GI Disorders Flashcards
(26 cards)
Illness involving the GI system can arise from which factors?
Congenital defects, acquired disease, infection, and injury
Pediatrics GI system?
Before birth the placenta provides nutrients, GI tract structurally complete at birth but its immature (until 2 yrs), infants have higher amount of body water/higher metabolic rate, sucking is a reflex until 6 weeks of age (then its voluntary), stomach capacity is 10-20 mL at birth, pancreatic enzyme secretion starts at 4 months, liver matures over first yr of life, excrectory control by 2-3 yrs, newborns poop 8-10x/day
What is NEC? What factors is it caused by (as well as predisposing)?
Necrotizing enterocolitis. Most common/serious GI disorder. Inflammatory disease of bowel that causes injury to GI tract. Caused by several factors (intestinal ischemic, bacterial/viral infection). Predisposing factor is immaturity of the gut (premature babies at risk because they have immature guts)
What does NEC do to the body and S+S?
Babies don’t absorb nutrient because they poop too much/can’b absorb nutrients. S+S: vomiting, bloody diarrhea*, abdominal distension, feeding intolerance, irritability, lethargy, refusal to feed
Dx and treatment of NEC?
Physical assessment, abdominal x ray. Treatment by NPO or IV fluids, parenteral IV nutrition to see if they can tolerate formula, and start antibiotics (can’t be long term)
Long term complications of NEC?
Malabsorption/inability to absorb nutrients, short bowel, scar/narrow of bowel causing obstruction or blockage, scarring within abdomen causing later pain/female infertility, and problems d/t long term use of parenteral nutrtion (should only be short term)
Complications of premature babies?
Intraventricular hemorrhage (bleeding in brain), retinopathy (abnormal growth of blood vessels in eyes), feeding/nutrition problems, anemia (RBC have shorter half life), respiratory distress syndrome (incomplete lung development, more immature=increased risk to develop this).
CVC and types? what are they used fo
CVC inserted into large central vein with tip places outside right atrium in the superior vena cava. These reduce amount of pokes/stress on the baby and family. 5 types- short term (percutaneous), PICC, tunneled, implanted, and hemodialysis.
Used for- resuscitation, hemodialysis, long term therapy, administer IV fluids/PN/blood/meds
Complications of CVC?
Air embolism, occlusion (most common), infection, extravasation, malposition/external catheter damage
What is dehydration/vomiting acute GI disorders caused by?
Caused by infections, GI structural anomalies, neurological (hit to head could throw up), endocrine, and food poisoning.
What viral and bacterial infections cause diarrhea?
V- rotovirus, norwalk, CMV, adenovirus
B- salmonella, E-coli, shigella, C-diff
Mild, moderate and severe symptoms of dehydration?
Mild- soft/flat fontanel, normal eyes, mucosa pink/moist, turgor elastic, normal HR/BP, UO slightly decreased, extremities- warm, pink, brisk CR, they are alert
Mod- alert/irritable, sunken fontanel, sunken eye orbits, pale/slightly dry mucosa, decreased turgor, increased HR, normal BP, delayed CR, UO <1ml/kg/hr
Severe- alert to irritable/coma, sunken fontanel, deep sunken orbits/no tears, dry mucosa, tenting turgor, bradycardia, maybe hypotension, UO <1 ml/kg/hr, extremities- cool, dusky, delayed CR
How to treat dehydration?
Oral rehydration or oral hydration solution (with NA and glucose) for mild/moderate, or IV fluids for severe.
What is a cleft lip and palate? and when to repair surgically
During early pregnancy the lips or palate don’t fuse together. Causes a split. Repair surgically and you can barely tell after. Cleft lip- repair 2-3 months, palate repaired 6-18 months
Complications of cleft lips/palates?
Susceptibility to colds, hearing loss, speech deficits, feeding difficulties, choking, inadequate intake, otitis media (Eustachian tube don’t drain fluid properly from middle ear to throat), dental cavities/missing/displaced teeth
Nursing interventions post-op for cleft lip repair?
Airway managment, soft arm restraints to protect incision/prevent baby from touching their face, wound managment, pain meds, speech therapy (early referral), don’t suction with yonkers, don’t put in hard spoons/soothers/straws into their mouths
What is hirschsprung’s disease? S+S
Absence of autonomic parasympathetic ganglion cells of the colon that prevents peristalsis at that portion of the intestine, which causes obstruction of intestine. S+S: mainly constipation because of lack of innervation of cells, failure to pass stool, abdominal distension, gradual onset of vomiting
Assessment in newborns/kids and treatment of hirschsprung’s disease?
Newborn- no meconium in first 24hrs, bilious vomiting, abdominal distension, fever
Older infants/kids- chronic constipation hx, abdominal distension, failure to thrive
Treatment- staged surgical repair: remove part of bowel that’s not working/take it out, put in colostomy, 2nd part of surgery is take out colostomy and reattach everything to hope it works again
What is tracheosophageal fistula? S+S
Abnormal opening between trachea/esophagus. Causes esophagus to end before it reaches stomach or there’s a fistula (abnormal connection) between esophagus and trachea. Most common is EA with distal TEF (fistula between trachea and bottom half of the esophagus). All require surgery immediately.
S+S: excessive salivation, coughing, choking, esophageal atresia and distal TEF, oral intake (food) enters lungs, air in stomach (risk of coughing, abdominal distension, choke)
Dx and treatment of TEF?
Dx- catheter passed into esophagus to check for resistance (means there’s a blunt end somewhere), barium swallow test to dx the problems
T- put on NPO, surgery to close fistula, all oral feedings are stopped/IV fluids started
What is an imperforated anus?
Passage of feces is obstructed by structural anomaly of anus/rectum (can occur with or without fistula) that causes incomplete development or absence of anus. Signs are not being born with an opening or no BM
Dx, signs, and treatment of imperforated anus?
D- inspection of perineum, rectal atresia (absence of anal opening) present with abdominal distension, vomit, failure to pass stool,
T- stop oral feeds, start IV fluids, surgery to close fistula and create an anal opening
What is intussusception, S+S, and treatment?
Occurs when one portion of the bowel slides/invaginates into the next. Causes extreme pain, edema, vascular compromise, and bowel obstruction. S+S: pain (sudden in the abdomen), vomiting, diarrhea, currant jelly/gelatinous stools
T- can try to give barium enema to reduce it or surgery
What is pyloric stenosis? s+s and treatment
Hyper trophy of circular pylorus muscle that causes stenosis of passage between stomach/duodenum which partially blocks the human of the stomach. Causes ineffective feeding r/t vomiting. S+S: projectile vomiting every feed, irritability, failure to gain weight, dehydration signs, child appears hungry
Requires surgery (cut pylorus and relive gastric outlet obstruction)
