Pediatric Gi

Front 1

When does sucking and swallowing becoming voluntary?

Back 1

6 wks

Front 2

What is the stomach capacity of a newborn?

Back 2

10-20 ml

Front 3

What is the stomach capacity of a one month old?

Back 3

90-150 ml

Front 4

A newborn is deficient in enzymes until what age?

Back 4

4-6 months

Front 5

What happens by the 2nd year of life in the GI function?

Back 5

Adapts to a 3-meal/day feeding schedule
Neuromuscular function matures to allow for bowel control

Front 6

Causes of diarrhea:

Back 6

viral
bacterial
parasites
allergies
malabsorption
excess juice or water

Front 7

What is the goal of treatment for diarrhea?

Back 7

To fix Fluid and electrolyte imbalances

Front 8

What is the number 1 intervention for diarrhea?

Back 8

Oral rehydration with sodium and glucose
50-100 ml/kg over 4 hrs***

Front 9

Other Nursing Care for diarrhea:

Back 9

stool culture
regular diet unless dehydrated
monitor for hypokalemia
skin care
good hand washing

Front 10

Causes of vomiting:

Back 10

viral
bacterial
diabetes
GERD
increased ICP
bulimia

Front 11

Nursing care for vomiting:

Back 11

determine cause
monitor for hypokalemia
NPO 1-2 hrs, then small ORS q15 min., larger amounts when tolerated
IV therapy

Front 12

Gastroesophageal Reflux Disease (GERD)

Back 12

Transfer of gastric contents into the esophagus

Front 13

Causes of GERD:

Back 13

dysfunction of lower sphincter
delay in gastric emptying

Front 14

Clinical manifestations of GERD:

Back 14

regurgitation-most common
poor growth-from little absorption
irritability
choking
wheezing-from respiratory effects
apnea
heme+stools

Front 15

GERD nursing care:

Back 15

*Positioning-supine and upright for 30 min. after feeding
Feedings-thicken to nectar, NG, GT
Fundoplication-used for permanent tube

Front 16

GERD medications:

Back 16

Prilosec
Prevacid
Tagamet
Zantac
Used to reduce the amount of stomach acid and lessen the child's discomfort

Front 17

Celiac Disease or Gluten Sensitive Enteropathy (GSE)

Back 17

A chronic malabsorption disorder.
Sensitivity to gluten results in decreased absorption of surface area of villi.

Front 18

Symptoms of GSE:

Back 18

*diarrhea
steatorrhea
*growth problems
nutritional deficiencies
*abdominal distention

Front 19

Nursing care for GSE:

Back 19

Lifelong gluten free diet (no barley, wheat, rye)
substitute with corn, rice, soybean flour
NG tube may be needed initially to decrease distention

Front 20

What medication is used for GSE?

Back 20

Corticosteroids-used in acute flare ups or newly diagnosed to reduce inflammation

Front 21

Hidden sources of gluten:

Back 21

some prepared hamburgers, hot dogs, lunch meats
milk preparations (malts, ice cream)
canned soup
yogurt
malt flavoring and malt vinegar
rice or corn cereal

Front 22

Intussusception

Back 22

portion of intestine prolapses and then invaginates into another causing an obstruction

Front 23

What age has the highest incidence of intussusception?

Back 23

3 months-3 years

Front 24

Clinical manifestations of intussusception:

Back 24

abrupt onset
abdominal pain
irritability
knee-to-chest crying
no bowel movements
bloody stool-jelly like stools
vomiting
lethargy
sausage shaped mass

Front 25

Nursing care for intussusception:

Back 25

Prepare for barium/air pressure enema
Observe for sepsis/shock
Monitor stools-watch for change
Prepare for possible resection

Front 26

Post-op care for GI surgery:

Back 26

NG tube/NPO
abdominal assessment (look for returning bowel sounds)
Frequent vital signs
Pain management

Front 27

Anorectal Malformation

Back 27

Structural anomaly of anus and rectum
Unable to pass stool in the normal anatomical way.
No opening for stool to pass

Front 28

Clinical Manifestations of anorectal malformations:

Back 28

unable to pass stool (absence of meconium w/in first 24 hours)
stool in urine

Front 29

Nursing care for anorectal malformation:

Back 29

prepare for surgery
ostomy care
electrolyte balance
avoid rectal temps
accurate I/O
VS q4 hrs

Front 30

Nursing care post-op for anorectal malformation:

Back 30

protect surgical site
NPO
prevent infection
place child on abdomen
pain management

Front 31

Pyloric stenosis:

Back 31

pylorus muscle becomes hypertrophied and forms obstruction of pyloric canal

Front 32

When does pyloric stenosis usually occur?

Back 32

2 weeks-3 months

Front 33

Clinical manifestations of pyloric stenosis:

Back 33

*projectile vomiting
"olive" shaped mass RUQ
irritable
fails to gain weight
decreased serum chloride
increase pH and bicarb (met. alkalosis)
increased BUN

Front 34

Nursing Care for pyloric stenosis:

Back 34

post op care for pyloromyotomy
rehydration after NPO (gradual)
monitor fluid/electrolytes

Front 35

Hirschsprung Disease

Back 35

absence of ganglion cells in colon prevents peristalsis at that portion of the intestine, resulting in accumulation of intestinal contents and abd. distention

Front 36

Clinical manifestations of Hirschsprung Disease:

Back 36

no meconium in first 24 hrs**
constipation
abd distention
palpable fecal mass
irritability
poor feeder

Front 37

Nursing care for Hirschsprung Disease:

Back 37

Health hx-wt gain, nutritional intake, bowel elimination habits
High fiber diet-prevent constipation
Care of Ostomy

Front 38

Pre-op Care for Hirschsprung Disease:

Back 38

monitor for infection
manage pain
hydrate
measure abd circumference for distention
provide support
usually restrict PO intake to clear liquids

Front 39

Post-op care for hirschsprung disease:

Back 39

IV fluids and NG tube
I/O
pain meds (q hr)
assess stoma site
assess return of bowel function

Front 40

Esophageal Atresia (EA)
Tracheoesophageal Fistula (TEF)

Back 40

malformation that results from failure of esophagus to develop as a continuous tube
upper esophagus ends in blind pouch and lower esophagus connects stomach to trachea

Front 41

Clinical manifestations of EA or TEF:

Back 41

drooling, increased salivation
immediate regurgitation of feeding

Front 42

3 C's of EA and TEF:

Back 42

coughing
choking
cyanosis

Front 43

Nursing care Pre-op for EA and TEF:

Back 43

NPO
keep airway patent
position upright

Front 44

Nursing care Post-op for EA and TEF:

Back 44

keep airway patent
prevent hyperextension of neck
protect surgical sites
nutrition/sucking

Front 45

Omphalocele

Back 45

herniation of abdominal contents into base of umbilical cord

Front 46

Gastroschisis

Back 46

herniation of bowel to right of umbilicus
mostly seen with small intestine and ascending colon
no membrane covers the organ

Front 47

Clinical manifestations of omphalocele and gastroschisis:

Back 47

hypothermia
infection
obstruction

Front 48

Surgical closure of Omphalocele or gastroschisis:

Back 48

surgical, mesh bag and gradually push back into abdomen

Front 49

Nursing care for omphalocele and gastroschisis:

Back 49

warming solution to prevent hypothermia
cover with moist, sterile dressing
place patient on side
NG tube for decompression

Front 50

Cleft Lip and Palate

Back 50

Failure of the maxillary processes, oral and/or nasal cavities to fuse properly

Front 51

Clinical manifestations of cleft lip/palate:

Back 51

difficulty feeding (unable to breastfeed)
frequent ear infections
speech difficulty
aspiration

Front 52

Nursing care Pre-op for cleft lip/palate:

Back 52

assist with feeding
encourage bonding
acknowledge image issues-focus on positive
prep for surgery

Front 53

Nursing care Post-op for cleft lip/palate:

Back 53

airway
protect suture lines
arm restraints
positioning-supine
nutrition-assess calorie/fluid intake, small slow feedings
pain management