GI 3

Question 1

two disorders of IBD

Answer 1

1) Ulcerative colitis

2) Crohn’s disease (serious complication, growth failure)

Question 2

treatment of Crohn’s

Answer 2

• pharmacological
• nutritional
• surgical

Question 3

goals of Crohn’s

Answer 3

• control disease by remission and preventing relapse (maintain adequate nutrition)
• decrease inflammation
• correct nutritional deficit
• provide relief of symptoms
• no cure (management)

Question 4

nutritional management of Crohn’s

Answer 4

• dietary modifications
• vitamins
• oral supplements
• hyperalimentation

Question 5

meds for Crohn’s

Answer 5

• antibiotics
• antidiarrheal preparations
• anti inflammatory agents
• immunosuppressants
• analgesics or narcotics (be careful with narcotics in kids, can further compound bowel function)

Question 6

describe surgery for Crohn’s

Answer 6

• surgery is NOT curative
• palliative to improve QOL and sumptoms
• 70% of pts will require surgery eventually (drain, close, remove, repair)

Question 7

describe ulcerative colitis

Answer 7

-acute or chronic inflammation of colon
-characterized by bloody diarrhea
s/s: abd pain, bloody D, urgency, tenesmus

Question 8

diagnostics of UC

Answer 8

• radiological
• endoscopic
• evaluate characteristics and location of lesions

Question 9

treatment of UC

Answer 9

• disease control (induce remission, prevent replace, normal growth)
• *CURABLE with surgery (ileostomy)

Question 10

describe gastroenteritis

Answer 10

• inflammation of stomach and intestines
• acute or chronic
• results in: D/V, abd pain, fever
• *high risk if at day care or preschool

Question 11

diagnostics of gastroenteritis

Answer 11

• rectal/stool culture

- blood culture

Question 12

causes of gastroenteritis

Answer 12

• allergy
• viral or bacterial (giardia and rotavirus are most common)
• parasites
• food poisoning

Question 13

treatment of gastroenteritis

Answer 13

• *contact precautions (hand washing) to prevent spread
• acetaminophen for fever
• NO antidarrheals (for kids ever)
• antibiotics for shigella or giardia
• fluid replacement (oral or IV solutions up to 2x maintenance)

Question 14

what is important to replace if V

Answer 14

electrolytes

**small amounts of fluids in frequent intervals

Question 15

describe vomiting and causes of it

Answer 15

• forceful expulsion of stomach contents
• consequences: metabolic alkalosis, dehydration
• causes: allergic reaction, overfeeding, infection, CNS disorder, meds, pyloric stenosis, intussusception

Question 16

describe diarrhea

Answer 16

• loose watery stools
  acute: <14 days (ie/viral infection)
  chronic: >14 days

Question 17

causes of D

Answer 17

• infection (ROTAVIRUS)
• parasitic infestation
• association with URI, UTI, OM
• diet
• meds
• IBS
• can be r/t anxiety or travel

Question 18

s/s of D

Answer 18

• hyperactive BS
• at least 3 loose/liquid stools a day
• urgency
• abd pain
• cramping

Question 19

consequences of D

Answer 19

• dehydration
• electrolyte imbalance
• metabolic acidosis
• malnutrition

Question 20

what should you not give as a fluid replacement

Answer 20

gatorade and juice, have a lot of sucrose and can increase D

Question 21

describe constipation

Answer 21

• peaks between 2-4 years
• idiopathic or functional
• difficulty/infrequent passage of hard stool (straining, abd pain, withheld)

Question 22

how to manage constipation

Answer 22

• dietary (increase fluids and water)

- occasional stool softener

Question 23

management of chronic constipation

Answer 23

• needs bowel cleansing and maintenance therapy
• laxative (milk of magnesia and miralax)
• bowel retraining (regular toileting 2x/day)

Question 24

describe encopresis

Answer 24

• stool incontinence beyond age when normally able to control bowel
• soiling is involuntary and without warning
• usually results of fecal impaction and enlarged rectum
• *goal: establish regular bowel habits

Question 25

describe intestinal parasitic disease

Answer 25

• helminths (worms) and protozoa
• increased in daycare
• common infection in world

Question 26

what are the common intestinal parasitic disease

Answer 26

1) giardia

2) pinworms

Question 27

nursing responsibilities of intestinal parasitic disease

Answer 27

• identify parasite
• treat infection
• prevent initial infection and reinfection

Question 28

describe giardiasis

Answer 28

• most common intestinal parasitic pathogen
• transmission: person to person (water, diapers, food, animals)
• reportable to the health department
• diagnosis: stool sample
• s/s: abd cramp, D
  treatment: Flagyl

Question 29

describe enterobiasis

Answer 29

• *pinworms
• most common helminthic infection
• transmission: eggs are infested or inhaled
• diagnosed: tape test on perianal area
• sometimes in college kids d/t close proximity

Question 30

enterobiasis treatment

Answer 30

• vermox
• all household members should be treated
• should be repeated in 2 wks to prevent reinfection (wash sheets)

Question 31

describe hepatitis

Answer 31

• acute or chronic
• inflammation
• virus, bacterial, fungal, parasistic, chemical or drug toxicity
• 6 distinct viruses
• *vaccines for Hep A & B

Question 32

management of hepatitis

Answer 32

supportive

no specific treatment