Peds test # 2 - GI

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Peds test # 2 - GI
2012-04-13 22:37:51

Peds test @ 2- GI
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  1. esophagus, stomach, proximal duodenum
  2. distal duodenum, jejunum, ileum, cecum, proximal colon
  3. distal colon/rectum
  4. esophagus/stomach are identifiable at ? weeks gestation
  5. uncoordinated contractions of the gut and delayed gastric emptying
    26 weeks gestation
  6. motility fully developed and coordination of sucking/swallowing
    36 week gestation
  7. thick, greenish black material consisting of epithelial cells, digestive tract secretions and amniotic fluid
  8. automatic reflex action for first 3 months of life
  9. required to convert nutrients from usable energy
  10. responsible for absorption of water & sodium
    Large intestine
  11. the shape of an infant's stomach should be what?
    rounded and dome-shaped
  12. diaphragmatic hernia
  13. normal, especially in epigastric area
  14. protrusion through the umbilicus or rectus abdominis muscles
    umbilical hernia
  15. usually palpated 1-3 cm below right costal margin; greater than 3 cm is hepatomegaly, which may indicate infection, cardiac failure, liver disease
  16. often the presenting symptom in children with celiac disease
  17. most common in children from 6 months to 3 years old
    foreign bodies
  18. Seek medical advice for what pertaining to foreign bodies? (6)
    sharp/large objects, batteries, aspiration, GI perforation, lodged in esophagus/pharynx, small smooth objects
  19. leading cause of illness in children younger than 5
    acute diarrhea
  20. How to calculate how much fluid to give a child with diarrhea:
    allow 100 mL/kg for first 10 kg of body weight; allow 50 ml/kg for second 10 kg body; allow 20 mL/kg for remaining body weight
  21. inappropriate passage of feces; often with soiling
  22. mechanical obstruction from inadequate motility of intestine
    Hirschsprung Disease
  23. usually involves the rectum and some portion of the distal colon
    Hirschsprung Disease
  24. S/S of hirschsprung disease (4)
    aganglionic segment usually includes rectum & distal colon; accumulation of stool with distention; failure of internal/sphincter to relax; enterocolitis may occur
  25. Newborn S/S of hirchsprung disease (4)
    failure to pass meconium w/in the first 48 hours of life; abdominal distension that is relieved by rectal stimulation or enemas; vomiting; neonatal enterocolitis
  26. what kind of diet does a patient need before having surgery for Hirschsprung disease?
    Low fiber, high calorie, high protein
  27. Transfer of gastric contents into the esophagus; occcurs in everyone
  28. associated with apnea, bronchospasm, laryngospasm, pneumonia
  29. therapeutic management for GER: (5)
    small, frequent feeds; continuous NG feeds severe cases, fequent burping, thickening of feeds controversial, positioning controversial
  30. promotes gastic emptying and increases lower esophageal sphincter pressure
    Prokinetic agents
  31. Reduce amount of acid present in gastric contents
    Tagamet, zantec, pepcid
  32. proton pump inhibitors that inhibit gastric acid secretion
    Prilosec, prevacid
  33. nursing considerations for GER: (4)
    educate parents about positioning, feeding changes, educate about medications, inflammatory diseases
  34. acute inflammation and infection of vermiform appendix/most common causes of abdominal pain; due to a closed-loop obstruction of the appendix
    Acute appendicitus
  35. most common congenital malformation of GI tract; results from imcomplete obliteration of fetal omphalomesenteric duct that connects with the yolk sac; usually occurs w/o symptoms
    Meckel Diverticulum
  36. S/S of meckel diverticulum (6)
    rectal bleeding, sudden bright red stool, tarry stools, pain, inflammation, obstruction
  37. includes ulverative and Crohn's disease
    Inflammatory bowel disease
  38. S/S of ulcerative colitis
    intestinal bleeding, moderate to severe diarrhea, abdominal tenderness, mild anemia, anorexia, weight loss
  39. inflammation/ulceration of continous segments of the rectum/colon causing varying degrees of bleeding and edema
    ulcerative colitis
  40. chronic inflammatory disease that can affect any part or the entire GI tract from the mouth to the anus
    Chrohn Disease
  41. S/S of crohn disease
    diarrhea, abdominal pain and cramping, fever, weight loss, extraintestinal manifestations
  42. Goals of treatment for inflammatory bowel disease (4)
    control inflammation and reduce symptoms; obtain long term remission; promote normal growth/development; normal lifestyle
  43. most effective drugs for treating IBD
    corticosteroids (prednisone)
  44. effective in maintaining remission in mild to moderate disease
  45. side effects include HA, nausea, abdominal pain, rash
    azulfidine sulfasalazine
  46. side effects include worsening diarrhea, rectal bleeding, nephritis, pancreatitis, hair loss, hepatits, pericarditis
    mesalamine (asacol, pentasa)
  47. use to treat CD; alters cellular or humoral immunity; facilitates remission, decreases likelihood of recurrence
  48. constriction of pyloric sphincter with obstruction of gastric outlet; results from hypertrophy of the circular muscle of pylorus
    hypertrophic pyloric stenosis
  49. S/S of HPS (3)
    projectile vomiting, hungry/irritable, dehydrated with weight loss
  50. Lab values for HPS (3)
    matabolic alkalosis, decreased Na and K; increased BUN
  51. Therapeutic management for HPS (4)
    rehydration, surgery, resume feedings of clear liqueds 4 to 6 hrs post op, progress to full feeds w/in 48 hrs
  52. telescoping or invagination of one portion of intestine into another; most commonly occurs b/w 3 months and 3 years
  53. S/S of intussusception (6)
    sudden onset abdominal pain, palpable sausage shaped abd mass, currant jelly stools, rectal bleeding, lethargy, sepsis
  54. due to abnormal rotation around around the superior mesenteric artery during embryonic development
  55. occurs when intestine is twisted around itself and compromises blood supply go intestines
  56. intermittent vomiting, recurrent abdominal pain, abdominal distention, lower GI bleeding
    malrotation and volvulus
  57. characterized by chronic diarrhea and malabsorption of nutrients; may result in failure to thrive; digestive, absorptive, anatomic defects
    malabsorption syndromes
  58. also called gluten-induced enteropahy and celiac sprue
    celiac disease
  59. four characteristics of celiac disease
    steatorrhea, general malnutrition, abdominal distention, secondary vitamin deficiencies
  60. therapeutic management for celiac disease (2)
    gluten free diet; nutritional supplements esp. iron, folic acid, and fat soluable vitamins
  61. nursing considerations for celiac disease (4)
    dieatary management, read all labels, easier with infants and children than adolescents, may be lactose intolerance
  62. result of decreased mucosal surface area, usually due to extensive resection of small intestine
    short bowel syndrome
  63. goal management of SBS (4)
    preserve bowel length, maintain optimum nutritional status while intestinal adaption occurs, stimulate intestinal adaption, minimize compliations
  64. What are the stages of maintenance of SBS? (3)
    TPN, enternal feeding, exclusive enteral feeds
  65. incomplete fusion of structures surrounding oral cavity
    cleft lip/palate
  66. failure of esophagus to develop as a continuous passage or failure of esophagus and trachea to develop into separate structures; may occur separately or in combination
    esophageal artesia/tracheoesophageal fistula
  67. S/S of esophageal artesia/T. fistula includes: (4)
    constant drooling, normal suck with sudden cough/gag, abdominal distention with distal TEF, frequent aspirations in neonatal period
  68. herniation of abdominal contents through the umbilicus; usually enclosed inperitoneal sac
    omphalocele (belly button)
  69. herniation of intestine lateral to the umbilicus, usuallly right of umbiliucs, abdominal contents are exposed