GI missing information

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Prittyrick
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300227
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GI missing information
Updated:
2015-04-07 22:43:04
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  1. 1. Pyloric stenosis nx intervention
    • o preop
    • o - npo
    • o - weigh daily
    • o - monitor VS
    • o - i&o
    • o - complication
    • o - provide small frequent feeds with HOB up
    • o - burp freq
    • o - position on r side to prevent aspiration
    • o Post op
    • o - small freq feeds w/ electrolytes solution at first
    • o - advance to regular foods as tolerated
    • o - pacifer for comfort
    • o - position of r side to help flow thru pyloric valve
    • o - clean incision as ordered
    • o - monitor for vomiting
  2. 2. Intestinal disorder
    • o intussusception
    • o necrotizing entercolitis
    • o appendicitis
    • o celiac disease
  3. 3. intussusception
    • o def: invagnation of bowel segment into itself, most commonly at ileocecal valve. usually occurs at 6 months of age. 3 times more likely in males than females. medical emergency
    • o cause: unknown, possibly associated with lead point (something in bowel) meckel's diverticulum or polyps, hyperactive peristalsis, abnormal bowel lining
    • o Path: swelling on one side. it gets occulded and causes parts of the bowel to die
  4. 4. Intussusception complication, assessment, dx
    • o comp: bowel obstruction, strangalation of intestine, gangrene, shock, bowel perforation, peritonitis, death if treatment delay > 24hr
    • o assessment: colicky pain (comes and goes)., red current jelly stools with mucous and blood, abdomen distended/tender with sausage shaped mass, emesis with bile or fecal matter
    • o dx: abd x-ray wbc incre, air or barium enema
  5. 5. Intussussception med manage, surgery, nx intervention
    • o medical management: IVF, NG tube non operative reduction (air or barium enema), surgery
    • o indication for surgery: failure of non operative reduction, reoccurrent intuss, shock or sepsis
    • o Intervention:
    • o - prepare enema and monitor for return stools or need for surgery
    • o - monitor temp/vs, I&O and NG tube
    • o - post op- antibiotics, monitor incision, monitor for return of bowel sounds, emotional support for the family
  6. 6. Necrotizing enterocolitis (NEC)
    • o def: acute bowel inflammation with necrotic patches. inc risk for paralytic ileus, perforation and peritonitis. develops in approx 5% in NICU
    • o cause: ischemia to the bowel. babies with extremely low birth weight, abd extended, bloody stools, bililous vomiting
  7. 7. NEC complication, assessment, dx
    • o comp: grave condition in the immature infant, possible death. prognosis not sure until baby is feeding normal with bowel problems
    • o Assessment: signs appear in the first week of life. abdominal distension, firm, bloody stools, diarrhea, bilous vomiting (bc of blockage), apnea episodes, signs of blood loss, variable temp
    • o dx: abdominal rx-ray, in abd girth measurement
  8. 8. NEC med management nx intervention
    • o med management: stop PO feedings, maintain IVF or parenteral feedings, antibiotics, handle abd gently, possible temporary colostomy, surgically removal of the necrosed bowel
    • o - for perforation- peritoneal drain, laparotomy to remove fecal secretions from abdomen
    • o Nursing intervention: monitor VS, admin antibiotic, maintain IVF or parentanel feedings, prevent perforiation, I&O, ongoing assessment including measuring abd girth and monitoring bowel sounds
  9. 9. Appendicitis
    • o def: inflammation and obstruction of the blind sac at the end of the cecum. most common abd surgery in children
    • o cause: by harden fecal mass, stricture viral infection
    • o complication: ischemic bowel. gangrene, bowel perforation, peritonitis
  10. 10. appendicitis Assessment, dx, med management, nursing intervention
    • o assessment: anorexia, diffused abd pain, tenderness the localize in the RLQ at mcburney's point, rebound tenderness, decre bowel sounds, N/V fever
    • o dx, incr wbc, incre immature, CT. cxr to r/o pneumonia
    • o med manage: appendetomy, antibiotic, IVF
    • o nursing intervetion:
    • o - post op: position in semi fowler's or r side lying to decr pain, monitor drains, NG tube to lower wall suction, oral nutrition when bowel sounds return, antibiotics and pain meds.
  11. 11. appendix rupture
    • o appear acutely ill
    • o wbc > 20,000
    • o position in semi fowler position
    • o IVF hydration
    • o warm soaks at incision to promote drainage of infectious material
    • o monitor incision and abd closely for changes
    • o if peritonitis develops insert NG tube IV antibiotics
    • o signs of peritonitis: rigid abdomen, shallow respiration (cause deep breathing puts pressure on the abd which cause pain, fever
  12. 12. Celiac disease
    • o def: characterized by poor food absorption and intolerance of gluten (proteins found in grains like wheat, barley, oats, rye)
    • o cause: gluten intolerance, immunoglobulin A deficiency
    • o path: decrease in amt/activity of enzymes in intestinal mucosal cells, causes villi in proximal small intestine to atrophy and cause decre intestinal absorption
    • o complication: lymphoma of small intestine
  13. 13. Celiac disease assessment
    • o Steatorrhea (fatty stools) older kids, float
    • o chronic diarrhea
    • o anorexia
    • o generalized malnutrition/FTTcoagulation difficulty d/t malabsorption of fat souluble vita ADEK
    • o abd pain intolerance
    • o irritabilty
  14. 14. Celiac disease, dx, med management, nx interventions
    • o dx hypocalcemia, hypoalbuminemia, hypothrombiema, decre HBG, incre fat in stool, celiac screening
    • o med management: gluten free diet, should include soy, corn, rice, potato, breast milk, soy formula, fresh fruits, folate supplement Vita A and D in water soluble form
    • o Nursing intervention: eliminate gluten from the diet
    • o - encourage the things they can eat
    • o - breast milk and soy formula
    • o - replace vitamin and calories small frequent meals
    • o - monitor steatorrhea
  15. 15. disorder of lower bowel
    • o hirschsprung disease
    • o imperforate anus
  16. 16. hirschsprung disease
    • o def: abstinence of ganglionic cells in segment of colon. missing nerve cells in colon, peristalsis stops and stool builds up. you end of mega colon
    • o cause: congenital issue or it could be because of nothing
    • o path: stools will build up
    • o complication severe constipation, entercolitis (severe diarrhea, hypovolemia shock death
  17. 10. appendicitis Assessment, dx, med management, nursing intervention
    • o assessment: anorexia, diffused abd pain, tenderness the localize in the RLQ at mcburney's point, rebound tenderness, decre bowel sounds, N/V fever
    • o dx, incr wbc, incre immature, CT. cxr to r/o pneumonia
    • o med manage: appendetomy, antibiotic, IVF
    • o nursing intervetion:
    • o - post op: position in semi fowler's or r side lying to decr pain, monitor drains, NG tube to lower wall suction, oral nutrition when bowel sounds return, antibiotics and pain meds.
    • 11. appendix rupture
    • o appear acutely ill
    • o wbc > 20,000
    • o position in semi fowler position
    • o IVF hydration
    • o warm soaks at incision to promote drainage of infectious material
    • o monitor incision and abd closely for changes
    • o if peritonitis develops insert NG tube IV antibiotics
    • o signs of peritonitis: rigid abdomen, shallow respiration (cause deep breathing puts pressure on the abd which cause pain, fever
    • 12. Celiac disease
    • o def: characterized by poor food absorption and intolerance of gluten (proteins found in grains like wheat, barley, oats, rye)
    • o cause: gluten intolerance, immunoglobulin A deficiency
    • o path: decrease in amt/activity of enzymes in intestinal mucosal cells, causes villi in proximal small intestine to atrophy and cause decre intestinal absorption
    • o complication: lymphoma of small intestine
    • 13. Celiac disease assessment
    • o Steatorrhea (fatty stools) older kids, float
    • o chronic diarrhea
    • o anorexia
    • o generalized malnutrition/FTTcoagulation difficulty d/t malabsorption of fat souluble vita ADEK
    • o abd pain intolerance
    • o irritabilty
    • 14. Celiac disease, dx, med management, nx interventions
    • o dx hypocalcemia, hypoalbuminemia, hypothrombiema, decre HBG, incre fat in stool, celiac screening
    • o med management: gluten free diet, should include soy, corn, rice, potato, breast milk, soy formula, fresh fruits, folate supplement Vita A and D in water soluble form
    • o Nursing intervention: eliminate gluten from the diet
    • o - encourage the things they can eat
    • o - breast milk and soy formula
    • o - replace vitamin and calories small frequent meals
    • o - monitor steatorrhea
    • 15. disorder of lower bowel
    • o hirschsprung disease
    • o imperforate anus
    • 16. hirschsprung disease
    • o def: abstinence of ganglionic cells in segment of colon. missing nerve cells in colon, peristalsis stops and stool builds up. you end of mega colon
    • o cause: congenital issue or it could be because of nothing
    • o path: stools will build up
    • o complication severe constipation, entercolitis (severe diarrhea, hypovolemia shock death
    • 17. Hirschsprung disease assessment dx, med management, nursing intervention
    • o assessment: failure to pass meconium, and stool, liquid ribbon type stools. feel distention and stool mass, bilous vomiting cause stool not moving thru, irritablity, lethargy, FTT, weight loss, dehyrdration
    • o dx: rectal biopsy- looking for those ganglion cells, abd x-ray
    • o medical management: surgical dissection of affected portion
    • o nursing management:
    • o - pre op: IVF, vs, administer enema
    • o - post op: monitor I&O, stoma care, monitor for bowel sounds, start PO feed after the return, no rectal temps. parent ed, wound care, constipation, explosive stools

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