Week 5: CH 25 GI Flashcards
stomach of a newborn
20mL
stomach of a 30 day old
90mL
stomach of a 1 year old
360mL
why is gas not uncommon
stomach enzymes are deficient until 4-6 months
cleft lip
failure of the maxillary processes to fuse by 6 weeks gestation and failure of the tongue to move down at the correct time prevents the palatine from fusing
cleft palate vs cleft lip
cleft palate is harder to detect
approach to therapy for a cleft defect
plastic surgeon, dentist, audiologist, speech, ENT, lactation, and social work
post op care of cleft defect
- vitals
- monitor I/O
- observe for s/s of infection
- place upright and burp frequently
- use special feeder or dropper to start clear liquids
- nothing in the mouth
GER
return of gastric contents into the esophagus
3 mechanisms that allow reflux to occur
- lower esophageal relaxations
- incompetent lower esophageal sphincter
- anatomic disruption of esophagogastric junction
manifestations of GER
- regurgitation
- spitting up
- vomiting
- hungry/irritable
treatment of GER
- depends on severity
- medications or specific formula can be used if severe
pyloric stenosis
hypertrophied pyloric muscle causes symptoms of projectile vomiting and visible peristalsis
nursing considerations of pyloric stenosis
- avoid oral feeding
- IV therapy
- NG tube
- Strict I/O
- minimize weight loss
- promote rest/comfort
- prevent infection
omphalocele
congenital malformation that results when the intra-abdominal contents herniate through the umbilical cord
when does omphalocele occur
in week 11 of gestation when abdominal contents fail to return to the abdomen
where are the abdominal contents stored in omphalocele
in a sac that if ruptured the organs are eviscerated
what causes omphalocele
- multiple causes
- 50-70% of infants with omphalocele will have an associated anomaly
gastroschisis
congenital defect in which the bowel protrudes through the abdominal wall
difference in omphalocele vs gastroschisis
omphalocele has a sac and has higher % of anomaly
intussusception
portion of the intestine goes inside another part of the intestine
most common site of intussusception
ileocecal valve
manifestations of intussusception
- abdominal pain
- JELLY STOOLS
- vomiting
treatment of intussusception
- air reduction enema
- surgical reduction if needed
