nutrition and elimination

Question 1

pediatric anatomy of GI

Answer 1

weaker esophageal sphincter
immature digestion
high risk infection via mouth
shorter esophagus
20 teeth - affects ability to break down food

Question 2

absorption

Answer 2

slower in children - need more nutrients

Question 3

organs in charge of absorption

Answer 3

large and small intestines

small intestines - bigger+longer/wider

Question 4

liver

Answer 4

produces bile, digestion of fats

Question 5

GER

Answer 5

regurgitation of gastric contents into esophagus

Question 6

s/s of GER

Answer 6

spitting up
vomiting
heartburn
abdominal pain
dysphagia
recurrent pneumonia
weight loss
excessive crying

Question 7

GERD

Answer 7

esophageal tissue damage due to low pH of gastric acid

Question 8

s/s GERD

Answer 8

failure to gain weight
irritable
nausea
chest pain
tooth erosion
respiratory complications: bronchospasm
pneumonia
wheezing

Question 9

nursing interventions of GER

Answer 9

thicken feedings
elevate HOB
smaller more frequent feedings
burp frequently
histamine blockers and PPI - lowers amount of stomach acid

Question 10

nursing interventions of GERD

Answer 10

surgical intervention

gastric fundus wrapped around distal esophagus structure to create anti- reflex

Question 11

cleft lip and palate pre op

Answer 11

clean mouth and nose after feeding
keep chin tucked to inhibit swallowing
keep suction equipment available
promote family child bonding and attachment

Question 12

cleft lip and palate post op

Answer 12

elbow restraints
positioning - never on abd.
weigh daily
pain management - acetaminophen
elevate HOB
reposition q2hrs
prevent crying and sucking

Question 13

Hirschsprung disease

Answer 13

lack of nerve cells in lower part of colon, blockage of stools

Question 14

s/s Hirschsprung disease

Answer 14

monitor for first stool
(ribbon-like foul smelling stool)
poor feedings
poor weight gain
constipation
abdominal distention

Question 15

management of hirschsprung disease

Answer 15

X-ray

usually involves surgery procedure or temporary colostomy
NG suction
measure I/Os, IVFs
assess bowel function
ostomy care

Question 16

appendicitis

Answer 16

inflammation of appendix in RLQ
emergent surgery
sudden symptoms

pregnancy test to rule out ectopic pregnancy

Question 17

s/s appendicitis

Answer 17

sudden symptoms
abdominal pain
rebound tenderness right side of belly button
rapid shallow breathing/ tachycardia
rigid abdomen, guarding
constipation

Question 18

pyloric stenosis

Answer 18

stomach is blocked and food doesnt empty into duodenum

Question 19

s/s pyloric stenosis

Answer 19

projectile nonbilious vomiting
dehydration
metabolic alkalosis
no evidence of pain
pt seems hungry - never gets full
hyperactive bowel sounds

Question 20

pyloric stenosis management

Answer 20

fixed surgically
transition feedings
daily weights
restore hydration
NPO
small frequent feedings (pedialyte w/in 4-6hrs)

Question 21

intussusception

Answer 21

intestinal obstruction

part of bowel is moving back into intestines

can cause severe edema and cut off blood supply- ischemia and tissue death in bowel

Question 22

management of intussusception

Answer 22

ultrasound

air enema - pneumoenema
surgery

Question 23

s/s intussusception

Answer 23

acute sudden abdominal pain
edema
bloody stools
dehydration
tachycardia/respiratory distress
cycles of sudden pain
red currant jellylike stool(no feces)
vomiting (billious)

Question 24

hypotonic dehydration

Answer 24

greater loss of sodium than water

Question 24

manifestations of dehydration

Answer 24

dry oral mucosa and skin poor skin turgor decreased urine output sunken fontanelles

Question 25

hypertonic dehydration

Answer 25

greater loss of water than sodium

Question 26

isotonic dehydration

Answer 26

equal loss of water and sodium

Question 27

calculate % of dehydration

Answer 27

preillness wt * sick wt /healthy wt *100 = ___%

Question 28

severe dehydration clinical signs

Answer 28

increased pulses deep and rapid RR hyperirritable intense thirst

Question 29

moderate dehydration clinical signs

Answer 29

slight increased pulse slight tachypnea RR dry mucosa decreased urine

Question 30

oral rehydration

Answer 30

replaces fluid loss from vomiting an diarrhea in mild to moderate dehydration pedialyte type fluids- no jello, no caffeine, no broth no BRAT diet- banana, rice, apple, tea/toast

Question 31

daily maintenance fluid requirements math

Answer 31

100mL * 1st 10kg wt 50mL * 2nd 10kg wt 20mL * remaining wt