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66 Cards in this Set
- Front
- Back
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clinical manifestations of GI dysfunction
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1. failure to thrive 2. spit up 3. NVDC 4. ab pain/distend 5. gi bleed 6. jaundice 7. dysphagia 8. abnormal bowel sounds
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GI peds
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1. small stomach nn60 inf 250-300 2. gastric HCl low 3. pepsinogen = adult 3mo 4. food in stomach decr time
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4:2:1 rule
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1. first 10kg = 4ml/kg/hr 2. 2 3. 1
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diarrhea
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1. leading illness in children <5yo 2. 24% all deaths rt dehy/dia
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diarrhea factors
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1. weight loss 2. pulse 3. bp 4. behavior 5. thrist 6. mm 7. tears 8. ant font 9. ext jug 10. skin 11. urine spec grav
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diarrhea - weight loss
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i/c mild 5/3 mod 10/6 sev 15/10
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diarrhea - pulse
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incr = worse
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diarrhea - bp
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mod 10mm ortho sev ortho/shock
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diarrhea - behavior
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mod thirst/irrit sev incr irrit/leth
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diarrhea - thirst
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incr = worse
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diarrhea - mm
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incr = worse
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diarrhea - tears
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sunk = worse
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diarrhea - ant font
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sunk = worse
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diarrhea - ext jug
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not vis = worse
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diarrhea - skin
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>2yo is less useful cap ref mild 2+ mod 2-4 sev 4+
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diarrhea - urine spec grav
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>1.02 mild oliguria 3-500ml/day med anuria 50 ml/day severe
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acute diarrhea def
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sudden incr freq/consistency stool
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acute diarrhea patho
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1. infectious agent in GI 2. assoc with URI/UTI, Ab, laxative 3. self-limited 14d
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acute diarrhea nursing consid
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1. emo support anxiety/scared 2. promote rest/comfort: dark/quiet/toys 3. nutrition 4. discharge plan: handwash, symptoms, sep bathroom
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diarrtha - prevention
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1. fecal-oral route 2. teach pers hyg 3. clean water/decr contam 4. food prep 5. handwash
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pediatric dehydration tx
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1. D5 and 1/2 NS with 20meq/L KCl 2. Ringer's lactate
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constipation - def
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1. alteration in freq, consistency, ease of passage 2. comorbidity possible
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functional constipation
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idiopathic
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chronic constipation
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enviro/psychosoc factors
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constipation - tx
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1. hydrate 2. fiber: fiber, bran as per age
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1st meconium
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1. within 24-36h 2. if not ax for hirschprung, hypothyroid, meconium plug, meconium ileus/CF
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constipation - infant
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1. rt to diet 2. if bf rare 3. ff usual
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constipation - infant tx
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1. ab stim 2. mineral oil
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constipation - child
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1. enviro change 2. body control 3. stress 4. encopresis
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encopresis
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soiling underwear if toilet trained
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constipation - nursing consider
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1. history bowel patt 2. meds 3. diet 4. trip 5. educate 6. diet mod as per age
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hirschprung def
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1. aka congenital aganglionic megacolon 2. mech obs from decr motility 3. rare incr male/down 4. abs of ganglion in colon (one or many spots) 5. 75% rectosigmoid
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hirschprung tx
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surgery to remove affected part
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hirschprung clin manif
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1. aganglionic segment usu rectum/prox colon 2. stool accumulate 3. int anal spinc fail relax 4. enterocolitis
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enterocolotis symp
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1. fever 2. ab dist 3. diarrhea 4. dehydrate 5. sepsis 6. usu COD
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vomit tx
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1. 1-2d self limit 2. track output rt dehydrate
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vomit patho
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1. eats 2. bug 3. ICP
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vomit nurse consider
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1. anti-emetic 2. measure output 3. diet 4. hold feeds but hydrate 5. lie side/not back
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GER def
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1. transfer of gastric contents into esoph 2. everyone does it, freq = abnormal 3. GERD not req
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GERD def
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1. GER with damage 2. may occur without regurg/vomit
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GER nurse consider
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1. avoid spicy/fatty food 2. avoid ab pressure
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cleft lip/palate
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1. facial malform during embryonic dev 2. one or both
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cleft lip/palate - timeline
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7-11w lip, 7-12 palate
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cleft issues
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1. parrents maybe upset/vent 2. focus positive 3. bf/milk comes out 4.speech
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cleft patho
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1. max process fail to fuse 2. enviro/gen/folate suspected
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cleft tx
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1. surgery lip first 2. zplasty to decr retraction 3. protect suture line with logan bow 4. 12-18mo
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esophageal atresia def
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1. esoph and trach do not develop as parallel tracts 2. esoph ends as blind pouch 3\
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tracheoesophageal fistula def
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1. esoph and trach do not develop as parallel tracts 2. esoph ends connected to trach by fistula 3. TEF
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EA/TEF patho
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1. amniotic fluid 2. baby kidney
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EA/TEF nurse consider
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EA emergency surgery
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EA/TEF pre-op
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1. close obs/intervent to maintain air 2. suction 3. bed head lower to decr aspiration 4. IV 5. I&O
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EA/TEF post-op
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1. maintain gastrostomy drain 2. admin IV fluid/ab 3. TPN til gastrostomy/oral tolerated
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EA/TEF emo support
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1. educate 2. encourage bond 3. allow rents to participate in care
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pyloric stenosis def
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1. hypertrophic obs of pyloric sphincter 2. incr boys
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pyloric stenosis sympt
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1. obs sphincter 2. inability to move food-stomach/duodenum 3. vomit/dehydrate
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pyloric stenosis nurse consider
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1. fluid/electro needs 2. min weight loss 3. rest/comfort 4. prev inf 5. support care
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omphalocele def
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1. internals in pouch 2. hi risk inf
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omphalocele nurse consider
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1. keep moist/wet
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gastroschisis def
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1. ab contents outside
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gastroschisis tx
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1. hang contents on isolet 2. lower as space available
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renal system ax
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1. phys exam 2. history 3. obs symps 4. lab/radiological/other eval meth
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UTI def
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1. with/wo symptoms 2. multifactorial 3. common 4. hard to localize 5. incr 3mo uncircum 6. e.coli 80% 7. anal/perianal region
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UTI symptoms
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1. incontinent in toilet train 2. strong/foul urine 3. freq/urgency
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UTI nurse consider
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1. urine/blood culture & sensitivity test 2. penicillin/sulfonamide/ceph/nitrofurantoin 3. ID risks 4. prevention
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wilm's def
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1. aka nephroblastoma 2. kidney/renal and intraab tumor of childhood 3. 3x more common in afro 4. peak age dx 3yo 5. incr male
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wilm's nurse consider
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1. chemo and surg 2. do not palpate ab
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