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Pediatric GI Flashcards

(51 cards)

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1
Q

Where is amylase made?
What does it do?

A

Mouth
Breaks down complex carbs to simple ones

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1
Q

Where are lipase and trypsin made?

A

Pancreas
Lipase>fats to fatty acids and glycerol
Trypsin>Peptides (short chains of amino acids) to amino acids

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2
Q

Size of baby’s stomach at day 1

A

Cherry (5—-7 mL)
You make about 30 mL of colostrum in 1st 24 hours

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3
Q

Size of baby’s stomach at day 3

A

Walnut (25 mL)

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4
Q

Size of baby’s stomach at week 1

A

Apricot (45–60 mL)

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5
Q

Size of baby’s stomach at month 1

A

Egg (80—150 mL)

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6
Q

How will you assess for cleft palate in NB? What may be the first sign of cleft palate?

A

Gloved finger in mouth/flashlight
Milk coming through nose

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7
Q

When does cleft palate/lip develop in utero?

A

6 weeks gestation

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8
Q

What are risk factors for cleft palate/lip?

A

Binge drinking
Smoking
Lip is usually in males
Palate in females

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9
Q

What modification to feeding will be needed in cleft lip/palate?

A

Slightly longer nipple for bottle
Nipple with compressible sides to squeeze milk into mouth. Cross cut nipple. Allow them time to swallow
Conserve any energy possible
Allows milk to go past cleft without gagging baby
Burp frequently
Hold upright while feeding
Breastfeeding possible if can get good latch

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10
Q

Some things baby is at risk for in cleft lip/palate.

A

Poor nutrition
Aspiration

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11
Q

When is cleft lip repair usually done?

A

3—5 months

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12
Q

When is cleft palate repair usually done?

A

Before 12 months

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13
Q

What should be avoided after cleft lip/palate repair?

A

Straws
Pacifiers
Spoons
Fingers
Toothbrush

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14
Q

What is focus in post op care of cleft palate/lip repair?

A

Keep suture line clean
Prevent suture line damage
Antibiotic ointment to lip
Elbow restraints for 6–8 days
Keep side lying or supine or in car seat to sleep

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15
Q

How often should elbow restraints be removed in babies?

A

Every 2 hours for 10–15 min
One arm at a time

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16
Q

Management of baby with esophageal atresia (EA) or tracheoesophageal fistula (TEF).
What should be kept in mind with these babies?

A

HOB 30–40 degrees
NG tube placed as far as possible and suctioned every 5-10 min or placed on low intermittent suction
IV fluids
Antibiotics (erythromycin)
Watch O2 Sat and keep baby warm
Kept NPO
TPN given
Gastronomy tube placed ASAP

Remember they will likely have other congenital abnormalities.

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17
Q

3 signs of EA or TEF

A

Coughing
Cyanosis
Choking
–with feeding–

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18
Q

What is anastomosis?

A

Connection made surgically
This will be the repair for EA/TEF

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19
Q

Biggest danger with EA/TEF

A

Aspiration»Pneumonia

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20
Q

How is EA/TEF usually found?

Study These Flashcards
A

NG tube will not advance

21
Q

What are some other signs of EA/TEF?

Study These Flashcards
A

Abdominal distention
Salivation
Respiratory distress

22
Q

What maternal pregnancy abnormality is usually associated with EA/TEF?

Study These Flashcards
A

Polyhydramnios

23
Q

S/Sx of GER/GERD in baby

Study These Flashcards
A

Irritability (GERD)
Failure to thrive (GERD)
Back arching (GERD)
Apnea, choking, coughing (GERD)
Vomiting/spitting up (GER)
Recurrent otitis media (GERD)

24
Difference between GER and GERD
GER is common and most babies grow out of. GERD is chronic and needs more aggressive treatment
25
Tx for GERD/GER
Small frequent feedings Sit upright to feed Thicken formula Frequent burping --Prone position is best to prevent regurgitation, however, caution needed. Do only when baby is awake and can observe.--
26
Biggest danger in GERD
Risk for aspiration and apnea
27
S/Sx of hiatal hernia in NB
Vomiting Pain Coughing, wheezing, short bursts of apnea Failure to thrive
28
What is congenital diaphragmatic hernia? S/Sx?
Opening in diaphragm Abdominal organs in thoracic cavity S/Sx: Diminished or absent breath sounds Scaphoid abdomen (sunken) Bowel sounds in thoracic area RESPIRATORY DISTRESS AT BIRTH
29
What other anomalies are commonly present in babies with imperforate anus?
EA/TEF Cardiac --More common in males--
30
What is gastroschisis? Gas-stros-cuz-is
Herniation of intestines around umbilicus Not covered in sac
31
What is some nursing care for gastroschisis and omphalocele?
IV/NG TPN Cover with sterile moist material Thermoregulation KEY Sterile technique with herniation Fluid volume management
32
What is omphalocele? Ooomf-fal-a-seal
Large herniation of intestines into umbilical cord
33
Biggest threat in gastroschisis and omphalocele?
Sepsis and bowel obstruction
34
What is cause of umbilical hernia? What to teach parents?
Imperfect closure of muscles around umbilicus. It is easily reduced. More common in black and LBW babies. Teaching: Usually resolves on own in 1st year. No surgery needed unless it becomes a problem. Monitor for changes. Don't bind it. Signs of strangulation (vomiting, pain, irreducible mass)
35
What is encopresis?
Repeated involuntary pooping in kid older than 4 Must find cause
36
Recommendation for child with constipation.
Apple juice
37
What is tenesmus?
Feeling like you need to poop all the time
38
Which in NOT appropriate for treating pain in appendicitis? Cold pack vs Hot pack
Hot pack is a no-no Increased blood flow>>inflammation>>rupture
39
What is Meckel diverticulum? S/Sx Tx Nursing considerations
Congenital anomaly in GI tract Large diverticulum in lower small intestine Causes bloody "currant jelly" stools, abdominal pain, anemia Tx is surgery to remove Watch for hypovolemia, monitor stool
40
What is hypertrophic pyloric stenosis? Who is most likely to have it?
Narrowing of pyloric sphincter Doesn't allow stomach to empty Males, white, term, fam history
41
3 P's of hypertrophic pyloric stenosis? Other S/Sx?
Projectile vomiting Palpable firm mass (size of olive in RUQ) Peristaltic waves Irritable, hungry baby May be dehydrated and hyperbili
42
Nursing care for hypertrophic pyloric stenosis?
NG tube and decompression IV fluid and electrolyte replacement Output Daily weight HOB elevated Prep for surgery (pyloromyotomy)
43
What is intussusception?
Bowel telescopes into self (usually at ileocecal valve)>>obstructs flow>>bleeding>>"current jelly" stools>>edema>>strangulation>>ischemia>>sepsis
44
Who typically get intussusception?
Healthy males with no GI hx Post viral episode 5---9 months old
45
S/Sx of intussusception?
Abdominal pain (healthy baby suddenly starts crying and flexing legs in pain) Vomiting bile Sausage shaped abdominal mass Currant jelly stool and diarrhea (may come later)
46
Nursing care of intussusception?
NG tube with decompression Fluid and electrolyte balance Pain meds Sedation meds Prep for hydrostatic reduction
47
What is a volvulus? Who is at high risk? S/Sx?
Twisting of bowel Happens in development in utero High risk are kids with neuro impairment S/Sx: Pain, bilious vomiting, bowel obstruction signs
48
What is Hirschsprung disease? Who is at high risk?
No nerves in colon (can involve entire or parts of colon) Causes lower bowel obstruction in NB Males, Down syndrome
49
What is cardinal sign of Hirschsprung ? Other S/Sx?
No or delayed meconium stools No meconium within 48 hours Chronic constipation as get older Pellet/ribbon like stools that are foul smelling Can have nutritional issues, abdominal distention, thin extremities, poor eaters
50
Tx for Hirschsprung?
Removal of aganglionic portions and resecting

Gastrointestinal (5 decks)

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