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65 Cards in this Set
- Front
- Back
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broken down epithelial cells and amniotic fluid
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meconium
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eating disorder characterized by compulsive ingestion of food and nonfood
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Pica
-two types ----food pica ----nonfood pica |
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absorption of water, sodium, and the role of colonic bacteria takes place in this part of the intestines.
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large intestines
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osmosis, carrier-mediated diffussion, and active energy-driven transport (pump) takes place in this part of the intestines.
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small intestines
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3 or more days of bloody, painful stools, or lack of stools
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constipation
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extremely long periods of no stool.....
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obstipation
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constipation with fecal soiling
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ecopresis
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increase fiber, regular toilet times after meals, shrinking the rectum, instruction on enema, and reassurance
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patient teaching for constipation
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congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestines. There is an absence of ganglion cells. The internal sphincter is unable to relax and evacuate the stool.
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Hirschsprung disease.
-often associated with downs syndrome |
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Clinical Manifestations
-abdominal distention -vomiting -constipation -ribbonlike foulsmelling stool -failure to pass meconium plug(infants) s |
Hirschsprung disease
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confirm diagnosis of Hirschsprung disease
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-rectal biopsy for absence of ganglion cells
-anorectal manometry, uses a balloon to check reflex pressure of the sphincture -xray -barium enema |
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-rectal biopsy to check for absence of ganglion cells
-anorectal manometry, check reflex reponse of sphincter |
Ways to diagnose Hirschsprung disease
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2 surgery procedure
-1st remove aganglionic portion of bowel -temporary ostomy -2nd sx pull- through of normal bowel through muscular sleeve of rectum, with closing of ostomy. |
Treatment for Hirschsprung disease
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chemical digestion consists of.....
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-enzymes
-hormones -mucos -hydrochloric acid -water |
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Transfer of gastric contents to the esophagus during transient relaxation of the lower esophageal sphincter
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GER
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passage of refluxed gastric contents into the oropharynx
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regurgitation
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clinical manifestations
-vomiting -regurgitation -anorexia -dysphagia -arching of back during feedings -irritability |
GER
-becomes GERD with bleeding and FTT |
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-usually diagnosised w/history
-barium swallow -upper GI -esophageal ph monitoring -endoscopy w/biopsy -scintigraphy and manometry |
GER
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Nissen fundoplication-
sx to develop an LES that resists passage of gastric contents for what disease? |
GER
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Clinical manifestations
-recurent abdominal pain over 3 months -alternating diarrhea and constipation -flatulence -bloating/feeling of abdominal distention -feeling of incomplete evacuation of bowel -urgency to defecate |
IBS
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With IBS symptoms what should be ruled out?
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-lactose intolerance
-parasitic infection -inflammatory bowel disease |
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treatment of IBS
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-treat symptoms
-reduce stress -high fiber diet |
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Dietary intervention for IBS
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-eat slowly
-increase fiber -avoid carbonated beverages -relieve stressors |
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-abdominal pain around the umbilicus
-nausea, vomiting,anorexia -diarrhea -possible hip pain -febrile or afebrile -may have other common signs of illness |
Appendicitis
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Diagnostic for appendicitis
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-H and P
-CBC -UA -HCG(r/o pregnancy) |
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Nursing role in Appendicits
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-monitor IV
-open wound care -possible penrose drain -pain management -antibiotics w/rupture -NG for GI decompression -NPO if no bowel sounds |
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Most common malformation of the GI tract. Often exists without causing problems.
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Meckel Diverticulum
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Clinical manifestations
-painless rectal bleed -bright red/currant jelly like stools -intermittent tarry stools -intestinal obstruction |
Meckel Diverticulum
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Diagnostic tools for Meckels Diverticulum
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-H and P
-radionucleotide scintigraphy -lab work to r/o bleeding disorder or severity of bleeding |
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Name two major forms of Inflammatory Bowel Disease
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Ulcerative colitis
Chron's Disease |
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Clinical manifestations
-GI sysmptoms -extraintestinal -systemic inflammatory process -exacerbations -remissions without complete resolution |
IBD-irritable bowel disease
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Inflammation limited to colon and rectum. Distal colon and rectum often severely effected.
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Ulcerative colitis
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inflammation usually limited to colon and rectum.
Inflammation ususally limited to submucosa and mucosa and involves continuous segments along the length of the bowel, with degrees of ulceration, bleeding, edema |
ulcerative colitis
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Clinical manifestation
-water and electrolytes poorly absorbed -loose stools -bloody diarrhea abdominal pain -growth abnormalities -usually withour fever or weightloss |
Ulcerative Colitis
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chronic inflammatory process of GI tract, anywhere from the mouth to the anus. Most commonly affects the terminal ileum.
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Crohn's disease
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Clinical manifestations
-diarrhea -abdominal pain w/cramps -weight loss -mild gi symptoms -poor growth -rectal bleed -mouth ulcers |
Chrohn's disease
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Diagnostic eval for IBD
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-H and P
-radiologic -endoscopy -histologic -hemoccult -cbc, sed rate, protein, albumin, iron, zinc, mg, b12, |
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Nursing role in IBD....
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-nutritional support
---small frequent meals ---no increased fiber -drug compliance -teaching w/ TPN or NG -care colostomy or ileostomy |
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Ulcerative condition causing loss of tissue of the mucosal, submucosal, and sometimes muscular layers of a GI tract exposed to acid-pepsin secretions.
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Peptic Ulcer
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Name the two classes of ulcers.
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1. Gastric(mucosal of stomach)
2. duodenal (pylorus or duodenum) Or Primary or Secondary |
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What are primary ulcers?
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-chronic
-no predisposing factors -located in the duodenum -usually occur with older children/adolescents |
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What are secondary ulcers?
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-acute
-result of disease or injury -occur at all age groups -usually located in the stomache |
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-chronic abdominal pain(especially when empty, middle of night)
-recurrent vomiting -hematemesis -melena -chronic anemia -abdominal tenderness |
Clinical manifestations of peptic ulcer disease
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How do you diagnose PUD?
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-history and physical
-CBC -Erythrocyte -sed rate -UA -stool -fiberoptic endoscopy |
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Management for PUD....
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-antacids
-decrease stress -relieve discomfort -sulcralfate -avoid caffiene -H2 blockers -often reoccur |
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-projectile vomiting
-ftt -wt. loss -hungry and irritable -brown emesis -dehydration -olive like palpable mass epigastric area |
hypertrophic pyloric stenosis
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How do you diagnose HPS
-hypertrophic pyloric stenosis |
-H and P
-Olive like mass in epigastric area -ultrasound |
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Treatment for hypertrophic pyloric stenosis
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pylorotomy surgery
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Nursing consideration for hypertrophic pyloric stenosis
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-vomiting normal first 24-48 hours
-IV fluids for hydration -I and O -NG for decompression -monitor drainage -pain management |
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Clinical manifestation of intussusception.....
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-currant jelly stool
-sudden onset of cramping/pain -sausage shape abdominal mass -inconsolable crying -emesis -rectal bleed -draw knees to chest in pain |
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Intussueception is diagnosed by.....
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-subjective findings
-abdominal radiograph -barium enema |
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Nursing considerations for Intussusception....
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-NG for suction
-antibiotic -monitor stool(barium pass) -monitor hemmorrhage -monitor electrolytes and fluid |
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disease where villous atrophy leads to malabsorption due to gluten exposure....
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Celiac Disease
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Four charactersitics of celiac disease
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-steatorrhea(fatty stools)
-malnutrition -abdominal distention -secondary vitamin deficiency |
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Clinical manifestations of celiac disease
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-ftt
-diarrhea -abdominal distention -muscle wasting -anorexia -irritability -all noticed when solid foods introduced |
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How is celiac disease diagnosed?
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-remission after gluten is removed
-IgG and IgA are gone after gluten removed |
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treatment and nursing considerations for celiac disease
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-managed through gluten free diet
-may need to be temporarily lactose free diet -decrease fiber until inflammation decreases |
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SBS-short bowel syndrome
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-result of decreased surface area, usually due to extensive resection of small intestines
-necrotizing enterocolitis -volvulus |
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management of SBS
-short bowel syndrome |
-first phase is TPN
-2nd phase is enteral feeding asap to stimulate the adaption process. |
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What are the complications of TPN?
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-central venous catheter infection
-thrombus due to catheter -metabolic complications -----hyperlipidemia,glycemic,electrolytes -cholestasis and liver dysfunction - |
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-coffee ground emesis
-hematemesis (bloody) |
clinical manifestation of upper GI bleed
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Possible causes of upper GI bleed....
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-esophagitis
-esophageal varicies -peptic ulcer -gastritis -gastric perforation(an emergency) |
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-hematochezia(red rectal bleed)
-tarry stools (melena) |
clinical manifestation of lower GI bleed
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Possible causes of lower GI bleed....
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-anal fissure
-colonic polyps -enteric infection(most common) -intussusception |
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Nursing considerations for GI bleed....
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-o2
-suction -IV -monitor for shock -possible ng tube -no rectal temps -thorough H and P |
