GI. pt 2 (Exam 2) Flashcards
(27 cards)
Abdominal Wall Defects: Omphalocele
Herniation of the abdominal contents through the umbilical rings (stomach contents contained) (surgery in uteroro)
Abdominal wall has not come together like it should
Intact peritoneal sac around intestines to keep it contained
Abdromnial Wall Defects: Gastrochisis
Herniations of the abdominal contents
No peritoneal sac around the intestines
Intestines are not contained at all so they are enlarging because nothing is containing them
Abdominal Wall Defects: Therapeutic Management
Loosely cover with saline soaked pad and plastic drape
NICU then SILO pouch keeping intestine contained
IV fluids
Antibiotics
Surgical correction- stages - SILO POUCH in-between is shorted
Abnormal Wall Defects: Nursing considerations
Sterile technique and careful handling
Monitor for ileus
-listen to SILO and make sure they have peristalsis and bowel sounds
Family support
Gastroenteritis
Seconds leading cause of death world wide
Most common cause of death in children world wide
Belly Bug / Diarrhea
Gastroenteritis Etology
Virus = 70/80%
Bacterial = 10-20%
Protozoa = <10%
What is the most likely cause of infectious diarrhea?
Virus
Rotavirus and norovirus
Viral Gastroenteritis: Manifestations
Low grade fever
nausea
Vomiting
Abdominal cramps
Watery diarrhea
T/F: Viral gastroenteritis keeps shedding even weeks after symptoms go away?
Yes
They are still contagious
Bacterial Diarrhea
“Food poisoning”
Fecal - Oral transmission
Bacterial Diarrhea: Symptoms
Bloody diarrhea
Severe cramping
Malaise
Is antibiotic treatment needs for bacterial diarrhea?
No always
Diarrhea: Treatment
Oral Rehydration Solutions:
-Infalyte
-Pedialyte
-Naturalyte
Avoid fruit juices - cola - sports drinks
Normal diet with ORS for mild to moderate dehydration
Intravenous fluids for moderate to severe dehydration
Diarrhea: Nursing Management
Restore F/E balance by ORS and IV
Prevent spread of infection
Prevent skin breakdown (keep zinc oxide treatment on bottom)
Reduce fear and anxiety
Provide health education for prevention and home management
Constipation: Etiology
Structural disorders
Hypothyroidism
Hypercalcemia
Lead poisoning
Drugs
Spinal cord lesions
MOST IS FUNCTIONAL:
-Children not taking the time
-Starting school
In constipation do we worry about quality or quanitity?
Quality, not everyone use the bathroom everyday. They can multiple days and be fine
Constipation: Therapeutic Management
Dietary (initially)
-Age plus 5 for grams of fiber
-Need a lot of water
-Need activity and exercise
Stool softeners (If dietary doesn’t work)
-Miralax
-If previous measures do not work
How long does it take miralax to work?
3 days
be patient
Increase fiber with infants
Baby food - carrots - prunes - pears
If a child is constipated and stretches out the colon, how long does it take for the colon to go back to normal size
6 months so have to keep them cleaned out for 6 months
How much fiber should a child have?
5g of fiber + their age (ex: if 5yr then 10g)
might need fluids
Mgt of constipation
- Water
- Add in real fruit instead of fruit juice
- Miralax
- Routine time every single day
(do this for 6 months)
Why is important to have a seat and stool for children using the restroom
To prevent constipation
If child is dangling and wobbling the sphincter can not relax enough
Encopresis
Leakage of stool around the constipation that is impacted
