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18 Cards in this Set
- Front
- Back
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How would you describe intussusception?
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The prolapse or "telescoping" of one portion of the intestine into another.
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What age it usually occur?
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Usually occurs in toddlers between 3 - 24 months
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What is the main difference in signs and symptoms between intussusception and hirshsprungs?
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Intussusception has dark red jelly like stools (due to trauma from ischemia)
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What are signs and symptoms of intussusception?
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1. Acute sudden abdominal pain / tenderness
2. Red currant jelly stool 3. Possible septic shock within 12 hours |
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How do we diagnose intussusception?
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Abdominal ultrasound
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How do we treat intussusception?
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1. Hydrostatic reduction - inserting a rectal catheter and using a combination of water + air to un-telescope the intestine.
2. Surgery |
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What are nursing interventions for intussusception?
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1. Monitor for infection, shock, pain
2. Maintain hydration of the patient 3. Prepare child or parent for hydrostatic reduction - such as teaching, getting consent, NPO, NG tube if they ate something. 4. Test for occult stool before and after procedure 5. If surgery, general post op care |
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What is GER caused by?
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a. Inappropriate relaxation of LES (lower esophageal sphincter) making the LES pressure less than the intra abdominal pressure, so things get pushed back up.
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What are the 2 things GER can lead to which are your focus of care?
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Aspiration
Pneumonia |
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At what age does the change of GER go down? why?
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a. Chance of GER goes down around 12 to 18 months directly related to growth (such as the LES muscle getting bigger and stronger so it can hold down the contents) + the fact that they have a change in diet from liquid to solids which are heavier and hard to come back up.
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What are the signs and symptoms of GER?
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1. Vomiting & FREQUENT spitting up
2. Gagging during feeds 3. BOLDED: Arching away during feedings so they don't 4. Frequent upper respiratory infections (due to aspiration) or otitis media |
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What is the most important thing we use in diagnosing the baby with GER?
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History of feedings (how often they feed and how often they are spitting up)
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What the 3 options we have to help diagnose GER?
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1. History of feedings
2. PH probe study 3. GI barium swallow or endoscopy to vizualize |
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What are your nursing interventions for GER?
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1. Positioning
2. Dietary modifications 3. Medications 4. Fundoplication surgery |
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As a nursing intervention how would you position a patient with GER? (2 things)
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Prone with head of bed elevated to 30 degrees or more
Try and lay them on their right side since that puts pressure on the L.E.S. |
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For nursing interventions what 4 dietary change recommends would you give for a child with GER?
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1. Small, frequent meals with burping often
2. Avoid spicy, fatty, citrus, or caffeinated foods (mom does this if breastfeeding) 3. Possible thickening formula 4. Pre-digested formula |
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For nursing interventions what 4 types of medications can we give to help with GER?
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1. Prokinetic agents (Reglan) which increase LES pressure and gastric motility
2. H2 antagonists (Tagament, Zantac, Pepcid) are added if there is esophagitis to lower acid production 3. Proton pump inhibitors (Prevacid) are added if H2 antagonists above are ineffective 4. Sulcrafate is given to protect mucous membranes |
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What is the surgery used for GER?
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Fundoplication surgery
Basically you cut off the passageway from the esophagus to the stomach and put in a permanent G-tube to feed them. |
