GI

Question 1

What is Cleft palate/Cleft lip ?

Answer 1

An orofacial defect that affects the oropharynx and increased the risk of malnutrition and aspiration

Question 2

When do Cleft palate/Cleft lip occur ?

Answer 2

These defects occur during fetal development

Question 3

In the Pre-op phase of cleft lip/cleft palate, infants must be fed how ?

Answer 3

Must be fed with an…

• Elongated nipple
  OR
• Medicine dropper down the side of the mouth to prevent aspiration

Question 4

When feeding infants in the pre-op phase with cleft lip/cleft palate, what must you do frequently ?

Answer 4

Burp frequently because they swallow lots of air

Question 5

Anytime a baby is swallowing a lot of air, it puts them at risk for ?

Answer 5

• Abdominal distention

- and Abdominal Distention puts them at risk for vomiting and aspiration

Question 6

If a baby is born with both cleft lip and cleft palate, which problem do they correct first ?

Answer 6

Cleft lip

have to wait until palate is more bone than cartilage

Question 7

Why is the Cleft lip fixed first ?

Answer 7

Because repairing the cleft lip assists with feeding and promotes parental bonding

Question 8

What is the goal post-op cleft lip and (cleft palate ?) repair ?

Answer 8

Goal is to protect the suture line

Question 9

How should you position a child following a cleft lip repair ?

Answer 9

Position the child supine or side-lying

Question 10

What position should you NOT place a child in following a cleft lip repair ?

Answer 10

Prone position

Question 11

With a cleft palate what do you want to avoid doing post-op ?

Answer 11

Avoid putting hard or rough foods or utensils in the Childs mouth

–> You do not ant to do anything that will disrupt the suture line

(elbow restraints if needed, but want to avoid restraints as much as possible!)

Question 12

What kind of diet do you want a child with a cleft palate repair to have post-op ? and why ?

Answer 12

Soft diet (until well healed)
B/c don't want anything that will disrupt the suture line

Question 13

What is the best time for a cleft palate repair to be done ?

Answer 13

Before speech develops, usually between ages 1 to 2 years

Question 14

What is GERD also known as ?

Answer 14

Gastroesophageal reflux Disease

Question 15

What is GERD ?

Answer 15

A disorder characterized by a backwash or reflux of gastric contents into the esophagus

Question 16

GERD is the chronic form of what ?

Answer 16

GE reflux

Question 17

With both GERD and GE reflux you have the risk of what ? causing what ?

Answer 17

Risk of Aspiration of gastric contents into the lungs, which can lead to Pneumonia

Question 18

What position should a client with GERD maintain while eating ?

Answer 18

Upright position

Question 19

How long after eating should a client with GERD remain upright ?

Answer 19

30 minutes

Question 20

Upright position, along with frequent burping during feedings compromise what ?

Answer 20

What’s known as reflux precautions

Question 21

Can we alter feedings to help with reflux ?

Answer 21

Yes

• thickened formula may be better tolerated (ex: milk with rice, etc.)

Question 22

What is another Tx for GERD ?

Answer 22

Smaller more frequent feedings

Question 23

What is Pyloric stenosis ?

Answer 23

Disorder resulting in projectile vomiting during or after feedings

(baby wants to eat after)

Question 24

Signs and symptoms of Pyloric Stenosis ?

Answer 24

• on assessment of the abdomen, its possible to feel an olive shaped mass in the epigastric region, near the umbilicus. (its the enlarged pylorus)
• Projectile vomiting (b/c their is pressure behind the vomiting)

Question 25

Where is the Pylorus located ?

Answer 25

Lies between the stomach and small intestines and has a valve to keep GI content from moving backwards

Question 26

How is Pyloric stenosis diagnosed ?

Answer 26

Abdominal ultrasound

Question 27

What is the Tx for Pyloric Stenosis ?

Answer 27

• Hydration and electrolyte replacement
• Intak and output
• Monitor urine specific gravity
• Daily weights
• Surgery (will open sphincter so fluid can get through more easily)

Question 28

What is Intussusception ?

Answer 28

Name for the condition where a piece of the bowel telescopes in on itself forming an obstruction

Question 29

What are signs and symptoms of Intussusception ?

Answer 29

• Sudden onset
• Cramping & abdominal pain
• Drawing up of knees
• Inconsolability
• Episodes of pain
• Clasic symptom = Jelly stools ***
  (maroon and jelly texture d/t blood and mucous)

Question 30

With Intussusception, what can sometimes be done ?

and how do they work ?

Answer 30

An air-contrast, barium, or an ultrasound-guided saline enema

The pressure of the enema going through the bowel with these procedures will push out the telescoped area

Question 31

After an enema or surgery for Intussusception, why do they still keep them in the hospital for several days after ?

Answer 31

Because it might reoccur

Question 32

What is Hirschsprung’s disease ?

Answer 32

A congenital anomaly that results in a mechanical obstruction

Question 33

What is Hirschsprung’s disease also known as ?

Answer 33

Aganglionic Mega Colon

Question 34

Hirschsprung’s disease usually affects what part of the colon ?

Answer 34

Sigmoid colon

Question 35

What is the presenting symptom of Hirschsprung’s disease ?

Answer 35

Constipation

• b/c no nerves or peristalsis in that section of the colon (“Aganglionic”)

Question 36

What are signs and symptoms of Hirschsprung’s disease ?

Answer 36

• Constipation (presenting symptom)
• Abdomina distention
• Ribbon like stools that have a foul smell

Question 37

What is the Tx for Hirschsprung’s disease ?

Answer 37

Surgery to remove the portion of the bowel that is deseased