Flashcards in GI Deck (118)
What are indicators of fluid status?
Urinary output, mucous membranes, capillary refill, decreased skin elasticity and turgor, decreased blood pressure, increased HR, sunken eyes and fontanels
T or F. Compared to older children and adults, infants and young children have a greater need for water and are more vulnerable to alterations in fluid and electrolyte balance?
Fluid losses can be divided into 3 categories, what are they?
Insensible losses (occur through the skin), Urinary, and Fecal
Heat and humidity, body temperature, and respiratory rate influence what type of fluid loss?
Name 4 sources of fluid loss
Diarrhea, NG tube drain, polyuria, third spacing. If fluid intake and output are not matched, fluid imbalance can occur rapidly.
Sarah weighed 19lbs and 8 ounces at her MD visit last week. Today she weighs 8.1 kg, what is her weight loss (percent of dehydration)?
Insufficient use of nutrition to meet the demands for growth
Failure to thrive (FTT)
Premature birth, GERD, short bowel syndrome, malabsorption, and cleft lip are all examples of what?
Organic causes of FTT
State of cachexia caused by environmental factors describe what?
Inorganic causes of FTT. This includes abuse, inadequate preparation of formula by caregiver.
Abnormal signs and symptoms of MILD dehydration (3-5 percent)?
Tachy or slightly dry buccal mucosa, normal or mildly reduced UO, increased thirst.
Abnormal signs and symptoms of MODERATE dehydration (6- 9 percent)?
Rapid pulse, normal to low SBP, deep and increased RR, dry buccal mucosa, sunken anterior fontanels, sunken eyes, cool skin, reduced skin turgor, markedly reduced UO, listlessness and irritability.
Abnormal signs and symptoms of SEVERE dehydration (more than 10 percent)?
Rapid and weak or absent pulse; low SBP, deep; tachypnea or decreased to absent RR; parched buccal mucosa; markedly sunken anterior fontanels; markedly sunken eyes; tenting skin turgor; cool, mottled, acrococyanosis skin; anuria; grunting, lethargy, coma
What are 6 common causes of Infantile Colic?
Allergic reactions, GERD/ acid reflex, overstimulation, gas producing foods, air intake (from feeding or crying), immature digestion and nervous system
You're caring for a child you suspect has Infantile Colic. What are 6 common symptoms you expect to see?
Trapped stomach and intestinal gas, abdominal bloating, acute gastric and intestinal pains, intense and prolonged crying, sleeplessness/ exhaustion, stressed out parents
T or F. In the US, almost 200,000 under 5 are hospitalized for gastroenteritis and approx 200 children under 5 die of diarrhea and dehydration each year?
T or F. Acute gastroenteritis is caused by a variety of viral and bacterial pathogens only?
False. It is caused by a variety of viral, bacterial, and parasitic pathogens, such as rotavirus, e.coli, salmonella, and staphylococcus organisms.
BUN, SG, Lytes, Stool culture and stool WBC, O and P, and UA are common diagnostic test used to identify what condition?
Baby Amy is admitted for acute gastroenteritis. How will you treat her?
Assess state of hydration, correct fluid and electrolyte imbalance, and give PO ASAP (very mild, like pedialyte)
In regards to treatment for gastroenteritis/ acute diarrhea, what are the 4 major goals the management of this condition?
1. Assessment of fluid and electrolyte imbalance 2. Rehydration 3. Maintenance fluid therapy 4. Reintroduction of an adequate diet.
T or F. Infants and children with acute diarrhea and dehydration should be treated with fluid replacements, such as juice or plain water?
False. Infants and children should be first treated with oral rehydration therapy (ORT) and avoid juice, soda, and plain water
How is FTT managed?
Identify the cause (prenatal hx, patient's hx, current home practices), treat underlying cause to catch up weight gain by nutritional intervention and behavior modification, provide family support
In patients with gastroesophageal reflex, the lower esophageal __________ is open allowing reflex.
The MD on your floor has just reviewed Baby Johnny's diagnostic tests and has diagnosed him with gastroesophageal reflex (GERD). What tests did the MD evaluate to reach this diagnosis?
Upper GI series and PH probe
T or F. GERD becomes a disease when complications such as FTT, bleeding, and dysphagia develop/.
How is GERD managed?
By providing small, frequent feedings and implementing reflex precautions
What is included in reflex precautions?
thickening feedings with one tablespoon of rice cereal per ounce of formula and elevating the HOB 30 degrees after feeds.
Tagamet and Prevacid are examples of medications used to treat what condition?
GERD. Tagamet is a H2 Receptor antagonist and Prevacid is a PPI
Before a Nissen Fundoplication (surgery to tx GERD) can take place, what must first be observed and documented?
FTT, Esophagitis, and Recurrent aspiration pneumonia
This disease is described as the congenital absence of autonomic parasympathetic ganglion cells in a distal portion of the colon and rectum.
Hirschsprung Disease (HD). It is a mechanical obstruction caused by inadequate motility. Because there is no nerve stimulation, substances collect there and stretch the colon