GastroIntestinal

Question 1

Absorption in small intestine

Answer 1

Osmosis
Carrier mediated diffusion
Active energy driven transport “pump”

Question 2

Absorption in large inestine

Answer 2

water, sodium, colonic bacteria working

Question 3

Biliary Atresia

aka

Answer 3

EHBA

extrahepatic biliary atresia

Question 4

Biliary Atresia is..

Answer 4

a progressive inflammatory process that causes bile duct fibrosis, resulting in ductal obstruction

Question 5

Biliary Atresia

associated malformations

Answer 5

polysplenia, intestinal atresia, malrotation of intestine

Question 6

Biliary Atresia

Patho

Answer 6

cause is unknown

develops after birth

Question 7

Biliary Atresia

manifestations

Answer 7

infants are full term & healthy @ birth. If jaundice persists beyond 2 weeks of age
serum bilirubin is elevated
urine may be dark
stool become acholic or gray (indicating lack of bile pigment)
Hepatomegaly & firm on palpation.

Question 8

Biliary Atresia

Diagnostic

Answer 8

• Hx, physical,
• Labs: CBC, serum bili, liver function, TORCH titers, antitrypsin level, cytomegalovirus, hepatitis serology
• ultrasound, nuclear scintiscan, liver biopsy

Question 9

Biliary Atresia

Prognosis

Answer 9

surgically treated before 2 months of age…survive, but may need liver transplant: cirrhosis, malabsorption growth failure, pruritus, ascites,jaundice

Untreated: dead by 2 years old

Question 10

Biliary Atresia

Treatment

Answer 10

Kasai portoenterostomy

Question 11

Biliary Atresia

Nursing care

Answer 11

stoma care, nutritional therapy, supplements, gastrostomy feedings, growth failure, pruritus

Question 12

Omphalocele

Answer 12

Omphalocele—herniation of abdominal contents through umbilical ring, usually with an INTACT PERITONEAL SAC

Question 13

Gastroschisis

Answer 13

Gastroschisis—herniation is lateral to the umbilical ring (usually to the right), and peritoneal sac NOT present

Question 14

Omphalocele associated with

Answer 14

many other anomalies: brain, heart, GU, skeletal, imperforate anus, trisomies 13, 18, 21

Question 15

Prognosis for Omphalocele & Gastroschisis

Answer 15

Gastroschisis survivial w/ surgery: 90-95%

Omphalocele, less positive D/T associated anomilies

Question 16

Diarrhea is …..

Answer 16

Acute diarrhea is leading cause of illness in children younger than 5 years

Question 17

Acute infectious diarrhea

Answer 17

Acute infectious diarrhea—variety of causative organisms

Question 18

Diarrheal Disturbances

Answer 18

Gastroenteritis
Enteritis
Colitis
Enterocolitis

Question 19

Etiology of Diarrhea

Answer 19

Rotavirus
Salmonella, Shigella, Campylobacter
Giardia
Cryptosporidium
Clostridium difficile
Antibiotic therapy

Question 20

Chronic Nonspecific Diarrhea (CNSD)

Answer 20

AKA irritable colon of childhood
AKA toddlers’ diarrhea
6 to 54 months of age
Diarrhea >2 weeks’ duration
Normal growth/no evidence of malnutrition
No blood in the stool/no infection
Poor dietary habits and food sensitivities

Question 21

Chronic diarrhea

Answer 21

endures longer than 14 days

Question 22

Chronic diarrhea causes

Answer 22

IBD, food allergy lactose intolerance

Question 23

Contraindicated with diarrhea

Answer 23

Caffeinated beverages
BRAT diet
Clear liquids alone
Fluids with high carbohydrate content, low electrolyte content, and high osmolality
Sodas, fruit juice, gelatin, broth

Question 24

Prevention of Diarrhea

Answer 24

Most diarrhea is spread by the fecal-oral route
Teach personal hygiene
Clean water supply/protect from contamination
Careful food preparation
Hand washing