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Advanced Health Assessment > week 6 peds abdominal > Flashcards

week 6 peds abdominal Flashcards

1
Q

4 week gestation

A

pancreas, gallbladder, and liver begin to form

intestine already exists as single tube

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2
Q

infant GI tract

A

elasticity, musculature, and control mechanisms develop until 2-3 years old

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3
Q

liver

A

creates blood cells by week 6
glycogen by week 9
bile by week 12

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4
Q

pancreas

A

islets by week 12 -> insulin production

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5
Q

spleen

A

active in blood formation until 1st year of life then moves to destruction of blood cells

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6
Q

kidney

A

produces urine by week 12

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7
Q

infant hx

A 
gestation age
birth weight
passage of 1st meconium stool within 24 hours
jaundice 
vomiting 
diarrhea
colic
failure to gain wt 
steatorrhea 
enlarged abdomen
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8
Q

Children hx

A

constipation
dietary habits
abdominal pain
psychosocial stressors

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9
Q

intussusception patho

A

prolapse, or telescoping, of one segment of intestine into another -> intestinal obstruction
- common between 3-12mo

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10
Q

intussusception subjective

A 
acute intermittent abd. pain 
abd. distention 
vomiting
- can be dramatic onset 
legs and knees flexed up to abd. 
stools nml in beginning, then may be mixed with blood and mucus with a red currant jelly appearance.
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11
Q

intussusception objective

A

sausage shaped mass may be palpated in the R or LUQ
lower quadrants feel empty
abdominal distention and guarding

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12
Q

pyloric stenosis patho

A

hypertrophy of the circular muscle of the pylorus leading to obstruction of the pyloric sphincter

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13
Q

pyloric stenosis subjective

A

s/s develop after several weeks
- regurgitation -> projectile vomiting
feeding eagerly
failure to gain weight

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14
Q

pyloric stenosis objective

A

epigastric distention
possible visible wave of peristalsis in epigastric
small, rounded olive-shaped mass sometimes palpable in RUQ

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15
Q

Meconium ileus patho

A

distal intestinal obstruction caused by thick inspissated impacted meconium in the lower intestine of newborn

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16
Q

meconium ileus subjective

A

failure to pass meconium in the first 24 hours after birth
vomiting
abdominal distention

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17
Q

meconium ileus objective

A

abdominal distention
complicated -> shock s/s:
- tachycardia, hypotension

18
Q

biliary atresia patho

A

congenital obstruction or absence of some or all of the bile duct system

  • > bile flow obstruction
  • postnatal or embryonic onset
19
Q

biliary atresia subjective

A

s/s of neonatal cholestasis develop in the first several weeks
- jaundice, light clay-colored stools, dark urine
possible failure to gain wt

20
Q

biliary atresia objective

A

jaundice in the first 2 months
hepatomegaly- may be firm to palpation
splenomegaly may occur
embryonic type: pt may have heart murmurs as well

21
Q

meckel diverticulum patho

A

outpouching of the ileum that varies in size from a small appendiceal process to a segment of bowel several inches long
often in proximity of the ileocecal valve
- incomplete obliteration of the vitelline duct resulting in a blind-ending pouch

22
Q

meckel diverticulum subjective

A

most asymptomatic
can have rectal bleeding
possible abdominal pain

23
Q

meckel diverticulum objective

A

painless rectal bleeding
some present with intestinal obstruction
- abd. tenderness, guarding, rebound tenderness

24
Q

necrotizing enterocolitis patho

A

inflammatory disease of the GI mucosa associated with prematurity and gut immaturity

25
Q

necrotizing enterocolitis subjective

A 
may be subtle
inability to tolerate feedings (oral or nasogastric)
abd. distention
vomiting
blood stools
26
Q

necrotizing enterocolitis objective

A 
temperature instability 
subtle signs of distress
lethargy
abdominal distension 
apnea
respiratory distress 
Xray: air in the bowel wall (pneumatosis intestinalis)
27
Q

neuroblastoma patho

A

solid malignancy of embryonal origin in the peripheral sympathetic nervous system
- commonly arising form the adrenal medulla, may occur anywhere along the craniospinal axis though

28
Q

neuroblastoma subjective

A 
asymptomatic abdominal mass in a young child 
s/s could be
- malaise
- loss of appetite
- weight loss
- protrusion of one or both eyes
29
Q

neuroblastoma objective

A

firm, fixed, nontender, irregular, and nodular abdominal mass that crosses the midline
metastases to periorbital region
-> proptosis and infraorbital eccymoses
horner syndrome, ataxia, opsomyoclonus “dancing eyes and dancing feet”

30
Q

wilms tumor (nephroblastoma) patho

A

most common intraabdominal tumor of childhood
usually appears at 2-3 y/o
small percent genetic: chromosome 11

31
Q

wilms tumor subjective

A

painless enlargement of the abdomen or an abdominal mass

some may have abdominal pain, vomiting, hematuria

32
Q

wilms tumor objective

A

may be felt on abdominal examination
- firm, nontender mass deep within the flank, only slightly moveable, not crossing the midline, sometimes bilateral
HTN may be present

33
Q

hirschsprung disease patho

A

primary absence of parasympathetic ganglion cells in a segment of the colon

  • > interrupts intestinal motility, absence of peristalsis
  • > accumulation of stool proximal to the defect
34
Q

hirschsprung disease subjective

A

s/s begin with failure to pass meconium in the first 24-48 hours

  • failure to thrive, constipation, abd. distention, episodes of bilious vomiting and diarrhea
  • small ribbon stools
35
Q

hirschsprung disease objective

A

severe constipation
abdominal distention
stool palpated in the LLQ

36
Q

hemolytic uremic syndrome (HUS) patho

A

triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia
- most commonly caused by shiga-like toxin produced by E. coli

37
Q

hemolytic uremic syndrome subjective

A

preceding URI or gastroenteritis with fever, abd. pain, and vomiting
diarrhea becomes bloody
may lead to acute abd. or perforation
some w/ sudden onset pallor, weakness, lethargy, and dec. urine output

38
Q

hemolytic uremic syndrome objective

A 
dehydration
edema
petechiae
hepatosplenomegaly
severe GI disease: abd. distention, guarding, rebound tenderness
39
Q

umbilical hernia

A

common

60% of black babies born with this

40
Q

pinworms

A

caused by nemotoad parasite

Advanced Health Assessment (57 decks)

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