EXAM 2 NUTRITIONAL AND GI dysfunction

Question 1

failure to thrive

Answer 1

inadequate growth, diagnosed by height and weight below 5th percentile or abnormal deviation from established growth curve

Question 2

organic failure to thrive

Answer 2

identifiable cause (celiac)

Question 3

non organic failure to thrive

Answer 3

developmental delays, apathy, bad hygiene, feeding disorder, no stranger anxiety, avoidance of eye contact

Question 4

managing non organic FTT

Answer 4

catch up their growth, correct nutrition, treat underlying cause, education

accurate IO, daily weights, demonstrate proper care, provide parent emotional support, promote parent confidence

Question 5

feeding guidelines for non organic ftt

Answer 5

consistent staff
quiet, calm, talk to child
be persistent, fact to face posture, slow introduce new foods, follow rhythm of feeds and routine

Question 6

cleft lip and palate

Answer 6

abnormal lip openings, causes difficulty feeding, mouth breathing, dry mucus membranes, increase risk of infection

Question 7

management of CL/CP

Answer 7

surgery on lip in first week, palate closed 12-18months

Question 8

nursing care CL/CP

Answer 8

encourage bonding, reassuref

Question 9

preop CL/CP

Answer 9

upright feeding, special nipples, rest, burp a lot, will be noisy feeders

Question 10

postop CL/CP

Answer 10

protect airway by positioning
hypothermia, prevent infection, protect sutures, pain management, avoid things in mouth, suction carefully

Question 11

long term/ discharge CL/CP

Answer 11

altered speech, altered dentition, hearing issues, good tooth care post op, monitor ears, promote speech development

Question 12

esophageal atresia/traceoesophageal fistula

Answer 12

failure of esophagus to be a continuous passage or failure of esophagus and trachea to separate

Question 13

clinical manifestation of esophageal atresia

Answer 13

frothy saliva, choking, coughing, feedings return through nose and mouth, cyanosis and apnea

Question 14

diagnosis of esophageal atresia

Answer 14

radiopaque catheter until obstruction encountered

Question 15

postop nursing for esophageal atreasia

Answer 15

careful suction and positioning, provide non-nutritive sucking, ng to low suction, high humidity, prevent PNA, care for chest tubes, nutrition, comfort, teach resp distress to parentsa

Question 16

omphalocele

Answer 16

herniation of abdominal contents, remain in peritoneal sac, usually caught prenatally

Question 17

gastroschisis

Answer 17

herniation of abdominal contents, no sac

Question 18

management of abdominal wall defects

Answer 18

cover w saline pads and plastic, iv fluid, antibiotics, surg correction, careful handling

Question 19

gastroenteritis

Answer 19

diarrhea , 3+ stools per day, less than 14 days, 200grams/day loss. second leading cause of death world wide, dia

Question 20

viral gastroenteritis

Answer 20

most common cause, rotavirus and norovirus

low grade fever, n/v/d, abd cramps

Question 21

bacterial diarrhea

Answer 21

fecal-oral transmission, bloody diarrhea, severe cramping, malaise, abx treatment not always necessary

Question 22

general diarrhea treatment

Answer 22

ORS,
avoide fruit juice, colas, sport drinks, normal diet with ORS
iv fluids for moderate to severe dehydration

Question 23

nursing care of diarrhea

Answer 23

fluid therapy, prevent skin breakdown and infection, provide nutrition, reduce fear, infection control, education

Question 24

constipation

Answer 24

quality x quantity

could be caused by structure, hypothyroid, lead poisoning, spinal cord lesions
give diet recommendations and stool softeneres

Question 25

encopresis

Answer 25

chronic constipation where stool leaks around it management: purge bowel, retrain bowel teach, encourage compliance, empower child, positive reinforcement

Question 26

hirschsprung disease

Answer 26

lack of nerves to lower colon, become obtunded and intestines could rupture

Question 27

hirschsprung disease ages

Answer 27

newborn: failure to pass meconium in 48 hrs, refuse food, bilious vomiting, abd distension infancy: poor weight gain, constipation, distension, diarrhea, vomiting childhood: constipation, ribbon like stool, fecal pass, poor appetite and growth

Question 28

hirschsprung disease management

Answer 28

barium enema or rectal biopsy to diagnose temporary ostomy dyuring healing

Question 29

hirschsprung disease postop care

Answer 29

ng to suction, NPO, i and o, hydration status, abd assessment, ostomy careg

Question 30

gastroesophageal reflux disease GERD

Answer 30

gastric content into esophagus, relaxation of lower esophageal sphincter that is uncontrollable

Question 31

GERD risk factors

Answer 31

premature, bronchopulmonary dysplasia, neurologic disorders, scoliosis, asthma, cystic fibrosis

Question 32

infant GERD

Answer 32

spitting up, intermittent vomiting, irritable, aspiration pna

Question 33

children GERD

Answer 33

heartburn, anemic, aspiration pna, chronic cough, diff swallowing

Question 34

gerd mananagement

Answer 34

diagnosed w labs, ugi, pH probe, endoscopy medications: antacids or histamine receptor antagonist, proton pump blocker (omeprazole/prilosec) prokinetic meds (reglan, bethanechol cisapride) HOB 30 degrees, small feedings with thick forumula, avoid fat, chocolate, liquid, tomato, carbonation, educate parents, burp frequently

Question 35

hypertrophic pyloric sphincter

Answer 35

pyloris muscle becomes thick causing gastic outlet obstruction, causes projectile vomiting, hunger and irritability, dehydration, olive shaped mass felt

Question 36

hypertrophic pyloric sphincter nursing considerations

Answer 36

can be surgically corrected, fluid therapy, pre and postop care

Question 37

intussusception

Answer 37

intestine folds onto self can cause obstruction, inflammation, edema, ischemia, perforation, peritonitis, schock severe abdominal pain-knees to chest current jelly stools tender and distended abdomen recognize symtoms, may need ng for decompression, administer abc, provide nutrition and hydrationma

Question 38

celiac disease

Answer 38

inflammation of small intestinal mucosa, inability to digest fluten, wheat, rye, barley, oats no symptoms for 6m, 1-5 years peak increases malnutrition, anemia and rickets, foul stool, vomiting/constipation

Question 39

celiac management

Answer 39

diagnosed w biopsy, remove wheat, rye, barley, oats, educate parents on reading labels, can be called "hydrolyzed vegetable protein"

Question 40

short bowel syndrome

Answer 40

decreased mucosal surface area-causes malabsorption can be congenital defects, trauma, etc

Question 41

SBS problems, treatment

Answer 41

decreased fluid absorption, electrolyte, and nutrients preserve as much bowel as possible, maintain nutrition

Question 42

complications with SBS

Answer 42

central venous cath infections, TPN can cause metabolic complications, bacterial overgrowth

Question 43

nursing SBS

Answer 43

TPN, ensure sterile, CVAD non nutritive sucking, teach home care, skin care for diarrhea

Question 44

acute appendicitis

Answer 44

inflammation of appendix, usually after 2 yrs, ultrasound or T to confirm, umbilical or RLQ pain abd pain, guarding, rebound tenderness, nausea, vomiting, anorexia, low grade fever >102=PERITONITIS

Question 45

nursing for appendicitis

Answer 45

assessment, avoid enema and heating pad, prep for surgery