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Peds GI and Fluid Part II
Terms in this set (55)
Can you give H2 Receptor Antagonists (ranitidine/Zantac) with an antacid?
No, give them separately
H2 Receptor Antagonists (ranitidine/Zantac) inhibit the secretion of what?
When should patients take Proton Pump Inhibitors (lansoprazole/Prevacid)?
30 minutes before a meal
Which GI medications should be administered separately from other GI medications?
The lower esophageal sphincter (or LES) is a muscle that separates the esophagus from the stomach. What medication inhibits the tone of the LES , inhibits pepsin activity, and neutralizes gastric activity?
A Nissen fundoplication is performed in order to narrow part of the stomach so that the lower portion of the esophagus passes through a small tunnel of stomach muscle. This surgery is used to treat what condition?
Which Inflammatory Bowel Disease presents with skip lesions?
Children with Crohn's may experience delayed ______ development or failure to thrive
With which disease is pain in the eyes, fistulas, rash, and large joint arthritis more common?
Lab work may be abnormal for IBD:
____ may be elevated because of inflammation.
H and H may be _____ because they may be anemic.
May have mineral deficits.
May be low in _____ soluble vitamins.
Albumin may be ___.
ESR may be elevated because of inflammation.
H and H may be lower because they may be anemic.
May have mineral deficits.
May be low in fat soluble vitamins.
Albumin may be low.
How is Total Parenteral Nutrition usually administered?
Why should Crohns patients not have foods high in fiber?
Hard to digest foods (fiber-rich) cause inflammation and the inflammation can cause a bowel obstruction
Can Crohns patients have raw fruits?
What supplement may doctors recommend to Crohns patients to decrease inflammation?
For which IBD, does removing the colon cure the illness?
Ulcerative colitis (because ulcerative colitis is confined to the colon)
A patient with crown's disease has the damaged areas of their digestive track removed. Can the disease still pop up elsewhere?
Which digestive disease results in fatty, foul smelling stools called steatorrhea?
Celiac Disease is believed to be _______ mediated
Gluten is found in wheat, barely, rye, and ______ oats.
(We Barely Read Together)
At ___ months of age or older there is blood work that can be done to look for signs of Celiac Disease
How do you confirm Celiac Disease?
1) Tissue biopsy 2) They will also do an endoscopy before gluten is stopped, then stop gluten, and do another endoscopy to see if inflammation has decreased.
The greatest risk associated with Celiac Disease is the risk for developing:
lymphoma (cancer of the lymph nodes)
A patient with Celiac Disease finds out that barely does not produce GI distress symptoms even though it contains gluten. Can the patient have barely?
They shouldn't't because the gluten is still causing inflammation and damage.
Long-term side effect of steroid use is the development of ____ ______
5-Aminosalicylic Acid, 5-ASA (mesalamine) blocks _______ production and decreases inflammation in the colon.
Be aware of sulfa allergies, use cautiously in patients with liver disease, counsel that urine may become ______
What can happen if patients get freaked out by how they look while taking steroids and decide to stop the steroids cold turkey?
They could go into adrenal crisis! You have to wean off them very slowly
What are the two cause of projectile vomiting?
Obstruction or pyloric stenosis (not just undigested formula)
how often should babies be peeing and eating?
every 8-12 hours
If a patient is constipated and has a distended abdomen along with vomiting the nurse should suspect a:
A child begins vomiting. Do you immediately give Zofran?
No, give oral hydration fluids first.
What part of the brain stimulates vomiting?
Is GERD associated with an increased lower esophagaus pressure ?
No! GERD is not due to an increased lower esophagus pressure. GERD happens during transient relaxation of the sphincter; stomach contents get regurgitated back into esophagus causing damage
A patient with GERD has hematemesis, occult fecal blood, & obvious blood in stool. What does this imply?
There has been tissue damage
does thickening formula with rice cereal decrease reflux?
No, it just decreases emesis
What term is defined as inadequate growth due to insufficient caloric intake or inability to effectively use calories for growth?
Failure to thrive
Name three absorption issues that can lead to failure to thrive:
cystic fibrosis, celiac, and liver disease
A child has failure to thrive. What decreases first, weight or height?
First their weight will drop below the 5%tile then later height also below the 5%tile
What assessment tool should be used to see what the caregiver and child are doing during a feeding to assess for failure to thrive?
Nursing Child Assessment Satellite Training feeding scale
Is anxiety a trigger for IBD?
No! But having a chronic disease could cause anxiety
Severe _____ presents as frequent bloody diarrhea, abdominal pain, fever, and weight loss
What is the most common place to see ulcerative colitis?
The distal colon (it is limited to the distal colon and rectum)
What type of IBD most commonly presents with strictures?
Patients with Crohn's disease can develop ______ which can lead to infection and abscesses
Which type of IBD more often presents with growth delays?
What diagnostic test can detect abscesses or bowel wall thickening?
A CT scan
If a patient has elevated pANCA levels they most likely have:
What is the first-line treatment for moderate to severe IBD?
When assessing for dehydration, we can assess the ____ fontanel for sunkeness until the child is somewhere between 7-18 months.
Pancreatic enzyme replacements contain enzymes that digest fat, protein and complex carbohydrates. Some foods and drinks do not require enzymes because they contain only simple carbohydrates that are digested and absorbed easily.
What are examples of foods and drinks that do not require enzymes?
Soft drinks, sports drinks
Infant rehydrating formulas (like Pedialyte®)
Do you have to give pancreatic enzymes to a CF patient if the meal is predominately sugar or carbohydrate?
Can patients with ulcerative colitis have milk products?
Yes; as long as it is not a trigger food for the patient
Can patients with ulcerative colitis have nuts?
Nuts, including those cooked into other foods or made into flours, should be on your do-not-eat list if you have UC. The fiber in them is very hard to digest.
Are there s/s of mild dehydration?
During what level of dehydration, is dry mucous membranes observable?
no, usually the NG tube should NOT be replaced by the nurse if it is accidentally removed because of the risk of injury to the operative site
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