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3512 > Week 6 Gi part 2 > Flashcards

Week 6 Gi part 2 Flashcards

1
Q

why do newborns regurgitate?

A

because the esophogeal spincter is not fully developed until 1 mo

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2
Q

what are the 5 most common causes of pediatric gastroenteritis?

A

rotavirus, norovirus, e coli, salmonella, C diff

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3
Q

what is considered ‘moderate’ dehydration in peds/infants?

A

5-10% of body weight lost

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4
Q

if a child weighing 20 kg has lost <5% of their body weight in fluid, how do we rehydrate them?

A

give them 50ml/kg of body weight of an oral rehydrations solution (pedialyte) over 4 hours. in this case, 1000 mls total, or 250 mls/hr.

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5
Q

most common cause of emergency abdominal surgery in kids

A

appendicitis

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6
Q

what age range of kids is most likely to have appendicitis?

A

10-18

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7
Q

how do we assess for appendicitis in kids?

A

require them to do an activity which irritates the peritoneal area (jumping, climbing), or have child’s hand over mine to palpate

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8
Q

what are 3 interventions for a ruptured appendix?

A

rehydrate, antibiotics, prep for surgery

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9
Q

what are six interventions for appendicitis post-op?

A

-manage pain
- IV fluids and antibiotics
- NG to suction
-wound care
- mobilize pt
-psychological support

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10
Q

what are two ways i can protect the site after a cleft lip and palate surgery?

A

apply petroleum jelly, and elbow immobilizers

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11
Q

is the following a description of acute or chronic cholecystitis?
- a result of gallstones obstucting the cystic duct.
-a complication of cholelithiasis

A

acute

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12
Q

is the following a description of acute or chronic cholecystitis?
-gallbladder becomes fibrotic and atrophies

A
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13
Q

what is blumberg’s sign?

A

rebound tenderness d/t cholecystitis

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14
Q

what are two non-surgical stone managment options for cholecystitis

A
  • extra-corporeal shock wave lithotripsy (ESWL)
  • percutaneous transhepatic biliary catheter
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15
Q

Describe the care plan for a post-laparoscopic cholecystectomy patient (6 things)

A

-Pain management
-DB and C
-Prevent DVT through ambulation
-MOnitor/treat N&V (dance party)
-IV fluids until eating
-Dishcarge same day

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16
Q

what are the differences in post-op care for laparascopic vs. open cholecystectomy?

A

for open d/c is in 1-2 days post op, we give antibiotics, access the surgical site, and they’ll have a jackson pratt drain

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17
Q

what are the two extremes of pancreatitis

A

edema (mild) to necrotizing (severe)

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18
Q

is ascites found in acute or chronic pancreatitis?

A

chronic

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19
Q

are grey-blue flanks and absent bowel sounds found in acute or chronic pancreatitis?

A

acute

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20
Q

what are the complications of pacreatitis? name 6

A

jaundice
intermittent hyperglyc
++organ failure
coag defects
shock
paralytic ileus

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21
Q

three non-drug interventions for acute pancreatitis (two monitoring, one positioning)

A

fetal position, monitor for hypocalcemia, monitor respiratory status

22
Q

drugs for acute pancreatitis

A

opioids for pain, ranitidine and PPI, antibiotics if its necrotizing

23
Q

nutritional interventions for acute pancreatitis

A

NPO but provide oral care, NG tube w/ suction, jejunal tube feed after NPO and gradually resume food

24
Q

what is the particular different drug given for chronic pancreatitis as opposed to acute?

A

pancreatic enzymes

25
Q

when would we give TPN for pancreatitis?

A

in chronic (exacerbation)

26
Q

what should epople with chronic pancreatitis avoid?

A

high fat food, alcohol

27
Q

besides excessive ETOH intake, what causes liver cirrhosis?

A

hepatitis, NAFLD, drugs like acetaminophin, chronic biliary obstuction

28
Q

what interventino could be appropriate if ascites was affecting ability to breathe?

A

paracentesis

29
Q

people with liver cirrhosis should be screened for _________ ________

A

esophogeal varices

30
Q

three endoscopic therapies that treat bleeding in liver cirrhosis

A

ligation of bleeding veins, sclerotherapy (injected into varices), and balloon tamponade or stents

31
Q

how is sertraline used to treat symtpms of liver cirrhosis?

A

its an SSRI which tricks brain into not being itchy

32
Q

two goals of care for viral hepatits

A

prevent weight loss from compications of disease, and reduce fatigue d/t infection and decreased metabilic energy productino

33
Q

which drugs should be avoided in GERD and hiatal hernia?

A

oral contraceptive, anticholinergics, sedatives, NSAIDS, nitrates, Ca channel blockers as they all lower LES prsesure

34
Q

what will be in situ after a nissen fundoplication?

A

an NG tube to drain

35
Q

first sign of esophogeal tumor

A

dysphagia

36
Q

what is a non-surgical treatment for esophageal tumor that has a risk of perforation?

A

dilation

37
Q

highest priority post-op after removal of esophageal tumor

A

respiratory care

38
Q

how is nutrition delivered after esophogeal surgury/

A

initially through jejunostomy

39
Q

what is a VERY IMPORTANT thing to consider about the GI system of children/infants.

A

dehydration

40
Q

what three reasons are infants at higher risk for dehydration?

A

they can’t tell us about thirst
they have a high metabolic rate
they have a higher body surface area per body volume

41
Q

how many wet diapers a day do we want?

A

6

42
Q

what is a common nutritional deficiency in children?

A

vit D

43
Q

what is Hirschsprung disease?

A

part of the bowel is not innervated = no peristalsis

44
Q

what is congenital esophageal atresia?

A

when the esophagus does not connect to the stomach

45
Q

what are the early signs of dehydration in a baby?

A

decreased UO, ++ thirst, slightly dry MM

46
Q

what four types of issues can a cleft lip/palate cause?

A

feeding (fluid can go into sinuses)
dentition
speech
cosmetic

47
Q

what is barret’s esophagus?

A

when cells are pre-cancerous d/t gerd

48
Q

if a pt with GERD had wheezing, why would I be concerned?

A

because they may have aspirated stomaach acid

49
Q

what would keep me most busy managing a pt with acute pancreatitis?
what could be done to alleviate this?

A

pain management
patient controlled analgesic

50
Q
A

3512 (15 decks)

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