relative to body size
Greater body surface
Higher metabolic rate
Less able to concentrate urine

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5
Q

What are some clinical manifestations to dehydration

A 
Weight loss
Poor skin turgor 
Dry mucous membrane
Absent tearing and salivation
Sunken fontanel
Tachycardia
Rapid respirations
Irritable to lethargic
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6
Q

Extent of dehydration

A

Look at the slide

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7
Q

Fluid volume deficiet outcomes

A 
Moist mucous membranes
Sodium and potassium elevated
Capillary refill of 2 seconds or less
Skin turgor brisk
Fluid I & O balanced 
Voiding >1 mL/kg/hr
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8
Q

Oral hydration management

A

Mild dehydration: 50ml/kg over 4-6 hours
Moderate dehydration: 100ml/kg over 4-6 hours
Solution addresses electrolyte needs
Don’t want too much glucose because it will push fluid loss
Introduce fluid loss in 24 hours

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9
Q

Predisposing factors to diarrhea

A

Virus is big in daycare
Hand washing and sanitation: in fields and food packing area
Recent travel and hiking
Recent antibiotic use

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10
Q

What are the diarrhea bacterial agents

A 
E. Coli
Salmonella
Shigella
Campylobacter jejuni
Clostridium difficile
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11
Q

E. Coli reasons

A

Food borne
Watery
Abdominal cramps
Common in summer

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12
Q

Salmonella

A

Person to person or food borne
With children often transmitted from pet
Common in summer
Loose, slime, green, seldom bloody, rotten egg smell

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13
Q

Shigella

A

Most common less than 9 years
Appears very sick
Watery yellow green stool, blood with mucous

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14
Q

Campylobacter jejuni

A

Contaminated food and pets
Peak in less than 1 year
Watery and foul smelling, profuse diarrhea

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15
Q

Clostridium difficile

A

Alterations in normal flora
1-3 day incubation
Most mild watery diarrhea and can progress to extreme illness with high fever and prolonged diarrhea

16
Q

Diarrhea parasitic agents

A

Entamoeba histolytica

Giardia lambs: most common intestinal parasite
- bloating and flatulence with loose greasy stool

17
Q

Constipation causes

A

Passage of infrequent hard stools due to defects

Functional (inorganic): no underlying cause, can be gene
Organic: strictures, Hirschsprungs
Drugs: antacids, diruetics, opioids, iron, antihistamines
Metabolic: hypothyroidism, hypercalcemia, lead poisoning
Neuromuscular: spinal cord lesions
Psychiatric: stool holding, anorexia

18
Q

Nursing measures for constipation

A

Increase fluids
Give smaller goals to accomplish
Increase fiber intake

19
Q

Hirschsprungs disease

A

No peristolsis in bowel

Continuous smooth muscle spasm

20
Q

Clinical manifestations of Hirschsprungs disease

A

Neonatal: failure to pass meconium, bilious vomiting, poor feeding
Later: chronic constipation, ribbon like foul smelling stool

21
Q

Physical findings of Hirschsprungs

A

Enlarged distended abdomen
Palate fecal matter
Empty rectal ampulla
Visible peristalsis

22
Q

Treatment for Hirschsprungs

A

Resection of aganglionic segment
May have temporary colostomy before pull, through reanastomosis at rectum
Let family know it is temporary

23
Q

Nursing measures for Hirschsprungs

A

Help patient adjust to congenital defects
Foster parent-infant bonding
Prepare them for medical and surgical interventions
Assists with colostomy care

24
Q

What is gastroesophageal reflux

A

Flow of gastric content in esophagus as result of neuromuscular failure of lower esophageal sphincter
Becomes GERD is there symptoms or tissue damage from reflux-failure to thrive, bleeding, pneumonia
Apnea second to GERD

25
Q

Clinical manifestations of GERD

A 
Regurgitation - spitting up
Excessive crying
Weight loss
Esophagitis - heartburn, dysphasia
Anemia
Irritability
Pulmonary symptoms: cough, choke, wheeze
Nocturnal asthma
Cry after eating
26
Q

Treatment of GERD

A 
Avoid foods that exacerbate acid reflux
Weight control
Small, more frequent meals
Thickened feeding
Upright positioning
Prone after feeding
Medication
Head elevated 30 minutes
Surgery for infants
27
Q

Acute appendicitis

A 
Inflammation of vermiform appendix caused by obstruction of lumen of appendix usually hardened by fecal matter
RLQ 
Anorexia
Vomiting
Diarrhea or constipation
Low grade fever
28
Q

Physical finding of acute appendicitis

A

Pain at McGruneys point, right iliac fossa
Bowel sound depressed or hyperactive
Rectal exam may show tenderness

29
Q

Diagnosis and treatment for GERD

A

CAT scan
Laparoscopic
Current treatment philosophy
- see if body walls off abscess and if it does make a drain and have body naturally clear it out

30
Q

Cleft lip and palate

A

Most common congenital deformity
Facial malformation that occurs during embryonic period
Failure of the maxillary and median nasal processes to fuse
Midline fissure of the palate that results fro. Failure of two slides to fuse
May occur separate or together

31
Q

Nursing measures of cleft lip

A 
Feeding issues
Parental emotional needs
Post operative
Occur with other syndromes
Drug associated is diluadid 
Surgical repair is two steps
  - lip 6 months, concerned about maintaining lip line
  - palate 12-18 months, mouth grows and want more room. Preserve speech
32
Q

What I’d pyloric stenosis

A

Congenital hypertrophy of circular muscle of pyloric sphincter
More common in males
Increased family incidence
Milk can’t get into small intestines

33
Q

Clinical manifestations of pyloric stenosis

A

Vomiting after feelings: progressive
Usually start 2-4 weeks post-birth
Surgically treated by opening the muscle

34
Q

Intussusception

A

Imagination of one segment of bowels usually the terminal ilium, into the cecum
Telescopes in upon itself

35
Q

Clinical manifestations of intusseption

A 
Intense pain
Knees upto chest
Pain lasts several minutes and child is quiet
Early non-bilious vomiting
Current (red) jelly diarrhea stools
36
Q

Physical finding of intussuception

A 
Sausage shaped mass palpable in RUQ 
abdominal distention in tenderness
Fever
Bloody mucous on rectal exam
Shock like state
Cramping
37
Q

Treatment of Intussuception

A

Hydrostatic enema

Pediatrics (10 decks)

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