Unit XI: Nursing Care Child with GI issues
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103 terms
Terms | Definitions |
|---|---|
 FLACC | Face, Legs, Activity, Cry and Consolability |
| FLACC scale is used for | Pain tool for 6 months and older |
| NPO for solids | 8 hours |
| NPO for formula | 6 hours |
| NPO for breast milk | 4 hours |
| NPO for clear liquids | 2 hours |
| If NPO after midnight, do what after midnight | start IV, provide glucose so sugards don't drop, infants may not be able to store much glycogen |
| Skin turgor | pinch inner thighs and belly - check hydration status |
| Best way to check Hydration Status | Weight |
| increments of measureing fluid loss | every 4 hours |
| chemical pneumonia | when milk or breast milk is aspirated due to stickiness |
| Foregut | from pharynx to proximal duodenum, including liver, pancrease, biliary tract and lower respiratory tract |
| Midgut | from distal duodenum to transverse colon |
| Hindgut | from descending colon to anal canal |
| should be present at birth | sucking & swallowing |
| should be present at birth | extrusion reflex |
| gastric PH in new born | 1-3, compared to (0.1-1.5 in adult) |
| lipase | pancreatic enzyme that breaks down lipids/fats |
| protease (trypsin) | pancreatic enzyme that breaks down protein |
| amylase | pancreatic enzyme that breaks down carbs and starch |
| bile | emulsifies fat |
| by age 2 | GI mature, sphincter control (potty training) |
| trachealesophogeal fistual & esophageal atresia | failure of the esophagus to develop as a continuous passageway |
| fistula | opening between two adjacent areas |
| atresia | blind pouch |
| polyhydraminos is associated with | trachealesophageal fistula and esophageal atresia, because amniotic fluid builds up |
| 3 Cs | Cough, choke, cyanosis |
| abdomen fills with air | trachealesophageal fistula and esophageal atresia |
| ferril bag | an empy bag that releases gas into it |
| esophageal strictures | narrowing, scaring, stiffness |
| one anastomosis risk | respiratory distress |
| pyloric stenosis | an obstruction, at the outlet of the stomach |
| pyloric stenosis | 5x more likely in males |
| pyloric stenosis | progressive hypertrophy of circular muscle |
| pyloric stenosis | projectile vomiting (2-4 feet) |
| pyloric stenosis | dehydration, weight loss, baby with sunken fontanels |
| olive shaped mass in RUQ | seen in pyloric stenosis (enlarged pyloris) |
| pyloromyotomy | muscle splitting procedure |
| pyloromyotomy | should remain high fowlers 20-30 min. |
| pyloromyotomy | put on slight right side, it facilitates drainage |
| pyloromyotomy | hypoglycemic |
| gastroesophageal reflux | call ruminators, comes back up because of incompetent esophagus |
| begins at 20 weeks | swallowing |
| gastroesophageal reflux | vomiting/spitting |
| gastroesophageal reflux | hiccupping |
| gastroesophageal reflux | recurring otits media |
| gastroesophageal reflux | failure to thrive because losing weight, always hungry |
| Gold standard for Acid reflux test | TUTTLE test |
| TUTTLE test | pH probe, placed in stomach, as multimple sensors, placed in for 24 hours, only apple juice and water are allowed |
| reglan | increases lower esophageal pressure & gastric emptying time |
| Nissen fundoplication | take the fundus of the stomach and wrap it around the lower esophageal spincter, 270 wrap or 360 wrap |
| can't vomit | 360 nissen fundoplication wrap |
| omphalocele | congenital defect in which a sack containing abdominal contents protrudes from the umbilical stump. |
| omphalocele | occurs between 6-10 week, midgut grows, it elongates, and it projects from the abdomen, often returns to normal by 11th week |
| gastroschisis | congenital defect where the abdomen wall has formed but there is a weakness or herniation, usually to the right or left of an intact umbilical cord |
| gastroschisis | can have twisted, leathery or necrotic intestines; circulation can be cut off, higher in males |
| omphalocele | have warm IV saline drip onto gaze |
| omphalocele & gastroschisis | might need to be NPO for several weeks after surgery. |
| intussuception | most common cause of intestinal obstruction from 3 months to 3 years |
| intussuception | can have red, currant jelly-like stools, because blood leaks into the intestines |
| intussuception | felt in lower right quadrant |
| hirschsprung disease | absence of nerve innervations to a portion of the colon |
| hirschsprung disease | constipation, abdominal distention, vomiting |
| barium enema | shows dilated groups of bowel |
| anal agenesis | similar to atresia (did not descend totally) |
| how to treat anal stenosis | periodic dilatations, sitz bath |
| breastfed stool | yellow, pasty, sour milk odor |
| bottlefed | brown stool |
| extrahepatic biliary atresia | can be resolved by making an opening to connect to the liver to drain |
| intrahepatic biliary atresia | will require a liver transplant |
| jaundice is first seen | in the sclera |
| vitamin issues with biliary problems | vit A (vision), D (calcium uptake), E (supposed to help prevent hemolysis), K (clotting) |
| calcium supplements | with obstructed bile flow |
| binds to fat | calcium |
| gastroenteritis | massive diarrhea |
| gastroenteritis | can result in sepsis, shock, or death |
| gastroenteritis | inflammation can result in ulceration, bleeding, sepsis |
| enterotoxins | will cause massive loss of fluids |
| cytotoxins | will cause local edema of the intestine, malabsorption and dehydration |
| neurotoxins (shigella) | attacks the nerve cells |
| gastroenteritis | often seen in daycares, peaks in summer |
| gastroenteritis | can be water borne, salmonella, |
| metabolic acidosis | loss of NA, K, and NaHCO3 |
| tissue hypoxia | lactic acid build up |
| fat break down | ketosis |
| losing 15% of weight | very bad, near death |
| blood pressure drops | very last sign (severe sign) |
| 1ml/1kg/1hr | minium urinary output for a young child |
| celiac disease | inability to tolerate wheat protein (gluten); symptoms include foul-smelling diarrhea and emaciation; often accompanied by lactose intolerance |
| celiac disease | first evidence may be growth failure and diarrhea |
| celiac disease | when it becomes a crisis, can lead to explosive watery diarrhea |
| celiac disease | abdominal distension |
| celiac disease | mucosal inflammation, crypt hyperplasia, villous atrophy |
| celiac disease | gluten free diet is the cure |
| celiac disease | high calorie, protein, simple carbs, low in fat |
| lactose intolerance | Body is lacking the enzyme (lactase) that breaks apart lactose (glucose+galactose). Then, the molecules are 'too big.' Instead, bacteria come by and eat up the huge lactose molecules, and their digestive byproducts are the cause of the bowel irritation (gas, diarrhea, etc.). |
| breath hydrogen test | diagnose lactose intolerance |
| lactose intolerance | for infants, use fecal pH test (acidic +) |
| Encopresis | involuntary defecation not attributable to physical defects or illness |
| Encopresis | inappropriate, and must be 4 years old |
| Encopresis | constipation can be a cause |
| steatorrhea | greater than normal amounts of fat in the feces which are frothy and foul smelling and floating |
| cries scale | used for less than 6 months |
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