Gastrointestinal #4

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Author:
jtisby
ID:
220597
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Gastrointestinal #4
Updated:
2013-05-22 02:44:37
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Gastrointestinal WWCC Spring 2013
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Gastrointestinal #4
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  1. Define Cleft Lip

    (6pts)
    • -soft tissue of the lips fuse closed
    • -congenital/hereditary
    • -occurs more often than cleft palate
    • -occurs more often in males
    • -occurs between 5-8 weeks gestation
    • -may be unilateral or bilateral with unilateral more common
  2. Define Cleft Palate

    (5pts)
    • -Failure of the bony structures of the mouth to fuse
    • -congenital/hereditary
    • -occurs more often in males
    • -occurs between 7-12 weeks gestation
    • -unilateral or bilateral, or midline
  3. Isolated Cleft Palate
    Associated with genetic syndromes more frequently than with cleft lip/palate
  4. Cleft Lip/Palate -  Feeding
    • -feeding difficulty depends on degree & degree
    • -Unable to make airtight seal around nipple => difficulty sucking
    • -Gagging, choking. milk from nose
    • -swallows air - needs frequent burping
    • -special bottles allow more suction
  5. Cleft Lip/Palate - Feeding considerations
    • Cleft Lip: may succeed with breast feeding
    • Cleft Palate: breast feeeding depends on breadth of defect

    • -Squeeze bottle, special scoops
    • -keep baby upright
    • -have suction available
    • -position on side after feeding
  6. Cleft Lip/Palate - Nursing management
    • -babies easily exhausted
    • -required frequent burping
    • -increased risk for aspiration
    • -consider parents feelings
  7. Cleft Lip/Palate - Repair

    (6pts)
    • Cheilopasty
    • Cleft Lip surgically repaired around 3-7 months
    • Cleft Palate repaired around 9-18 months
    • -increased risk for repeated ear infections
    • -child must be infection free for surgery
    • -speech begins to develop around 18 months
  8. C.H.A.M.P.E.D.
    • C: Celiac disease
    • H: Hirschsprung's disease
    • A: Appendicitis
    • M: Meckel's diverticulum
    • P: Pyloric stenosis
    • E: Esophageal artesia
    • D: Diarrhea
  9. F.I.G.H.T.S.
    • F: Failure to thrive
    • I: Imperforate anus
    • G: Gastroenteritis
    • H: Hernias
    • T: Thrush
    • S: Scurvy
  10. W.I.C.K.
    • W: Worms
    • I: Intussusception
    • C: Constipation
    • K: Kwashiorkor
  11. Celiac diaease
    • -intolerance to gluten
    • -life long gluten-free diet
    • -genetic presiposition
    • -autoimmune disorder
    • -appears between 1-5 yrs
  12. Celiac disease - Patho
    • -accumulation of amino acid glutamine
    • -causes atrophy of mucosal cells
    • -destruction of villi of sm intestines
    • -risk for small bowel cancer if untreated
  13. Celiac disease - S/S
    • -diarrhea (offensive odor)
    • -anorexia
    • -abdominal pain & distension
    • -muscle wasting esp. in buttocks
    • -vomiting
    • -anemia
    • -irritability
  14. Hirchsprung's disease (megacolon)
    • -absence of ganglion cells in rectum and bowel
    • -causes: mech obstr, decreases motility
    • -complication: enterocolitis (sm bowel & colon¬† inflammation)
    • -treatment:
    • non-surgical-stool softeners, diet, daily NS enemas
    • surgical-removal; maybe ostomy
  15. Appendicitis
    • -most common emergency abd surgery in childhood
    • -avg 10 yrs onset
    • -S/S: fever, chills, N/V, abd pain, no appitite,
    • -"hamburger test"
  16. Meckel's Diverticulum
    • -sm pouch cause by failure of duct to close during fetal development
    • -similar to Appendicitis
    • -congenital
    • -prone to inflammation
    • -common in boys
  17. Meckel's Diverticulum - S/S
    • -painless rectal bleeding
    • -common before 2 yrs
    • -possible abdominal pain
  18. Pyloric stenosis
    • -congenital narrowing/obstruction of lower end of stomach
    • -onset: 2-3 week after birth
    • -common in boys
    • -common surgical condition in infants
  19. Pyloric stenosis - S/S
    • -projectile vomiting (right after feeding)
    • -palpable olive-shaped mass in URQ of abdmn
    • -dehydration
    • -hunger

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