week 6 : peds gi tract Flashcards
how is children stomach different?
smaller stomach ( newborn ) 10-20 mls and 2 months = 200 mls
lower esophageal spincter is not fully developed until 1 month - regurtitate
true or false. younger than 6 months oral intake is primarily liquid, and babies have more risk for dehydration
true
true or false. higher body surface area of ratio, the body surface area represents their skin ( increase risk of dehyration )
true
what are the nutrional deficiencies common in children
vitamin d deficiencies
why could dehydration occur ?
vomitting and diarrhea due to gastroenteritis
what undergoes obstruction
intussusception ) most common cause in children - when part of the bowel telescopes into another part ( narrowing of the bowel or obstruction )
recall that common gi problems in children is congenital abnormalities
what undergoes this
o Hirschsprung Disease (aganglion)
o Cleft Lip or Palate
o Congenital esophageal atresia
o Abdominal hernias
true or false . * Inflammatory Bowel Disease * Peptic Ulcer Disease
* GERD
* Acute Appendicitis
* Liver Disease (Hepatitis/Cirrhosis)
are also common in children
true
what is gastroenteritis?
inflammation of the stomach mucosa and small intestine could be viral or bacterial
recall that gastroenteritis causes are viruses and bacteria , what undergoes this
rotavirus
norovirus
e.coli
salmonella
c.diff
what are the symptoms of gastroenteritis
nausea and vomitting, diarrhea, fever, malaise
what are the risk for gastroenteritisi
dehydration, acid base imbalance, shock
true or false. diarrhea change in their normal bowel pattern ( increase amount of stool ) in watery stool
self limitatiing
depending on the child - losing , extreme dehydration ( acid base imbalnce, metbaollic alkalotic )
this could occur in a child who has gastroenteritis
true
what is the degree of dehydration
what is mild dehydration
mild dehydration – less than 5 percent body weight loss
vital signs normal
minimal
increase thirst
slightly dry mm
slightly decrease urine output
what is a moderate dehydration
5-10 percent body weight loss
vital signs : increase hr
more symptoms :
skin turgor decrease
sunken fontanel/eyes
delayed cap refill
listless
what is the severe dehydration :
more than 10 percent of body weight loss
vital signs, increase hr and decrease in bp
serious com : lethargic, comatose, cool mottled extremities
what is the ORS , and ORT
ORS - oral rehydration
ORT - oral rehydration theraphy
what intervention would u do for no dehydration
age appropriate diet
replace ongoing possess with ORS
what intervention would u do for mild dehydration
rehydrate with ORS ( 5 mL/kg) over 4 hours
replace ongoing possess with ORS
age appropriate diet after rehydration
what is the intervention for moderate dehydration
rehydrate with ORS ( 100 ML) over 4 hours
replace ongoing losses with ORS
age appropriate diet after rehydration
what is the severe dehydration
intravenous resuscitation with normal saline or ringers lactate ( 20-40 mL) for 1 hour
reassess and repeat if necessary
begin ORT when pt is stable
replace ongoing losses with ORS
age appropriate diet after rehydration
just read when it comes to more interventions for dehydration ;
* Monitor hydration status/skin integrity
* Accurate Intake and Output
* Frequency/amount/characteristics of stool
* Urine output (# of diapers for infants)
* Daily weight
* LOC & vital signs
* Diagnostics: CBC, electrolytes
* Reintroduce normally diet as soon as tolerated
true or false. severe dehydration affect LOC
true
what is appendicitis ?
inflammation of the vermiform appendix
typically in the belly button and moves to lower quadrant
what is the common cause of emergency abdominal surgery in kids
appendicitis
appendicitis most common in kids what age ?
10-18
what are the symptoms of appendicitis ?
abdominal pain, fever , vomiting, elevated wbcs
more than 50 percent have atypical presentation
1/ have already perforated at a time of presentation
what is the assessment for appendicitis
abdominal assessment ( Childs hand over yours ) activities which irritate peritoneal area ( jump up and down, climb on to the stretcher )
true or false. peritoneum can become inflame in appendicitis
true
true or false according to appendicitis. sometimes moves down to the leg or to the back
vomiting or elevated blood counts
gastroenteritis ** detailed assessment is important
true
nursing interventions for non ruptured appendix
manage pain
monitor for signs of rupture
-pain management, good pain assessment and administer timed severity of their pain
prep for surgery - continuously reassess if the pain is moving, most appendix happen in the laparoscopic
ruptured appendix
prep op
pain control
rehydration
antibiotics
ng
( sudden release of pain level )
true or false. Peritonitis, board like abdomen, become distended (alot of fluid shifting) during pre op
true
what is the post op for ruptured appendix
pain managemnet
iv fluids and abx
ng to sunction ( how long ) ng will stay until the bowel sounds have return
early mobilization
pyschological support
what is a cleft lip palate?
congenital birth defect
can happen together or seperately
diagnostics for cleft lip palate
physical assesment
cleft lip palate nursing interventions
surgical repair : lip 2-3 months, palate before 12 months
they want the palate to be able to continue to grow in the child
what are the issues for cleft lip/palate
impairs feeding- cant create suction
dentition
speech impairment
cosmetic
what is the pre op for cleft lip/palate
breastfeeding-techniques= squeezing cheeks together to decrease width of cleft
true or false. less suck ability - special nipples (bottle) - pre op
true
create a bit of pressure ( emptys in their mouth )
in either case sit more upright ( and avoid aspiration )
they swallowing more of air ( burping is encourage )
true or false for cleft lip palate babies
true
what do we do post op for cleft lip palate surgery
analgesics
diet is npo - clear fluid once awake ( drugs have run off ) breastfeeding/bottle feeding/soft diet
how do we protect site in post op
apply petroem jelly
true or false. we utilize elbow immbolizers in post op for cleft lip apalte
yes we do ( prevent touching site ) reaching back
true or false. syringe feeding ( no sucking for 7 days in some facilities ) in post op cleft lip palate
true
when do we remove oral apcking/dressing in post op for cleft lip palate
2-3 days
