T2 - GI Disorders (Josh) Flashcards
Cleft Palate alone is more common in —
females
Cleft Lip is more common in —-
males
- Orientals and Native Americans
Cleft lip is a failure of the — and — nasal processes to fuse.
Maxillary
Median
The merging of the upper lip at midline is complete when?
7-8 weeks gestation
Fusion of palatal shelves occurs when?
7-12 weeks gestation
Midline defects (Cleft Palate, Lip) are affected by decreases in what?
Folic Acid
Best type of feeding for Cleft lip?
Breast b/c it conforms better to odd shape of lips
When is a Z-plasty ususally done to repair cleft pip?
When is a Palatoplasty usually down to repair cleft pallate?
2-3 mths old (Cleft Lip repair)
6-12 mths old (Cleft Palate repair)
When a baby is swallowing alot following cleft repair, what is it a sign of?
bleeding
Complications w/ Cleft repair recovery?
- Middle Ear infection
- Nasopharyngeal infection
- Sinus infection
- some hearing loss
- Speech delay
What is esophageal atresia (tracheoesophageal fistula)?
failure of esophagus to connect to stomach
instead it fuses to the trachea during development
Etiology of tracheoesophageal defects.
VACTERL
Vertebral defect Anorectal malformation Cardiac defect Tracheosesophareal fistula Esophageal atresia Renal anomalies Limb defect
What is HPS?
Hypertrophic Pyloric Stenosis
a GI obstruction of lower stomach sphincter that occurs mostly in white first-born boys in first few weeks of life
What is the most common craniofacial malformation?
Cleft Lip/Palate
Does family history of cleft palate/lip lead to the disorder?
Yes
Immediate nursing problems post-op with Cleft Palate/Lip?
- Bleeding
- Infant Upset
- Nose breathers, so will not be able to breathe through nose
- Inflammation
What is the device used to hold the repaired lip together?
Logan’s Bar
What must be avoided post-op for Cleft Palate/Lip?
- pacifiers
- straws
- mouth utensils
What type of restraints for CP/CL? How long?
elbow restraints
4-6 weeks
An abnormal between two vessels that ends in a blind pouch.
Fistula
Symptoms of Esophageal Atresia w/ Fistula.
- drool/saliva have no place to go
- cough and sputter
- laryngospasm
- abdominal distension from air
- spit up goes to trachea
— is a GI obstruction disorder that usually occurs in the first few weeks of life.
HPS (Hypertrophic Pyloric Stenosis)
- mostly in white first born males
— is enlarged circular muscle of the pyloris.
HPS (Hypertrophic Pyloric Stenosis)
Hallmark sign of HPS:
OLIVE MASS palpated in epigastrium
In —-, the pyloric sphincter is blocked.
HPS
HPS issues:
- projectile emesis
- still hungry after feeding
- decreased stooling and urinating due to less fluid getting through
- FTT and dehydration
Management of HPS
- Surgery (pyloromyotomy)
- Correction of fluid and electrolyte imbalance before surgery
- Post-operative feeding
introduce gradually within 4-6 hours - Full feeding schedule by 48 hours post-op
— is the most common cause of intestinal obstruction in the first 2 years of life.
Intussusception
- males predominately in 3:2 ratio)
Intussusception is more common with who?
- Males (3:2 ratio)
- CF
Hallmark sign of Intussusception?
Currant jelly-stools
Risk factor for Intussusception?
Cystic Fibrosis (CF)
Which disorder has a sausage-shaped abdominal mass?
Intussusception
- in RUQ
– is also known as Congenital Aganglionic Megacolon.
Hirschprung Disease
What is the most common cause of neonatal obstruction?
Hirschprung Disease
— is associated w/ Down’s Syndrome.
Hirschprung Disease
Hirschprung Disease is seen in a newborn who fails to pass meconium within —-
24-48 hrs after birth
Hirschprung Disease is caused by what?
absence of ganglion cells in large intestine that sense when to push poop out
leads to toxic megacolon
Surgical intervention for Hirschprung Disease
1) Colostomy
2) re-positioning of healthy bowel
3) closure of colostomy
— is caused by bile duct fibrosis.
Biliary Atresia
If untreated, Biliary Atresia leads to —
death before age 2
What is treatment for Biliary Atresia?
surgical liver transplant
— is the absence of an external opening to the rectum.
Imperforate Anus
- first sign is no passage of meconium within first 24 hrs
Check for — with Imperforate Anus.
Anal Wink
—- happens during 7-10th week of gestation.
Diaphragmatic Hernia
Types of Abdominal Wall Defects.
- Omphalocele
- Gastroschisis
In —, babies are born with intestines hanging out.
Omphalocele (has a small sack over it)
Gastroschisis (no sack over it)
In Short Bowel Syndrome, the leading causes of death are —
sepsis
liver failure
In short bowel syndrome, what is the length of the bowel?
Normal (250 cm)
SBS (100 cm)
— is another term for acid indegestion.
Gastroesophageal Refulx (GER)
note: GERD is tissue damage from GER
GER is self-limiting and usually resolves by –
1 year of age
Lower esophageal sphincter dysfunction leads to —
GER
Nursing Care for GER:
Do what with formjula?
Thicken it with 1 t - 1T rice cereal per 1 oz forumla
— is a surgical procedure that wraps the fundus of the stomach around the distal esophagus to decrease GER.
Nissen Fundoplication
Most common type of hernia is —
umbilical hernia
When the intestines push through an opening in the diaphragm.
Diaphragmatic Hernia
- happens during 7-10th wk of gestation