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NURS 332 > Chapter 22: GI Dysfunction > Flashcards

Chapter 22: GI Dysfunction Flashcards

1
Q

Explain generally how daily maintenance fluid requirements are calculated.

5 steps

A
  • determine child’s weight in kg
  • calculate 100 mL/kg for the first 10 kg of weight
  • calculate 50 mL/kg for the second 10 kg of weight
  • calculate 20 mL/kg for the remaining kg of weight
  • add values together
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2
Q

What is Hirschsprung disease?

A
  • AKA congenital aganglionic megacolon
  • mechanical obstruction from inadequate motility of the intestine d/t absence of ganglion cells in the colon
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3
Q

What population of children experiences Hirschsprung disease more commonly?

A
  • more common in males
  • more common in children with Down syndrome
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4
Q

What are signs and symptoms of Hirschsprung disease?

4 signs and symptoms

A
  1. accumulation of stool with distention of abdomen
  2. failure of internal anal sphincter to relax
  3. enterocolitis (inflammation of small and large intestines)
  4. neonates – delayed passage of first mec
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5
Q

How is Hirschsprung disease diagnosed?

3 diagnostic evaluations

A
  1. X-ray with barium enema
  2. anorectal manometric exam – catheter with balloon inserted into rectum to determine internal pressure
  3. rectal biopsy – confirms diagnosis
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6
Q

How is Hirschsprung disease treated?

4 treatments

A
  1. enema
  2. surgery to remove aganglionic portion – most common
  3. low fiber diet
  4. measure abdominal girth and circumference (measure at umbilicus)
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7
Q

What is gastroesophageal reflux (GER)? What predisposes children to GER?

5 predisposing factors

A
  • GER: transfer of gastric contents into the esophagus, but with no damage to tissues
  • predisposing factors:
    1. prematurity
    2. borderline personality disorder (BPD)
    3. cystic fibrosis
    4. asthma
    5. cerebral palsy
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8
Q

What are some signs and symptoms of GER? How is GER diagnosed?

3 s/s; 2 diagnosis methods

A
  • signs and symptoms:
    1. frequent spitting up
    2. lack of weight gain
    3. ALTE (apparent life-threatening event) or BRUE (brief resolved unexplained event)
  • diagnosed by:
    1. H&P
    2. pH study of intraesophagus – gold standard
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9
Q

How is GER managed?

5 management techniques

A
  1. dietary changes
  2. meds – H2 antagonists (-tidine meds)
  3. surgery if severe
  4. positioning
  5. special caution when feeding
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10
Q

What is acute appendicitis, and what causes it?

A
  • acute appendicitis: inflammation of appendix
  • caused by obstruction or infection
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11
Q

How is acute appendicitis diagnosed?

3 diagnostic tests

A
  • H&P
  • ultrasound
  • CT scan
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12
Q

How is appendicitis managed?

5 management methods

A
  1. appendectomy
  2. IVF
  3. antibiotics for perforation up to 82% if less than 5 years old
  4. suction if ruptured
  5. pain medication if ruptured
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13
Q

What is biliary atresia? What is the major sign/symptom?

A
  • AKA extrahepatic biliary atresia
  • biliary atresia: failure of extrahepatic bile ducts to develop/are closed
  • major s/s: jaundice
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14
Q

How is biliary atresia diagnosed?

2 diagnostic tests

A
  • H&P
  • HIDA scan – checks functioning of gallbladder
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15
Q

How is biliary atresia managed?

2 treatments

A
  1. Kasai procedure – removal of blocked bile ducts and gallbladder and replacing with a segment of the child’s own small intestine to form a new extrahepatic bile duct
  2. liver transplant
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16
Q

What is the best age for the Kasai procedure for biliary atresia?

A

less than 2 months old
* 75 - 90% survival rate

17
Q

What are cleft lip and cleft palate?

A
  • cleft lip: hole in upper lip d/t incomplete formation
  • cleft palate: hole in roof of mouth d/t incomplete formation
18
Q

How are cleft lip and cleft palate diagnosed?

A
  • visual exam of oral cavity
  • fetal ultrasound
19
Q

How are cleft lip and cleft palate managed?

5 management methods

A
  1. CL repair – surgery by 2 - 3 months so infant can feed properly
  2. CP repair – surgery by 12 months to not interfere with growth, but want to fix in time for speech development
  3. feed using wide-based nipple
  4. provide cheek support while feeding
  5. burp frequently during feeds
20
Q

What is an esophageal atresia/tracheoesophageal fistula?

A
  • failure of the esophagus to develop as a continuous passage separate from the trachea
  • esophagus instead ends in a blind pouch or a pouch connected to the trachea by a fistula
21
Q

What are some signs and symptoms of esophageal atresia/tracheoesophageal fistula? (3 C’s)

A
  1. coughing
  2. choking
  3. cyanosis
22
Q

How is esophageal atresia/tracheoesophageal fistula managed?

5 management methods

A
  1. NPO
  2. IVF
  3. upright position
  4. suction
  5. surgery
23
Q

What is gastroschisis?

A

protrusion of bowel through a defect in the abdominal wall to the side of the umbilicus

24
Q

What is omphalocele?

A

when intra-abdominal contents herniate through the umbilical cord

25
Q

What is hypertrophic pyloric stenosis?

A
  • constriction of the pyloric sphincter with obstruction of gastric outlet
  • lumen becomes inflammed and edematous –> obstruction
26
Q

What are the major signs and symptoms of hypertrophic pyloric stenosis?

3 signs/symptoms

A
  • projectile vomiting
  • dehydration
  • electrolyte imbalance/depletion
27
Q

What is intussusception?

A
  • telescoping of a portion of the intestine into another
  • obstructs passage of stool –> inflammation, edema, decreased bloodflow
28
Q

At what age of children is intussusception most common?

A

3 months to 3 years

29
Q

What are some signs and symptoms of intussusception?

2 signs/symptoms

A
  • sudden onset of crampy abdominal pain
  • currant jelly stool (bright red stools) from strangulation of intestines
30
Q

How is intussusception diagnosed?

2 diagnostic tests

A
  • ultrasound
  • rectal exam demonstrating blood and mucus
31
Q

How is intussusception treated? What could occur if not treated promptly?

2 treatments; 4 possible outcomes

A
  • treatments:
    1. enema
    2. surgery
  • if not treated promptly, could result in:
    1. bowel ischemia
    2. perforation
    3. peritonitis
    4. death
32
Q

What is short bowel syndrome (SBS)?

A
  • malabsorptive disorder d/t decreased mucosal surface area
  • usually the result of small bowel resection
33
Q

What is necrotizing enterocolitis?

A
  • an acute inflammatory disease of the bowel
  • mostly affects infants with vascularly compromised GI tracts
34
Q

How is necrotizing enterocolitis treated?

2 treatments

A
  • NPO for 24 - 48 hrs if suspect birth asphyxia
  • minimal enteral feedings of breastmilk –> promotes intestinal maturation
35
Q

What are some nursing interventions for necrotizing enterocolitis?

3 interventions

A
  • check for abdominal distention
  • antibiotics
  • monitor nutritional needs

NURS 332 (13 decks)

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