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Health and Illness 4 : Part2 > week 6 : peds gi tract > Flashcards

week 6 : peds gi tract Flashcards

1
Q

how is children stomach different?

A

smaller stomach ( newborn ) 10-20 mls and 2 months = 200 mls

lower esophageal spincter is not fully developed until 1 month - regurtitate

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2
Q

true or false. younger than 6 months oral intake is primarily liquid, and babies have more risk for dehydration

A

true

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3
Q

true or false. higher body surface area of ratio, the body surface area represents their skin ( increase risk of dehyration )

A

true

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4
Q

what are the nutrional deficiencies common in children

A

vitamin d deficiencies

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5
Q

why could dehydration occur ?

A

vomitting and diarrhea due to gastroenteritis

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6
Q

what undergoes obstruction

A

intussusception ) most common cause in children - when part of the bowel telescopes into another part ( narrowing of the bowel or obstruction )

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7
Q

recall that common gi problems in children is congenital abnormalities
what undergoes this

A

o Hirschsprung Disease (aganglion)
o Cleft Lip or Palate
o Congenital esophageal atresia
o Abdominal hernias

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8
Q

true or false . * Inflammatory Bowel Disease * Peptic Ulcer Disease
* GERD
* Acute Appendicitis
* Liver Disease (Hepatitis/Cirrhosis)

are also common in children

A

true

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9
Q

what is gastroenteritis?

A

inflammation of the stomach mucosa and small intestine could be viral or bacterial

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10
Q

recall that gastroenteritis causes are viruses and bacteria , what undergoes this

A

rotavirus
norovirus
e.coli
salmonella
c.diff

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11
Q

what are the symptoms of gastroenteritis

A

nausea and vomitting, diarrhea, fever, malaise

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12
Q

what are the risk for gastroenteritisi

A

dehydration, acid base imbalance, shock

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13
Q

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

A

true

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14
Q

what is the degree of dehydration

what is mild dehydration

A

mild dehydration – less than 5 percent body weight loss

vital signs normal
minimal
increase thirst
slightly dry mm
slightly decrease urine output

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15
Q

what is a moderate dehydration
5-10 percent body weight loss

A

vital signs : increase hr

more symptoms :
skin turgor decrease
sunken fontanel/eyes
delayed cap refill
listless

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16
Q

what is the severe dehydration :
more than 10 percent of body weight loss

A

vital signs, increase hr and decrease in bp
serious com : lethargic, comatose, cool mottled extremities

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17
Q

what is the ORS , and ORT

A

ORS - oral rehydration
ORT - oral rehydration theraphy

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18
Q

what intervention would u do for no dehydration

A

age appropriate diet
replace ongoing possess with ORS

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19
Q

what intervention would u do for mild dehydration

A

rehydrate with ORS ( 5 mL/kg) over 4 hours
replace ongoing possess with ORS
age appropriate diet after rehydration

20
Q

what is the intervention for moderate dehydration

A

rehydrate with ORS ( 100 ML) over 4 hours
replace ongoing losses with ORS
age appropriate diet after rehydration

21
Q

what is the severe dehydration

A

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

22
Q

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

A
23
Q

true or false. severe dehydration affect LOC

A

true

24
Q

what is appendicitis ?

A

inflammation of the vermiform appendix
typically in the belly button and moves to lower quadrant

25
Q

what is the common cause of emergency abdominal surgery in kids

A

appendicitis

26
Q

appendicitis most common in kids what age ?

A

10-18

27
Q

what are the symptoms of appendicitis ?

A

abdominal pain, fever , vomiting, elevated wbcs

more than 50 percent have atypical presentation
1/ have already perforated at a time of presentation

28
Q

what is the assessment for appendicitis

A

abdominal assessment ( Childs hand over yours ) activities which irritate peritoneal area ( jump up and down, climb on to the stretcher )

29
Q

true or false. peritoneum can become inflame in appendicitis

A

true

30
Q

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

A

true

31
Q

nursing interventions for non ruptured appendix

A

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

32
Q

ruptured appendix
prep op

A

pain control
rehydration
antibiotics
ng
( sudden release of pain level )

33
Q

true or false. Peritonitis, board like abdomen, become distended (alot of fluid shifting) during pre op

A

true

34
Q

what is the post op for ruptured appendix

A

pain managemnet
iv fluids and abx
ng to sunction ( how long ) ng will stay until the bowel sounds have return
early mobilization
pyschological support

35
Q

what is a cleft lip palate?

A

congenital birth defect
can happen together or seperately

36
Q

diagnostics for cleft lip palate

A

physical assesment

36
Q

cleft lip palate nursing interventions
surgical repair : lip 2-3 months, palate before 12 months

A

they want the palate to be able to continue to grow in the child

36
Q

what are the issues for cleft lip/palate

A

impairs feeding- cant create suction
dentition
speech impairment
cosmetic

37
Q

what is the pre op for cleft lip/palate

A

breastfeeding-techniques= squeezing cheeks together to decrease width of cleft

38
Q

true or false. less suck ability - special nipples (bottle) - pre op

A

true

39
Q

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

A

true

40
Q

what do we do post op for cleft lip palate surgery

A

analgesics
diet is npo - clear fluid once awake ( drugs have run off ) breastfeeding/bottle feeding/soft diet

41
Q

how do we protect site in post op

A

apply petroem jelly

42
Q

true or false. we utilize elbow immbolizers in post op for cleft lip apalte

A

yes we do ( prevent touching site ) reaching back

43
Q

true or false. syringe feeding ( no sucking for 7 days in some facilities ) in post op cleft lip palate

A

true

44
Q

when do we remove oral apcking/dressing in post op for cleft lip palate

A

2-3 days

Health and Illness 4 : Part2 (9 decks)

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