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NCLEX-RN (8) Pediatrics > GastroIntestinal > Flashcards

Flashcards in GastroIntestinal Deck (46)
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1

What is the priority concern for a child that is vomiting?

Risk of aspiration

Maintain a patent airway.

2

What should be done if a child vomits right after giving a medication?

Do NOT give another dose of medication if a child vomits. 

3

What type of room should a child with diarrhea be placed in?

Child with diarrhea needs to be placed in a private room on enteric precautions.

Use gown and gloves; and wash hands with soap and water.

 

4

What is the priority concern with both vomiting and diarrhea?

Dehydration

5

What are the characteristic signs and symptoms of dehydration in a child?

  • sunken fontanels (in an infant)
  • poor skin turgor
  • decreased urinary output
  • dry mucous membranes
  • decreased tear production

6

What is given to a child with mild to moderate dehydration to rehydrate?

Rehydrate with Pedialyte or another rehydration therapy that contains electrolytes.

 

7

What are the interventions for a child with severe dehydration?

  • keep NPO
  • give IV fluids

8
Describe:

Cleft lip and cleft palate

Cleft lip and cleft palate are a congenital condition where the upper palate or lip doesn't fuse completely together.

9

How should an infant with a cleft lip or palate be fed?

Hold the infant upright and direct the formula to the side and back of the mouth to prevent aspiration.

10

How is an infant positioned after a cleft lip or palate repair?

Lay infant on side or back to prevent them from rubbing face on bed and causing trauma.

11

What type of restraints does an infant wear after a cleft repair?

Elbow restraints

12

What should NOT be placed in the mouth of an infant after a cleft repair?

After a cleft repair, do NOT place a tongue depressor, thermometer, straws, spoons, forks or pacifiers in the mouth due to risk of trauma.

13
Describe:

Esophageal atresia and tracheoesophageal fistula

Immediate complication

Esophageal atresia and tracheoesophageal fistula is when the esophagus forms an unnatural connection with the trachea causing food to enter the airway.

There is a high risk of aspiration.

14

What are the characteristic signs and symptoms of esophageal atresia and tracheoesophageal fistula?

Signs and symptoms of esophageal atresia and tracheoesophageal fistula are "The 3 C's":

  • coughing and choking during feeding
  • cyanosis

15
Treatment:

Esophageal atresia and tracheoesophageal fistula

Surgery to repair the trachea and esophagus.

16

What tube may an infant have after an esophageal and trachea repair surgery?

Gastrostomy tube for nutrition while the esophagus heals.

17

What is the teaching to parents after an esophagus and trachea repair surgery?

  • poor feeding
  • dysphagia
  • drooling
  • coughing during feedings
  • vomiting undigested food

Report these symptoms to the HCP.

18
Describe:

Hypertrophic pyloric stenosis

Hypertrophic pyloric stenosis is projectile vomiting due to a restricted pylorus caused by an enlarged muscular area.

19

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

  • projectile vomiting
  • peristaltic waves that occur over the abdomen from left to right after a feeding
  • an olive-shaped mass in the epigastrium just right of the umbilicus

20
Treatment:

Hypertrophic pyloric stenosis

Pyloromyotomy or pyloroplasty to make the opening of the pylorus bigger.

21
Describe:

Lactose intolerance

Lactose intolerance is a lack of or deficiency of the enzyme lactase. 

This enzyme is needed to digest foods with lactose such as milk.

 

22

What are the characteristic signs and symptoms of lactose intolerance?

Lactose intolerance signs and symptoms occur after dairy products are consumed:

  • abdominal distention and cramps
  • diarrhea and excessive flatus

23
Interventions:

Lactose intolerance

  1. limit dairy products
  2. take supplemental enzyme tablets that digest lactose
  3. encourage foods such as hard cheese, cottage cheese, and yogurt
    • has the inactivated form of lactose

24

What is the child with lactose intolerance at risk for?

Lactose intolerance can cause Vitamin D and calcium deficiencies.

Teach parents to provide these supplements.

25
Describe:

Celiac disease

Celiac disease is an intolerance to gluten, a component of protein. 

Don't eat foods with gluten: "BROW":

  • Barley
  • Rye
  • Oats
  • Wheat

26

What is the characteristic symptom of celiac disease?

Watery diarrhea which can lead to fluid and electrolyte imbalances.

27
Describe:

Hirschsprung's disease

Hirschsprung's disease is a birth defect in which nerves are missing from parts of the intestine.

If not treated, the child can have a bowel obstruction, enterocolitis, and perforation.

28
Interventions:

Hirschsprung's disease

Hirschsprung's disease interventions focus on preventing constipation and obstruction:

  • healthy diet
  • stool softeners
  • rectal irrigation

The goal is to have at least 2 soft bowel movements a day.

29

What is the last resort treatment for Hirschsprung's disease?

Surgery to remove the part of the colon that does not have nerves.

30

What tube will a child have after surgery for Hirschsprung's disease?

NG tube to decompress the stomach while the bowels heal.

31
Describe:

Intussusception

Intussusception is when part of the intestine folds into the section immediately ahead of it causing a blockage.

It typically involves the small bowel.

32

What is the characteristic symptom of intussusception?

Currant jelly-like stools containing blood and mucus

33
Interventions:

Intussusception

Interventions for Intussusception focus on assessing for perforation and monitoring bowel movements:

  • hydrostatic reduction: this is the use of air or fluids to move the folded intestine back to the normal area
  • monitor for soft brown stools

34
Describe:

Imperforate anus

Imperforate anus is a birth defect in which the opening to the anus is missing or blocked.

35
Treatment:

Imperforate anus

Imperforate anus is treated with surgery to make an anal opening.

Child may have a temporary colostomy.

36

What position is an infant placed in after surgery to correct imperforate anus?

After surgery to correct imperforate anus, the position focuses on preventing tension on the perineum:

  • side-lying supine with hips elevated or
  • 90-degree angle with legs in air

37

If a child is suspected of ingesting a poison what is the first response by the parents?

Call the Poison Control Center.

38

At what age is lead poisoning screened for?

Lead poisoning is screened at 1 - 2 years old.

If it is a low-risk area for lead poisoning, screening may not be done.

39

What is the treatment for severe lead poisoning?

Chelation therapy: medications are administered to remove lead from the blood.

40

What are some sources of lead poisoning?

Sources of lead are from lead paint from old houses, contaminated dust, soil, and water.

Children may chew on window sills with old lead paint.

41
Immediate complication

What is the treatment for acetaminophen overdose?

  • give acetylcysteine
  • use activated charcoal with gastric lavage

42
Immediate complication

What is the treatment for aspirin (acetylsalicylic acid) overdose?

Give activated charcoal

43
Immediate complication

What is the treatment for corrosive poisoning in a child, such as household cleaners, bleach, paint or batteries?

  • give water or milk
  • don't induce vomiting as it can cause damage to the esophagus

44
Describe:

Intestinal parasites

Intestinal parasites are pinworms that come out of the anus.

Anal itching is common.

45

How are pinworms diagnosed?

Diagnosis of pinworms is by a piece of tape that is placed firmly against the anus and then removed in the morning.

Place in a jar or plastic bag and take it to a lab for analysis.

46
Treatment:

Pinworms

  • medications are given to kill the parasites
  • the whole family is treated

These meds are not given to children less than 2 years old due to toxicity.