NURS330 > Peds GI Disorders > Flashcards

Peds GI Disorders Flashcards

nursing care of the child with a Gastrointestinal disorder (55 cards)

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1
Q

Pediatric growth and development GI system principles

A
  • b/f birth, placenta provides nutrients & waste
  • GI tract structurally complete at birth but is immature
  • sucking is a reflex until 6wks of age, then it is voluntary
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2
Q

before birth, what provides the fetus with nutrients

A

the placenta provides nutrients and waste

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3
Q

t/f the GI tract is structurally complete at birth

A

True (but is immature)

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4
Q

sucking is a reflex until what age

A

6wks - then it is voluntary

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5
Q

when does the sucking reflex develop

A

34wk in utero

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6
Q

intestinal mobility is ______ in newborns

A

increased

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7
Q

when does a baby/s enzyme secretion start to increase?

A

begins to increase at 4months of age

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8
Q

when does the liver mature

A

the liver matures over the 1st year of life

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9
Q

how many meals should a kid be eating by age 2 (& why?)

A

3 meals a day because by this age pancreatic enzymes are developed

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10
Q

kids have excretory control by _______yrs

A

2-3yrs

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11
Q

common GI challenges in pediatrics

A

Necrotizing enterocolitis
Cleft lip & palate
Hirschsprung’s Disease
Tracheoesophageal fistula
Intussusception
Pyloric stenosis

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12
Q

Necrotizing Enterocolitis (NEC)

A

NEC is a potentially life-threatening inflammatory disease of the intestinal tract & is caused by several factors (e.g., intestinal ischemia, bacterial/viral infection)
- immaturity of the intestine is thought to be a predisposing factor
(most common GI disorder)

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13
Q

what is the most common acquired GI disorder among preterm neonates?

A

Necrotizing enterocolitis (NEC)

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14
Q

symptoms of Necrotizing Enterocolitis (NEC)

A

Vomiting
Bloody diarrhea
Abdominal distension
Feeding intolerance
Irritability or Lethargy

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15
Q

Diagnosis of Necrotizing Enterocolitis (NEC)

A

physical assessment & abdominal X-ray

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16
Q

Treatment of Necrotizing Enterocolitis (NEC)

A

treatment is prompt
child is immediately NPO,
Receives CVC or IV fluids,
Prescribed IV antibiotics
surgical resection

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17
Q

long-term complications of NEC

A
  • malabsorption/inability of the bowel to absorb nutrients normally
  • short bowel
  • scarring/narrowing of the bowel causing an obstruction
  • scarring within abd causing later pain & possible female infertility
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18
Q

short bowel

A

when one has too little bowel to absorb all the nutrients needed by the body

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19
Q

intraventricular hemorrhage (IVH) Grades

A

Grade 1: (Least serious) a bleed that is confined to the area that it begins
Gr. 2: bleed goes into the ventricles of the brain
Gr. 3: blood builds up in the ventricles
Gr. 4: collection of blood within the brain tissue

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20
Q

retinopathy of prematurity (ROP)

A

abnormal growth of blood vessels within the baby’s eyes

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21
Q

prematurity feeding and nutrition

A

if the baby is born before 34wks it means that they dont have a sucking reflex which complicates feeding

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22
Q

respiratory distress syndrome (prematurity)

A

incomplete lung development and has insufficient surfactant in lungs

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23
Q

central venous catheters

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A

catheter that is inserted into a large central vein with the tip placed outside the right atrium, usually in the superior vena cava (used in many different scenarios)

24
Q

5 types of central venous catheters

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A
  • short term (percutaneous)
  • tunneled
  • PICC
  • implanted
  • hemodialysis
25
purpose of central venous catheters
- resuscitation - hemodialysis - long-term therapies (e.g., chemo, peripheral nutrition) - used for administration of IV fluid, PN, blood products, medications & chemotherapy
26
central venous catheter complications
- air embolism - occlusion - infection - malposition or external catheter damage - extravasation
27
Acute GI disorder - Dehydration/vomiting causes
there are many causes - infections - GI structural anomalies - neurologic - endocrine - other (food poisoning)
28
viral causes of acute diarrhea
rotovirus adenovirus norwalk cytomegalovirus (CMV)
29
bacterial causes of acute diarrhea
salmonella Escherichia coli (E.coli) shigella clostridium difficile (C-diff)
30
assessment of mild dehydration
Mental status: Alert Fontanels: soft/flat Eyes: normal Oral mucosa: pink/moist Skin Turgor: elastic HR: normal BP: normal Extremities: warm, pink, brisk CP Urine output: may be slightly decreased
31
assessment of moderate dehydration
Mental status: alert/irritable listless Fontanels: sucken Eyes: mildly sucken orbits Oral mucosa: pale/slightly dry Skin Turgor: decreased HR: may be elevated BP: normal Extremities: delayed cap refill Urine output: <1ml/kg/hr
32
assessment of severe dehydration
Mental status: alert to irritable/comatose Fontanels: sucken Eyes: deeply sucken orbits, no tears Oral mucosa: dry Skin Turgor: tenting HR: elevated, progressing to bradycardia BP: normal, progressing to hypotension Extremities: cool, dusky, sign delay cap refill Urine output: sign <1ml/kg/hr
33
treatment for dehydration
mid to mod = oral rehydration (solution should contain NA & glucose) severe = IV fluids (NS or ringers lactate)
34
formula for fluid maintenance
100ml/kg for the first 10kg 50ml/kg for the next 10kg 20ml/kg for remaining kg
35
cleft lip & palate
opening of the upper lip and nose during early pregnancy separate areas of the face develop individually and then join together
36
when does the lip and palate develop in utero?
lip = 5-6wks palate = 7-9wks
37
management of cleft lip/palate
surgery - a cleft lip will be repaired shortly after birth (2-3months) - the palate is repaired around 6-18 months
38
complications of cleft lip/palate
- susceptibility to colds - hearing loss - speech defects - larger # of dental caries or missing/malformed teeth - otitis media b/c eustachian tubes dont drain properly - feeding difficulties**
39
nursing interventions for cleft lip/palate post-op
**airway management soft arm restraints to protect incision wound management pain management (meds) post op
40
Hirschsprung (congenital aganglionic megacolon)
Hirschsprung's disease is the absence of autonomic parasympathetic ganglion cells of the colon that prevents peristalsis at that portion of the intestine causes obstruction of the intestine
41
Hirschsprung's disease - symptoms
- gradual onset of vomiting - abd distention - most commonly characterized by constipation - infant = failure to pass meconium (typically presents in the first 6wks of life)
42
Assessment of Hirschsprung's disease in the newborn
- no meconium in first 24hrs - bilious vomiting - abdominal distention - fever
43
assessment of Hirschsprung's disease in older infants/children
- HX of chronic constipation - abd distention - failure to thrive
44
treatment of Hirschsprung's disease
staged surgical repair (take out part of intestine that doesn't have peristalsis
45
tracheoesophageal fistula (TEF)
TEF represents an abnormal opening between the trachea & esophagus
46
Tracheoesophageal Fistula (TEF) diagnosis
a catheter is gently passed into the esophagus to check for resistance a barium swallow test is used to diagnose the problems
47
Tracheoesophageal Fistula (TEF) Treatment
- surgery to close the fistula & anastomosing the esophageal segments - all oral feedings are stopped & IV fluids are started
48
imperforated anus
the passage of fecal material is obstructed by a structural anomaly of the anus and rectum (can occur with or without a fistula)
49
imperforated anus diagnosis
- inspection of the perineum (fistula) - rectal atresia (absence of anal opening) presents with abd distention, vomiting, & failure to pass mec - US & lower GI studies confirm the diagnosis & demonstrate the extent of the anomaly
50
imperforated anus treatment
- oral feeds are stopped - surgery - close fistula and create anal opening - manual dilations are used in the case of anal stenosis - surgical site must be closely monitored for infection/be kept clean
51
intussusception
occurs when 1 portion of the bowel slides/invaginates into the next
52
intussusception symptoms
vomiting "currant jelly" & gelatinous stools pain
53
treatment of intussusception
barium enema
54
pyloric stenosis
hypertrophy of the circular pylorus muscle results in stenosis of the passage between the stomach and duodenum, partially obstructing the lumen of the stomach
55
pyloric stenosis symptoms
(symptoms become evident at 2-8wks) projectile vomiting irritability failure to weight gain signs of dehydration child appears hungry
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