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Chapter 24

Alterations in gastrointestinal function(Peds)

QuestionsAnswer
Describe the functions of the pancreas Secretes enzymes, electrolytes, and bicarbonate to aid in digestion/absorption of fats, proteins, and carbs. Also regulates blood glucose metabolism through production of insulin, glucagon, and gastrin.
Describe the functions of the liver Production of blood clotting factors, fibrinogen, and prothrombin; secretion of bile and bilirubin; metabolism of fat, protein, and carbs; detoxification of horomones and drugs; and storage of vitamins A, D, E, and K and glycogen.
What are the functions of the spleen? Contains 30% of circulating platelets, a site for RBC production, and defends against infection.
Why do infants frequently regurgitate small amounts of feedings? The cardiac sphincter is relaxed.
Enzymes are usually not present in sufficient quantitites to aid digestion until 4-6 mos of age. What enzymes are lacking? What is a common resulting problem? Amylase, lipase, and trypsin. Abdominal distention from gas.
Children born with a cleft lip/palate have an increased incidence of what other problems? Dental deformity, otitis media, hearing loss, and speech problems.
Why is it important to prevent crying (via pain medication/distraction) following a cleft lip/palate repair? Prolonged crying may disrupt the suture line.
What are some special considerations when feeding an infant with cleft lip/palate? Feed the infant with head & chest elevated to prevent milk from coming through the nose; allow extra time to feed, followed by rest b/c the prolonged feedings can lead to fatigue; burp infant more frequently, infants with cleft palate tend to swallow air
What are S&S of esophageal atresia/tracheoesophageal fistula? Excessive salivation/drooling, cyanois, chockin, coughing, sneezing, milk return through the nose and mouth, aspiration (risk for pnemonia), and distendend abdomen r/t air trapping.
Esophageal atresia is a surgical emergency. What nursing management is required during the preoperative period? Maintain airway, lower HOB slightly to minimize aspiration of secretions, continuous/ow intermittent suction to remove secretions from teh blind pouch, withhold oral fluids, provide maintenance IV fluids.
What are potential postoperative complications r/t correction of esophageal atresia? Gastroesophageal reflux, aspiration, and stricture formation.
What measurement is diagnostic of pyloric stenosis? A thickened pylorus of >4mm in diameter and length of >18mm for the pyloric channel. Determined with an abdominal ultrasound.
What are common electrolyte imbalances found in an infant with pyloric stenosis? Hypochloremia and metabolic alkalosis. Hypokalemia (r/t potassium lost during projectile vomitting) may also occur.
What is intussusception? One portion of the intestine prolapses and then invaginates or telescopes into another. It is on of the most common causes of intestinal obstruction during infancy.
What can intussusception lead to? Necrosis, peroration, hemorrage, and peritonitis.
As intussusception progresses, what does the stool look like and why? Red currant jelly b/c of the mix of blood and mucus.
Why can contrast enema sometimes be theraputic for a child with intussusception? The hydrostatic pressure from the contrast can move the bowel back into place.
GER most commonly resolves by what age? 1 year
What type of impairments are most commonly associated with GER? Neurological impairments, such as cerebral palsy
There is an association between GER and what allergy? Cow's milk allergy
What lab test leads to early diagnosis of both gastroschisis and omphalocele? Elevated maternal serum alpha-fetoprotein (MSAFP)
What is volvulus? A twisting of the intestine that disrupts blood flow and can lead to necrosis of the bowel, short bowel syndrome, and death.
What is Hirschsprung disease? An absence of parasympathetic ganglion cells in the colon prevents peristalsis in a portion of the intestine leading to an accumulation of intestinal contents and abdominal distention.
Created by: shanebarnes1978
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