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NCLEX-RN® > NCLEX-RN (8) Pediatrics > GastroIntestinal > Flashcards

GastroIntestinal Flashcards

Review the most common pediatric gastrointestinal diseases.

1
Q

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

A

Risk of aspiration.

Maintain a patent airway.

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2
Q

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

A

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

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3
Q

What can the child blow on after surgery to prevent respiratory complications?

A

A pinwheel! It’s fun :)

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4
Q

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

A

A private room on enteric precautions.

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

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5
Q

What is the priority concern with both vomiting and diarrhea?

A

Dehydration.

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6
Q

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

A
  • sunken fontanels (in an infant)
  • poor skin turgor
  • decreased urinary output
  • dry mucous membranes
  • decreased tear production
  • lethargy
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7
Q

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

A

Rehydrate with Pedialyte or another rehydration therapy that contains electrolytes.

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8
Q

What are the interventions for a child with severe dehydration?

A
  • keep NPO
  • give IV fluids
  • daily weights
  • monitor intake and output
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9
Q

Describe:

Cleft lip and cleft palate

A

Congenital condition where the upper palate or lip doesn’t fuse completely together.

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10
Q

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

A

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

Baby may still be able to breastfeed.

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11
Q

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

A

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

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12
Q

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

A

Elbow restraints.

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13
Q

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

A

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

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14
Q

Describe:

Esophageal atresia and tracheoesophageal fistula

(Immediate complication)

A

When the esophagus forms an unnatural connection with the trachea causing food to enter the airway.

There is a high risk of aspiration.

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15
Q

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

A
  • “The 3 C’s”:
    • coughing
    • choking during feeding
    • cyanosis
  • excessive drooling
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16
Q

Treatment:

Esophageal atresia and tracheoesophageal fistula

A
  • Surgery to repair the trachea and esophagus.
  • TPN
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17
Q

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

A

Gastrostomy tube for nutrition while the esophagus heals.

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18
Q

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

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

Report these symptoms to the HCP.

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19
Q

Describe:

Hypertrophic pyloric stenosis

A

Projectile vomiting due to a restricted pylorus caused by an enlarged muscular area.

20
Q

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

A
  • 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
21
Q

Treatment:

Hypertrophic pyloric stenosis

A

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

22
Q

Describe:

Lactose intolerance

A

A lack of or deficiency of the enzyme lactase.

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

23
Q

What are the characteristic signs and symptoms of lactose intolerance?

A

Occur after dairy products are consumed:

  • abdominal distention and cramps
  • diarrhea and excessive flatus
24
Q

Interventions:

Lactose intolerance

A
  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
25
Q

What is the child with lactose intolerance at risk for?

A

Vitamin D and calcium deficiencies.

Teach parents to provide these supplements.

26
Q

Describe:

Celiac disease

A

An intolerance to gluten, a component of protein.

Don’t eat foods with gluten: “BROW”:

  • Barley
  • Rye
  • Oats
  • Wheat
27
Q

What is the characteristic symptom of celiac disease?

A

Watery diarrhea which can lead to fluid and electrolyte imbalances.

28
Q

Describe:

Hirschsprung’s disease

A

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.

29
Q

Interventions:

Hirschsprung’s disease

A

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.

30
Q

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

A

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

31
Q

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

A

NG tube to decompress the stomach while the bowels heal.

32
Q

Describe:

Intussusception

A

When part of the intestine folds into the section immediately ahead of it causing a blockage.

It typically involves the small bowel.

33
Q

What is the characteristic symptom of intussusception?

A

Currant jelly-like stools containing blood and mucus.

34
Q

Interventions:

Intussusception

A

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
35
Q

Describe:

Imperforate anus

A

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

36
Q

Treatment:

Imperforate anus

A

Surgery to make an anal opening.

Child may have a temporary colostomy.

37
Q

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

A

Focuses on preventing tension on the perineum:

  • side-lying supine with hips elevated or
  • 90-degree angle with legs in air
38
Q

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

A

Call the Poison Control Center.

39
Q

At what age is lead poisoning screened for?

A

At 1 - 2 years old.

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

40
Q

What is the treatment for severe lead poisoning?

A

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

41
Q

What are some sources of lead poisoning?

A

Lead paint from old houses, contaminated dust, soil, and water.

Children may chew on window sills with old lead paint.

42
Q

What is the treatment for acetaminophen overdose?

(Immediate complication)

A
  • give acetylcysteine
  • use activated charcoal with gastric lavage
43
Q

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

(Immediate complication)

A

Give activated charcoal.

44
Q

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

(Immediate complication)

A
  • give water or milk
  • don’t induce vomiting as it can cause damage to the esophagus
45
Q

Describe:

Intestinal parasites

A

Pinworms that come out of the anus.

Anal itching is common.

46
Q

How are pinworms diagnosed?

A

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.

47
Q

Treatment:

Pinworms

A
  • 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.

NCLEX-RN (8) Pediatrics (14 decks)

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