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GI
nursing 241
| Term | Definition |
|---|---|
| dehydration | fluid output>fluid intake |
| cause of dehydration | vomiting, diarrhea, fever, burns, tachypnea |
| infants more vulnerable to dehydration bc....... | relatively greater bsa relative to body mass, higher bmr, immature kidneys (cannot dilute or concentrate urine), inc fluid requirements |
| two types of diarrhea | acute. less than 14 days. chronic. longer than 14 days |
| hx of diarrhea | fever, travel, daycare, vomiting, meds, ingestions, stool character |
| assessment of dehydration and diarrhea | MM's, weight loss, skin, fontanelles |
| treatment of diarrhea | ORT!!! vomiting is NOT a contraindication for ort |
| treatment for intractable diarrhea of infancy | hydralized protein (easier to digest bc it is partially digested already) |
| celiac disease | body's inability to absorb gluten found in wheat, rye, barley, and oats |
| treatment for celiac disease | STRICT gluten free diet. lots of teaching needs to be done |
| celiac crisis | profuse diarrhea usually unexplained |
| appendicitis | acute obstruction of outflow (fecolith-dry, hardened stool), increased pressure leads to blood vessel compression, then ischemia, ulceration, inflammation, necrosis |
| complication of appendicitis | after necrosis, RUPTURE which can cause peritonitis |
| s/s of appendicitis | abd cramping, rlq pain b/w anterior superior iliac crest and umbilicus, bent over posture |
| hypertrophic pyloric stenosis | thickened pyloric sphincter narrows pyloric channel that makes it hard for food to pass to duodenum |
| s/s of hps | projectile vomit, hyperperistalsis (working overtime to try and get food to pass), non-bilius, 30-60 mins after feeding, risk for fvd, metabolic alkalosis, hypochloremia, ftt, very hungry, weight loss, uncomfy |
| tx of hps | pyloromyotomy preop: emphasis on hydration. postop: glucose water or ort 4-6 hrs after surgery, advance as tolerated |
| intussusception | inversion of 1 portion of intestine within another |
| s/s of intussesception | sudden abd pain, vomiting, lethargy, red curreny jelly life stools |
| tx of intussesception | radiographic enema. diagnostic or therapeutic |
| cl&cp | may have speech impairment, problems with soft palate and nasopharynx, improper tooth alignment, hearing impairment, eustacian tube malfunction (inc risk for otitis media. uri reqs immediate attn) |
| nursing interventions cl&cp | family support, handling infant, emphasize the positive, encourage child to talk and utilize throat muscles |
| cheiloplasty | accustom child to needs of early postop period - DO NOT want child laying on face. need to protect surgical site |
| palatoplasty | avoid placing objects in mouth. ok to lay on tummy, better on side |
| tracheoesophageal fistula/esophageal atresia | failure of esophagus to develop as a continuous passage. infant may breathe saliva and fluids from stomach into the lungs and aspirate. child cant swallow and digest food safely - surgical emergency |
| s/s of tef/ea | coughing choking cyanosis - 3 c's |
| tx of tef/ea | litigation of fistula preop: npo, continuous suction, elevate hob, iv fluids postop: gastrostomy drainage, iv fluids, antibiotics, tpn |
| hernias | abdominal (umbilical, omphalocele, hastrochisis), diaphragmatic, hiatal, inguinal |
| diaphragmatic hernia | intestines and other abd organs enter thoracic cavity. manifests as acute resp distress, cyanosis, scaphoid abd |
| tx of dhernia | after birth child will need ventilation. ecmo. position child on affected side to max oxygenation. DO NOT put bag and mask o2 bc they can swallow air into gut, making it bigger |
| hiatal hernia | protrusion of stomach through esophageal hiatus |
| s/s hiatal hernia | dysphagia, ftt, frequent unexplained resp problems |
| tx of hiatal hernia | nonpharm, pharm, lastly surgery |
| tx of inguinal hernia | if not be reducible, then herniography - process of repair by using fascia or mesh.. most common complication is the inability to void |
| cholecystitis | inflammation of gall bladder. interferes with bile drainage into duodenum. may be calculous or acalculous |
| s/s cholecystitis | pain, tenderness, rigidity upper right abd referred pain to R shoulder, vague fullness in ruq after eating fatty foods |
| tx of cholecystitis | nonpharm, pharm, then surgery if nothing works (diet low in fat, ng suction, rest, iv fluids, analgesics, antibiotics, ercp, eswl) |
| hirschsprungs disease | aganglionic: absence of ganglion cells in one or more segments of the colon megacolon: accumulation of stool with distention of the colon |
Created by:
eileenrx
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