Week 10: GI/GU Flashcards
What makes infants more vulnerable to GI infections?
Their mouth is highly vascular and is a common entry point for infection.
Why do infants experience more reflux than adults?
They have a shorter esophagus and weaker lower esophageal sphincter (LES).
How does stomach capacity change from birth to 1 year?
Newborn: 10–20 mL; 1 year: 210–360 mL.
What liver immaturity issues are seen in infants?
Reduced detoxification and decreased vitamin and glycogen storage.
Why do infants get gassy early on?
Enzymes needed for digestion mature around 4–6 months.
What is a major risk for infants with GI issues like vomiting or diarrhea?
Dehydration.
How do you calculate daily maintenance fluid for a child under 10 kg?
100 mL/kg/day.
How do you calculate daily maintenance fluid for a child 11–20 kg?
1000 mL + 50 mL/kg for weight above 10 kg.
How do you calculate daily maintenance fluid for a child >20 kg?
1500 mL + 20 mL/kg for weight above 20 kg.
What is the 4-2-1 rule for hourly fluid maintenance?
4 mL/kg (first 10 kg) + 2 mL/kg (next 10 kg) + 1 mL/kg (above 20 kg).
What does Failure to Thrive (FTT) mean?
Weight below the 5th percentile for age.
What are the 4 I’s of FTT causes?
Inadequate intake, inadequate absorption, increased metabolism, increased losses.
What causes diarrhea in infants most commonly?
Acute: viral (e.g., rotavirus); Chronic: IBD, food allergies.
What is encopresis?
Involuntary stool leakage, often from chronic constipation.
What are signs of Hirschsprung disease?
No meconium in 24–48 hrs, distended abdomen, bilious vomiting.
What causes Hirschsprung disease?
Lack of ganglion cells in the colon → poor motility.
When is GER considered normal in infants?
If it resolves by ~12 months and has no weight loss or other complications.
When does GER become GERD?
If reflux causes pain, poor weight gain, or esophagitis.
How is GERD managed in infants?
Upright feeding, thicken feeds, meds (PPIs), surgery (Nissen fundoplication).
What type of vomit is concerning in infants?
Bilious, bloody, persistent, or accompanied by dehydration/neurological signs.
What acid-base imbalance is common with persistent vomiting?
Metabolic alkalosis.
Compare Crohn’s disease and Ulcerative Colitis.
Crohn’s: patchy, entire GI tract; UC: continuous, colon only.
What are signs of cleft lip/palate in infants?
Difficulty feeding, risk of aspiration, speech issues.
How do you feed a baby with cleft palate?
Upright position, special bottles, slow feeding.
What is an omphalocele?
Abdominal contents herniated into a sac at the umbilicus.
What is gastroschisis?
Exposed abdominal contents without a sac, usually right of umbilicus.
What are signs of pyloric stenosis?
Projectile vomiting, olive-shaped mass in RUQ, dehydration.
What acid-base imbalance is seen with pyloric stenosis?
Metabolic alkalosis due to vomiting.
What are signs of intussusception?
Intermittent abdominal pain, red currant jelly stool, sausage-shaped mass.
How is intussusception treated?
Air or barium enema (may reduce telescoping); surgery if needed.
What is the most common cause of UTI in children?
E. coli.
What are common UTI symptoms in young children?
Fever, irritability, poor feeding, foul-smelling urine.
How can UTIs be prevented in kids?
Wipe front to back, encourage voiding, avoid bubble baths.
What is vesicoureteral reflux (VUR)?
Backward flow of urine from bladder to ureters/kidneys → recurrent UTIs.
What should never be done to a child with a suspected Wilm’s tumor?
Do NOT palpate the abdomen.
What is Wilm’s tumor?
A malignant kidney tumor in children; usually unilateral and firm, non-tender.
What are top nursing priorities for GI/GU disorders?
Maintain nutrition, fluid/electrolyte balance, prevent complications, support family.
What distinguishes GER from GERD?
GER is normal and self-resolves; GERD causes complications and may need meds/surgery.
What condition is associated with failure to pass meconium?
Hirschsprung disease.
What should be taught to parents about cleft palate care?
Feed upright, use special nipples, monitor for aspiration, plan for surgery.
