Flashcards in GI Disorders Deck (77):
What does vitamin A deficiency cause?
Diarrhea, dehydration, blindness.
What are some sources of vitamin A?
Carrots, liver, eggs, cabbage, artichokes
What can vitamin D deficiency cause?
Rickets- mostly in 3rd world countries.
What are some sources of vitamin D?
What is Kwashiorkor?
Associated with protein, mineral, vitamin A deficiency; "Older child sickness", thin extremities, ascities, blindness, diarrhea, circulatory failure.
What is Maramus?
Protein and caolorie malnutrition; atrophy of subQ fat, wrinkly, edema
What is treatment of Maramus?
Replace fluids, nutritional supplements, anti diarrhea and antibiotics
What are some general symptoms of GI dysfunction?
Failure to thrive, spitting up, N/V, diarrhea, jaundice, fever, weight gain from fluid.
What is encopresis?
overflow of feces; staining on pants.
What is hematemesis?
Bright red blood in vomit or spit up; Acute
What is coffee ground emesis?
Old blood in emesis and throw up; sign of upper GI bleeding; chronic.
What is hematochezia?
Bright red blood in stools; acute
What is melena?
Black tarry stool; upper GI bleed. Slow/chronic.
What is dehydration?
When fluid output exceeds intake.
What does isotonic dehydration mean?
Even dehydration and Na is normal.
What is hypotonic dehydration?
When the cells increase; use bolus; hyponatremic.
What is hypertonic dehydration?
Dangerous; hypernatremic, causes cerebral complications; give back slowly.
What percent of water is in a full term infant?
What degree of water loss is life threatening?
What are classic symptoms of dehydration?
Change in LOC, Increase HR, temp, Decrease skin turgor, sunken eyes and fontanels, irritable.
What are the goals of treatment for dehydration?
Rehydrate, maintain fluid therapy, and reintroduce normal diet.
What is the treatment for rehydration?
40-50 ml/kg of fluid per 4 hours, do not exceed 150ml/kg/day, no caffeine or soup or bland diet.
What is diarrhea?
Abnormal transport of intestinal water and electrolytes.
What are the types of diarrhea?
Acute or chronic, or acute infectious.
What is the treatment of diarrhea?
Strict I&O, IV replacement for electrolytes, salt, antiinfectives, antiparasitic, daily weights.
What is occurring with diarrhea metabolically?
Metabolic acidosis because it is depleting alkaline.
What are allergies? (r/t GI problems)
Severe reactions with the GI system
What are some common allergies that effect the GI system?
Cows milk, eggs, legumes, peanuts, shellfish, wheat, chocolate, fruit.
What is GERD?
Transfer of gastric contents into the esophagus
What is the cause of GERD?
Lower esophageal sphincter dysfunction with a delay of gastric emptying- food backs up.
What is the treatment of GERD?
Meds- Reglan, Proton pump inhibitors, or surgery
What are signs and symptoms of GERD?
Regurgitation, vomitting, weight loss, dysphagia, nocturnal asthma
What is Hirschsprung disease?
Congenital Aganglionic megacolon- a decrease in nerve intervention to bowel causing decrease mobility and mechanical obstruction.
What are the symptoms of Hirschsprung disease?
No stool, especially at birth, megacolon (protruding), obstruction, ischemic bowel, entercolitis.
How does entercolitis lead to death?
The bowel is inflamed, then perforates, then causes shock and death.
What are symptoms of Hirschsprung disease in infants?
No meconium, bilious vomitting, abdominal distention, explosive stools.
What are symptoms of Hirschsprung disease in older children?
Constipation, ribbon like stool, foul smell, abdominal distention, palpable fecal mass
What is the diagnosis of Hirschsprung disease?
Assessment of s/s and bowel function, small caliber emptying of rectum, x-ray to confirm.
What is the treatment of Hirschsprung disease?
Pull through, colostomy, ileostomy, replace fluids, enemas, low fiber/high calorie and protein diet.
What is the nursing care of clients with Hirschsprung disease?
Educate parents, post op care, colostomy care, nutritional education, home health care.
What is an acute inflammatory disease of the bowel?
Acute Appendicitis- inflammation of the appendix; danger of perforation.
What are the symptoms of acute appendicitis?
Right lower quadrant pain (might start at belly button), fever, rigid abdomen, vomitting or diarrhea OR constipation, anorexia, tachy, pallor
What is the diagnosis of acute appendicitis?
Assess McBurney point, CT, ultrasound, increase in WBCs and Bands, increase in C reactive protin
What is the McBurney Point?
Between the iliac creast and umbilicus there is rebound pain when palpated.
What is the treatment of acute appendicitis?
Appendectomy- can be lap or open (usually open when bowel effected)
What is a complication of appendicitis?
Rupture and peritonitis
What are the inflammatory bowel diseases?
Ulcerative colitis and Crohn's
What is ulcerative colitis?
Inflammation limited to colon and rectum; can be mild/mod/severe
What are symptoms of UC?
Diarrhea, rectal bleeding, abdominal pain, colicky
What is Crohn's disease?
Chronic inflammation involving any part of the GI tract from mouth to anus- most often terminal ileum & layers of bowel wall. Occurs in discontinuous fashion. (Skip lesions)
What are symptoms of Crohn's disease?
Abdominal pain, diarrhea, decrease in appetite, weight loss, growth delay and development.
What is the diagnosis of UC and Crohns?
Patient history, PE, lab studies, CT, ultrasound.
What are the goals of treatment for inflammatory bowel diseases?
To control inflammatory process, obtain long term remission, promote normal growth
What is the treatment for inflammatory bowel diseases?
Individualied, managed according to type, severity, location, and response to therapy.
What are structural defects?
Cleft lip and palate.
What is cleft lip and palate?
Malformation during embryonic stage 7/8th week
What is a cleft lip?
failure of maxillary and median nasal process to fuse.
What is a cleft palate?
Midline fissure of palate from failure of both sides to fuse.
What is the cause of structural defects?
Teratogen exposure prenatally (alcohol), associated with other syndromes, genetic
How are structural defects diagnosed?
What is the treatment for structural defects?
Cleft lip=early surgery, cleft palate=later surgery
What are some nursing care techniques for children with structural defects?
Parent support, long term care,follow up, assist with feeding, post of care, analgesic, antibiotic ointment
What are some obstructive disorders?
Hypertrophic pyloric stenosis and intussusception.
What is hypertrophic pyloric stenosis?
Circular muscle of pylorus thickens and causes an increase in mass, narrowing pyloric canal. (where the stomach and duodenum meet) (narrows at sphinctor, liquid accumulates)
What are clinical manifestations of hypertrophic pyloric stenosis?
Projectile vomitting, weight loss, distended abdomen, palpated olive shaped tumor, visible peristaltic waves
What is the treatment of hypertrophic pyloric stenosis?
Surgical- pyloromyotomy, small frequent feedings.
What is Intussusception?
An obstruction before 3 years, promiximal segment of bowel telescopes into the distal segment pulling the mesentary with it, leading to obstruction. Causes decreased blood flow, increase muscous and bleeding
What is a common site of intussusception?
What are symptoms of intussusception?
Severe colicky pain, abdominal pain, vomit, jelly stools, diarrhea
How is intussusception diagnosed?
Barium enema, x ray, rectal exam
What is the treatment for intusception?
Usually barium enema helps, surgical
What is an Omphalocele?
A covered defect of umbilical ring where organs herniate- thin peritoneal sac covers it. Can rupture
What is an open omphalocele?
Gastroschiasis- bowel herniates through defect in abdominal wall. Cover with moist gauze and surgery
What is short bowel syndrome?
Decreased mucosal surface resulting from extensive resection of small intestine; from anomalies, ischemia, trauma
What is the therapeutic goal of congenital abnormalities of the GI system?
Preserve bowel, maintain nutrition, stimulate feedings, minimize complications.
What is the care and management of patients with congenital bowel abnormalities?
Parental and caretaker support, educate, NGT, Long term treatment of vitamins and TPN