Shared Flashcard Set

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Peds
GI Disorders
156
Nursing
Not Applicable
04/07/2013

Additional Nursing Flashcards

 


 

Cards

Term
Failure of the tissues of the GI tract to separate properly from the respiratory tract early in prenatal like are called?
Definition

Esophageal Atresia or

Tracheoesophageal Fistula (TEF)

Term
What is the most common type of TEF?
Definition
Upper esophagus ends in a blind pouch with the lower esophagus connecting to the trachea
Term
What % of children get the most common type of TEF?
Definition
84%
Term
What illnesses can children get from the most common cause of TEF?
Definition

Distension

Aspiration pneumonia from the gastric juices

Term
Which TEF will cause vomiting?
Definition
Upper esophagus and the lower esophagus end in a blind pouch
Term
Name the other 3 TEF?
Definition
  1. Upper esophagus is attached to the trachea along with lower esophagus
  2. Upper esophagus connects to the trachea and lower esophagus ends in a blind pouch
  3. Upper esophagus connects to trachea lower esophagus connects to the stomach
Term
What does the nurse assess with TEF?
Definition
The first feeding to see if there is any obstruction
Term
What is the first sign of TEF prenatally?
Definition
The mother has an excess of amniotic fluid in the sac.
Term
What is polyhyramnios?
Definition
excess of amniotic fluid in sac
Term
At birth, what is the first sign of TEF?
Definition
infant will vomit and choke during first feeding
Term
What happens when the upper end of the esophagus ends in a blind pouch?
Definition
infant will drool because they can't swallow accumulated secretions
Term
What happens when the upper end of the esophagus is attached to the trachea?
Definition
Newborn will choke resulting in coughing, cyanosis, and apnea
Term
What happens when the lower end of the esophagus enters the trachea?
Definition
air enters the stomach when the infant breathes causing abdominal distention
Term
What is the goal in TEF?
Definition
to prevent pneumonia, choking and apnea
Term
What is the treatment for TEF?
Definition
surgery
Term
What happens when the GI tract and the anus end in blind pouches?
Definition
Imperforate Anus
Term
What are some s/s of Imperforate Anus?
Definition

failure to pass meconium in the first 24 hours

failed routine exam of anus

Term
What is the treatment for Imperforate Anus?
Definition
temporay colostomy until anal canal is surgically repaired
Term
What is a narrowing obstruction of the pylorus caused by overgrowth of the circular muscles of the pylorus or by spasms of the sphincter?
Definition
Pyloric Stenosis
Term
When do s/s of PS first appear?
Definition
within 2-3 weeks
Term
What is the most common surgical condition of the digestive tract in infancy?
Definition
Pyloric stenosis
Term
These s/s: projectile vomiting immediately after birth, dehydration with sunken fontanels, poor skin tugor, decrease in wet diapers, olive-shaped mass felt RUQ of abdomen, distended stomach or peristaltic waves visible during feedings are of what condition?
Definition
Pyloric stenosis
Term
What is pyloromyotomy?
Definition
surgical intervention to enlarge the opening of the pylrous
Term
What are some NI for pyloric stenosis?
Definition
IV fluids, weigh diapers, I&O, daily weights, frequent VS postop, glucose feeding for the first feeding after surgery then progress to small frequent feeding to avoid over feeding
Term
What is also known as gluten enteropathy or spure disease?
Definition
Celiac Disease
Term
What is the leading cause of malabsorption problems in children?
Definition
Celiac Disease
Term
S/S of Celiac Disease occur at what age?
Definition
6 months to 2 years
Term
What are some foods high in gluten?
Definition
Wheat, barley, oats and rye
Term
What are some s/s of Celiac Disease?
Definition

frothy, bulky, large stools

abdominal distention with atrophy of the buttocks

Term
How is the Dx of Celiac disease confirmed?
Definition
Serum IgA test and small bowel biopsy
Term
What is also known as Aganglionic Megacolon?
Definition
hirschsprung's disease
Term
When there is an absence of ganglionic innervation to the muscle of a segment of bowel causing lack of normal peristalsis is called?
Definition
Hirschsprung's Disease
Term
What is ganglionic innervation?
Definition
absence of nerve cells
Term
Hirschsprung's Disease result in?
Definition
chronic constipation
Term
What is usually seen in the lower portion of the sigmoid colon?
Definition
Hirschsprungs Disease
Term
These s/s: ribbonlike stools, abdominal distention, higher incidence with Down Syndrome children, no meconium stool within 24-48h, undernutrition, poor feedings, constipation and diarrhea are common in what condition?
Definition
Hirschsprung's Disease
Term
What is the treatment for Hirschsprung's Disease?
Definition
Surgery-impaired part of colon is removed and an anastomosis of the intestine is performed- 12mo-18mo
Term
This condition causes slipping of one part of the intestine into another part just below it-
Definition
Intussusception
Term
What is a common site for Intussusception?
Definition
at the ileocecal valve-sm intestine opens into the ascending colon
Term
Occurs in boys at what age?
Definition
3 months - 6 years
Term
These s/s-severe abdominal pain with crying, straining efforts, kicking, and drawing up of legs, green or greenish yellow emesis, currant jelly stools (stools containing blood and mucus with no feces present), fever up to 106F- are of what condition?
Definition
Intussusception
Term
Barium enema is the first treatment of choice of?
Definition
Intussusception
Term
If reduction is not accomplished by barium enema then is will occur-
Definition
Surgery
Term
What does the barium enema do for Intssusception?
Definition
pushes small intestine back into place
Term
What develops when the vitelline duct fails to disappear completely, thus resulting in a small blind pouch ususally occurs at the ileocecal valve and connect to the umbilicus by a cord?
Definition
Meckel's Diverticulum
Term
What is the most common congenital malformation of the GI tract?
Definition
Meckel's Diverticulum
Term
These s/s- painless rectal bleeding, bright red or dark stools, abdominal pain are of what condition?
Definition
Meckel's Diverticulum
Term
How is the Dx made of Merkel's Diverticulum?
Definition
Barium enema and radionuclide scintigraphy
Term
What is treatment of Merkel's Diverticulum?
Definition
Surgery with removal of diverticulum
Term
What are the two types of Hernias?
Definition

Inguinal

Umbilical

Term
What hernia is the protrusion of part of the abdomen contents through the groin?
Definition
Inguinal
Term
What hernia is the protrusion of the portion of the intestine through the belly button?
Definition
Umbilical
Term
What hernia can be put back in place by gentle pressure?
Definition
Reducible Hernias
Term
Which hernias cannot be put back in place?
Definition
Incarcerated or irreducible
Term
These s/s-irritable, fretfulness, constipation, vomiting, abdominal pain are of what condition?
Definition
Hernias
Term
What is Herniorrhaphy?
Definition
hernia sugery
Term
What is inflammation of the stomach and intestines?
Definition

Gastroenteritis

 

Term
What is inflammation of the colon?
Definition
Colitis
Term
What is inflammation of the colon and small intestines?
Definition
Enterocolitis
Term
Gastroenteritis, Colitis, and Enterocolitis are most common diseases causing ...?
Definition
Diarrhea
Term
Disorders of motility are usually caused by...?
Definition
food intolerance, overfeeding, improper formula preparation, or indigestion of high amount of sorbitol
Term
What is the treatment of Gastroenteritis?
Definition
  • oral dehydrating solutions-Pedialyte, Lytren, Ricelyte, or Resol
  • accurate I&O -weighing diapers or weigh child daily
  • Good skin care with frequent diaper changes
  • Frequent handwashing
Term
What is the most common cause of Gastroenteritis?
Definition
food poisoning
Term
What is the treatment for Gastroeneteritis?
Definition
Observe for s/s of deyhdration and enteric precautions and standard precautions
Term
What is the sudden contractions of the diaphragn and muscles of the stomach?
Definition
Vomiting
Term
What are the various causes of vomiting?
Definition
viruses, formula intolerance, infections, pneumonia, and intracranial pressue
Term
What are the treatments of vomiting?
Definition
Teach feeding techinques to parents, accurate I&O, charting time, amount, color, consistency, force, and fequency; IV fluids, and administer antiemetics (Tigan or Phenergan) for persistant vomiting
Term
What condition is when the lower esophageal sphincter is relaxed or not competent, which allows the stomach contents to be easily regurgitated into the esophagus?
Definition
Gastroesophageal Reflux
Term
What condition is seen in preterm infants who have neuromuscular delays and in children with neuromuscular disorders (Cerebral Palsy/Downs Syndrome)?
Definition
Gastroesophageal Reflux
Term
These s/s-vomiting (first or second week of life), wt loss, failure to thrive and respiratroy problems are caused by this condition?
Definition
Gastroesophageal Reflux
Term
What test is performed for Gastroesophageal Reflux?
Definition
Barium swallow
Term
What medication is given for GR?
Definition
Reglen, Tagament, or Zantac
Term
How is formula given to an infant with GR?
Definition
1 tsp rice with 1 oz of formula-upright to feed for 30" after feeding
Term
When is medication given to infants with GR?
Definition
30" before feeding
Term
An apnick monitor is used for what condition?
Definition
Gastroesophageal Reflux
Term
What is some teaching is given to parents for GR?
Definition
frequent burping, avoid overfeeding, thicken formula, upright position after feedings
Term
What is the sudden increase in stools from the infants normal pattern with fluid consistency and color that is green or contains mucus or blood?
Definition
Diarrhea
Term
What is the most common cause of stomach conditions?
Definition
Diarrhea
Term
What can cause diarrhea?
Definition
inflammation, infection, medication, food or posioning
Term
What can diarrhea be a indication of if lasting more that 2 weeks?
Definition
malabsorption, long term inflammatory disease, or allergy response
Term
These s/s-watery, yellowish stools that expelled with force, listless, poor appetite, fever, vomiting, dehydration, decreased urine output and hyperactive bowel sounds- are an indication of what condition?
Definition
Diarrhea
Term
What are the 5 types of Diarrhea?
Definition

Rotavirus-occurs in daycares

E coli- poorly cooked foods or lack of hygiene-attacks the kidneys and causes hemolytic anemia

Salmanella- contaminated foods or pet contact- most common

C Dif- prolonged antibiotic therapy

Giardia lamblia- intestinal protozoan-contacted from swimming in lakes, ponds etc

Term
What are some at home treatments for diarrhea?
Definition

Brat diet-bananas, rice, applesauce, and toast

Pedialyte-24-48h

Advance to soft bland diet

Avoid sodas, fruit juices, chicken broth, and gelatin

Term
What condition is the difficult or infrequent defication with the passage of hard dry fecal material associated with abdominal discomforts or blood-streaked stool?
Definition
Constipation
Term
What indicates constipation?
Definition
fewer than 7 bm's in a 2 week period
Term
Which fruit is a natural laxative?
Definition
Pear juice
Term
What are some treatments for constipation?
Definition

increase roughage in diet including fiber

increase fluid intake

stool softener may be prescribed

establish routine bowel habits

Term
What occurs more quickly in children than in adults?
Definition
Fluid turnover and dehydration
Term
Why do infants adapt poorly to rapid shift changes?
Definition
immature kidneys
Term
What depends on fluid balance, cardiovascular, renal, adrenal, pituitary, parathyroid, and pulmonary regulatory mechanisms?
Definition
Electrolyte imbalance
Term
What are preferred over IV fluids?
Definition
Pedialyte or Infalyte
Term
How much intracellular fluids to children have in their bodies?
Definition
62%
Term
How much is extracellular fluid in children?
Definition
38%
Term
What is used when the child cannot take oral fluids to replace their electrolyte imbalance?
Definition
Parenteral Fluids
Term
What IV fluid is .45NS?
Definition
Hypotonic
Term
What IV fluid is D2.5% +.4%NS and D5+.2NS?
Definition
Isotonic
Term
What IV fluid is used for school-age children?
Definition

.9%NS+LR

 

Term
Which IV fluid is rarely used?
Definition
D5H2O
Term
What IV fluid is D5+.45NS?
Definition
hypertonic
Term
What IV fluid is used for school-age children (hypertonic)?
Definition
D5.9%NS or D10.9%NS
Term
What IV fluid is used for burns?
Definition
D5LR
Term
What happens when the fluid output exceeds fluid intake?
Definition
Dehydration
Term
What is the assessment of a dehydrated child?
Definition

History-wt changes, history of illiness contacts, stool & vomiting frequencies

Clinical Exam- daily wt, skin turgor, mucous membrane moisture, fontanel fullness, and mental state

Lab Test- CBC, BUN, Ca, Glucose, Osmolarity, Creatinine, and Electrolytes

Urinalysis- specific gravity, pH, glucose, ketones, amino acids, and culture if s/s of infection

Term
What is considered mild dehydration?
Definition
up to 5% wt loss
Term
What is considered moderate dehydration?
Definition
5%-10% wt loss
Term
What is considered severe dehydration?
Definition
above 10% wt loss
Term
What type of dehydration is when the child has lost equal amounts of fluids and electrolytes?
Definition
Isotonic
Term
What type of dehydration is when the child has lost more electrolytes than fluids?
Definition
Hypotonic
Term
What type of dehydration is when the child has lost more fluids than electrolytes?
Definition
Hypertonic/severe vomiting
Term
Treatments of dehydration include:
Definition
What type of IV fluids to give, maybe a supplement of K+ or not, and the amount and rate of IV fluids given
Term
What condition happens when the body receives more fluid than it can excrete?
Definition
Overhydration
Term
What are the s/s of overhydration?
Definition

Edema is present in excess fluid in the interstitialspaces

Cerebral edema with head injuries- give mannitol

Term
What is severe generalized edema?
Definition
Anasarca
Term
What are some treatments for overhydration?
Definition
Daily wt and weigh diapers, Accurate I&O, check for edema around eyes, presacral, occipital or genital areas, correlate lab findings with oral fluid intake and foods, restrict fluid and Na+ diet, reposition frequently
Term
What happens when children fail to gain or often lose wt without an obvious cause?
Definition
Failure to thrive
Term
What are the two types of Failure to Thrive in children?
Definition

Organic pathology

Non organic pathology

Term
What failure to thrive is caused by physical disease?
Definition
Organic
Term
What failure to thrive is caused by lack of parent-infant interaction, neglect, environmental factors or lack of nutritional need?
Definition
Non organic
Term
What is the treatment for FTT?
Definition
plan needs to be developed to meet the needs for the child to include develoopmental, physical and psychological
Term
Which FTT is reported to authorities?
Definition
Non organic
Term
What condition is a severe deficiency of protein in their diet?
Definition
Kwashiorkor
Term
What type of child may get Kwashiorkors?
Definition
children between 1-4 who have been weaned from the breast when the next child is born
Term
What condition are these s/s-muscle weakness, generalized abdomen edema, diarrhea, skin infections, irritability, anorexia and vomiting, hair loss/thinning with white streaks present, apathetic and weak?
Definition
Kwashiorkor
Term
What is the main focus of Kwashiorkor?
Definition
prevention
Term
What are some treatments of Kwashiorkor?
Definition
sprinkle protein powder on foods
Term
What is caused by the deficiency of Vit D?
Definition
Ricketts
Term
What are some s/s of Ricketts?
Definition
bowlegs, knock-knees, beading of the ribs, and improper formation of teeth
Term
What are some treatments for Ricketts?
Definition
vitamin supplements, foods high in Ca++ and Vit D and lots of sunshine
Term
What condition is defined by an insufficient diet of fruits and veggies that contain Vit C?
Definition
Scurvy
Term
What are some s/s of scurvy?
Definition
joint pains, bleeding gums, loose teeth, and lack of energy
Term
What are some treatments for Scurvy?
Definition
Foods high in Vit C
Term
What infection is the inflammation of the appendix with/without rupture or perforation of the appendix?
Definition
appendicitis
Term
What are some s/s of appendicitis?
Definition
periumbilical pain- increases within 4h then spreads to the RLQ, vomiting, infrequent mucus diarrhea, guarding, rebound tenderness, pain on lifting thigh in the supine position and pain in the RLQ when palpated during rectal exam
Term
What lab tests are done to confirm or rule out Dx?
Definition
urinalysis, c-reactive protein, KUB, ultrasound, CAT scan, CBC and BMP
Term
What condition is an infection of the mucous membrane of the mouth caused by a fungus?
Definition
Thrush
Term
What are some s/s of Thrush?
Definition
whte patches on tongue, inner lips, gums, and oral mucosa
Term
If untreated Thrush may cause what condition?
Definition
Pneumonitis
Term
What are some treatments of Thrush?
Definition
Local application of Mycostatin (nystatin), swab mouth after feedings, use disposable bottles, nipples, and pacifiers
Term
Which worms are usually seen in toddlers?
Definition
Pinworms
Term
What are some s/s of Pinworms?
Definition
Itching of the anal area, irritability, restlessness, weight loss, poor appetite, and fretfulness at night
Term
What is the treatment for pinworms?
Definition
anti helmintics
Term
What worms are caused by unsanitary disposal of human feces and poor hygiene practice?
Definition
Roundworms
Term
What are some s/s of Roundworms?
Definition

abd pain

chronic cough without fever

Term
What will Dx roundworms?
Definition
stool culture
Term
What is the goal in treatment of posions?
Definition
removal of the posion, prevent further absorption, call 911 then call posion control and seek med help
Term
What is the cause of hepatic distruction?
Definition
APAP overdose
Term
What is some treatments for APAP posioning?
Definition

Lavage

Mucomyst is the antedote for APAP

Monitor ALT & AST levels- repeat in 4h, 8h then daily

Term
What is the overdose of ASA?
Definition
Salicylate Posioning
Term
What are some treatments for ASA posioning?
Definition

Vit K is the antedote for ASA

peritoneal dialysis-used for acute renal failure, serum salicylate level drawn stat, monitor BUN and Creatinine levels-recheck in 4h

Term
What is plumbism?
Definition
Lead posioning
Term
What causes lead posioning?
Definition
a child repeatedly ingests or absorbs lead
Term
What can contain lead?
Definition
paints, food, water and air
Term
Lead can have a lasting effect on what system?
Definition
Nervous
Term
How is Lead posioning Dx?
Definition
blood test - over 20 do Knee xray
Term
What are some s/s of Lead Posioning?
Definition

weakness, weight loss, anorexia, pallor, irritability, vomiting, abd pain and constipation

 

Later stages-anemia, nervous system involvement, muscle incoordination, neuritis, convulsions and encephalitis

Term
What are some treatments for Lead posioning?
Definition
reduce the concentration of lead in tissues and blood by ingesting Iron and Vit C
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