GI Flashcards
Exam 2 (101 cards)
Pediatric anatomy and physiology GI tract
What makes up the GI tract?
GI tract = MOUTH –> ANUS
Pediatric anatomy and physiology GI tract
Primary functions of GI tract:
Digestion and absorption of nutrients and water
Elimination of waste products
Secretion of various substances required for digestion
Pediatric anatomy and physiology GI tract
When does GI tract mature?
*Babies are born with immature GI tracts that are not fully mature until age 2.
Pediatric anatomy and physiology GI tract:
How is the mouth?
Mouth: highly vascular; entry point of infection.
Pediatric anatomy and physiology GI tract: Esophagus:
Esophagus: LES not fully developed until age 1, causing regurgitation/reflux.
Pediatric anatomy and physiology GI tract:
What is newborn stomach capacity?
Newborn stomach capacity only 10 to 20 mL.
Pediatric anatomy and physiology GI tract: intestines
Intestines: small intestine not mature at birth.
Pediatric anatomy and physiology GI tract
Biliary system:
liver relatively large at birth;
pancreatic enzymes develop postnatally, not reaching adult levels until 2 years old.
Pediatric anatomy and physiology GI tract
Fluid balance and losses: proportionately greater amount of body water compared to adults.
Fluid balance and losses:
How much water in infants compared to adults?
Infants and children have a greater amount of body water than adults.
Fluid balance and losses:
How do they excrete and require compared to adults?
They require a larger amount of fluid intake and excrete more fluid, putting them at risk for fluid loss with illness.
Fluid balance and losses
What increases fluid loss?
FEVER increases fluid loss @ rate of 7 mL/kg/24 hour period for every sustained 1○C rise in temperature
Fluid balance and losses
How much fluid loss occurs from skin?
Fluid loss from the skin accounts for 2/3 of insensible loss.
Fluid balance and losses:
How is basal metabolic rate?
The basal metabolic rate is higher in order to support growth.
Fluid balance and losses: How is concentration of urine? Why?
Renal immaturity does not allow the kidneys to concentrate urine as well.
Assessment: Health history:
Past Medical History: previous illness, surgeries, food allergies
Family History: Irritable bowel, Crohn’s
Present illness: when the symptoms began, how does this differ from normal for them, how have the symptoms been managed so far. Dietary information.
Chronic vs. acute?
Growth patterns – is there a point in the growth curve that you see when problems began?
Physical exam- how should you perform exams?
*Always perform exam from least invasive to most invasive.
Physical exam:
INSPECTION AND OBSERVATION:
Color (skin, eye, lip),
hydration (oral mucosa pink/moist, skin turgor elastic, tenting, tears?),
abdominal size and shape (protuberant could mean ascites (fluid or gaseous distention) or be normal variant; concave could mean blockage; look at umbilicus),
mental status (irritability and restlessness are early signs of mental change; lethargy).
Physical exam: AUSCULTATON:
Where are you listening? What are you listening for? What should you immediately report?
Listen for bowel sounds in all 4 quadrants.
Hyperactive sounds can be with diarrhea or gastroenteritis
Hypoactive or absent sounds (after 5 min of auscultating) may mean obstructive process
Immediately report
Physical exam: Percussion
Where is dullness?
Can have dullness 1-3 cm below right costal margin.
Are above symphysis pubis can be dull due to full bladder.
Physical exam: Percussion
Where would tympany occur?
Percussion every where should reveal tympany.
Physical exam:
PALPATION:
Leave this last.
First palpate lightly then deep.
Look for tenderness, lesions, tone.
The cecum may be felt as soft mass in LLQ.
RLQ tenderness, including rebound.
Common Medical Treatments:
Hydration (oral, enteral and IV)
Providing adequate nutrition (oral, enteral and IV)
Enemas and bowel preparations
Ostomies—surgical opening into a digestive organ
Probiotics—support/replace intestinal microbial flora
Medications
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