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LassanskePEDSexam2GI
| Question | Answer |
|---|---|
| BRAT diet is begun after vomiting and diarrhea have stopped. What is the BRAT diet made up of? | BRATBRATBRAT |
| How long would you have a patient on the BRAT diet? | 24-36 hours |
| Conditions requiring a high fiber diet? | Constipation, irritable bowel |
| foods to avoid in a gluten free diet? | wheat, oats, barley, rye |
| proteins in cow milk that causes allergy- | *casein (found in the curd) *whey (found in liquid part) |
| TX for cow milk allergy? | *remove all dairy *add casein hydrolysate milk formula, pregestimil (lactose free), Nutramigen (hypoallergenic formula to manage colic) *After 2 years, regular milk can be added back in small quantities to assess for continued allergy |
| CRAM diet adds this from the BRAT diet but excludes this.... | Milk added, toast is not |
| Intolerance to gluten | celiac disease |
| S/S of ???? *Steatorrhea *foul smelling stool *greasy/bulky stool *FTT *muscle wasting *irritable | Celiac disease |
| Mgmt of celiac disease? | *Gluten-free diet *high cal/simple carb, high protein *add foods back as the acute phase of disease resolves. *Avoid high roughage food til bowel is rested |
| S/S of lactase deficiency? | *abd pain *bloating *flatulence *diarrhea |
| DX for lactase deficiency? | breath hydrogen test |
| Collaborative mgmt of lactase deficiency | *Infant- soy based formula *small amounts of dairy if consumed *enzyme tabs; lactaid, dairy ease *Monitor need for Ca and Vit D products |
| Nursing interventions for lactase deficiency? | *Ht/wt, growth chart *assess stool consistency *diet management *additives to milk for deficiency *dietary consult *vitamins, proteins, minerals |
| Which Hep? *an RNA virus, spread by fecal-oral route, ingestion of contaminated food or water or through direct contact | Hep A (HAV) |
| Which Hep? *originally known as serum hepatitis, perinatal transmission, in other children and adolescents- risky behavior | Hep B (HBV) |
| Hep? rare in children, when discovered has usually been present for 1-20 years. | HEP C (HCV) |
| This virus can lead to hepatitis? | CMV- cytomegalovirus |
| S/S of what disorder? *jaundiced by 3-8 weeks of age *pale stools *dark urine *enlarged abd (liver/spleen) *ascites *malnutrition/growth failure *pruritis *irritable | Biliary atresia |
| What med would be given for pruritis cholestasis in Biliary atresia? | Rifampin will see orange urine |
| DX of atresia? | *liver scan *CBC *electrolytes *liver enzymes *liver biopsy *PT, PTT, bleeding times |
| First line operative intervention for Biliary atresia? | Kasia procedure |
| Kasai post procedure entails? | *antibiotics to prevent infection of the bile ducts *fat soluble (ADEK) *ursodeoxycholic acid (improves flow of bile, may protect liver cells *nutritional special formulas (predigested) *sometimes steroids |
| Explain the kansai procedure | Hepatic portoenterostomy; conduit is made to bypass the fibrotic extrahepatic biliary tree and re-establish bile drainage. |
| post-op care for Kansai procedure? | *Fluid mgmt *IV antibio *adb decompression via NG tube * |
| Etiology of cleft lip/palate? | *genetics *smoking in first trimester *folate deficiency |
| Failure of the maxillary and median nasal processes to fuse | Cleft lip |
| midline fissure of the palate that results in failure of the two sides to fuse | Cleft palate |
| When would a cheiloplasty be performed for the child born with cleft lip? | 6-12 weeks |
| When would a palatoplasty be performed? | Between 12-18 months, after normal growth and developmental palatal changes have occurred |
| Post op care for palatoplasty | *packing may be in place for 2-3 days *assess for respiratory difficulty *restraints *analgesia *sedation *diet |
| esophagus malformed, ends in a pouch | Esophageal atresia will see constant frothy saliva |
| Fistula between the esophagus and trachea | tracheoesophageal fistula *will see coughing, cyanosis, choking |
| Conditions that may cause GERD in children | *hx of TEF/atresia *prematurity *CF *cerebral palsy *scoliosis *neuro conditions *hiatal hernia |
| Diarrhea that lasts less than 14 days | *Acute* Chronic is longer than 14 |
| 6 things considered to be infectious diarrhea | 1. Rotavirus 2. Salmonella 3. E. Coli 4. Shigella 5. Clostridium difficile 6. helmintics |
| Definition of constipation | more than 3 days without stool |
| Very long intervals between bowel movements | obstipation |
| voluntary or involuntary passage of stools in child who has been toilet trained, typically older than 4. | encopresis |
| Causes of constipation in the newborn? | *hirschsprungs *ileus *meconium plugs *cystic fibrosis *diet |
| Constipation causes in the infant? | *diet *stricture *hirschsprungs |
| Constipation causes in the child? | *Holding behaviors *stress *pain *diet |
| congenital aganglionic megacolon | Hirschsprungs |
| S/S of Hirschsprung | *abd distention *failure to pass meconium *symptoms of bowel obstruction *impaction *poorly nourished |
| Dx of hirschsprung | *anorectal manometry (measures contractility in the anus/rectum *barium enema *rectal biopsy *x-ray |
| management of acute hirschsprung | *surgery, affected part of bowel removed, temporary ostomy performed. *nutritional support may be provided (TPN) |
| Common complication of acute hirschsprung? | Enterocolitis; antibiotics and lactose free diet may be ordered. Irregular bowel patterns may present even without enterocolitis |
| care for Chronic hirschsprung | May not require surgery, dietary modifications, stool softeners, isotonic irrigations to prevent impaction |
| Collaborative mgmt of hirschsprungs | *1st surgery, colostomy formed above area; affected part of Lg intest removed. *2nd surgery colostomy closed, healthy bowel reattached. |
| *protozoal, transmitted through close contact as in day cares *S/S; infant: NVD, anorexia, FTT <5 cramps, intermittent loose stools, constipation | Giardiasis |
| RX for giardiasis | *Quinicrine (atabrine) *flagyl *furazolidone (furoxone) |
| *Most common worm infection: ____________ S/S itching/digging, which spreads infection | Pinworms |
| How does someone contract pinworm infestation? | The eggs are ingested or inhaled |
| Tx for pinworms? | One dose of vermox |
| Type of parasite that comes from the soil, eggs or larvae get into the body when a child gets them on hands and puts hands in mouth | Roundworm |
| Primary source of infection of toxoplasmosis to humans are from cats. however, it can also be from........... | raw meat, esp pork. |
| Drug of choice to prevent toxoplasmosis | Trimethoprim/sulfamethoxaxole prevention, not treatment |
| Collaborative mgmt of toxoplasmosis? | *Pyrimethatmine (antimalarial) *sulfadiazine (antibiotic) often used in combo *clindamycin, spiramycin, aindamycin |
| Transmitted through infected water, areas of poor sanitation, public water supplies. Drinking unpasteurized cider, swimming in contaminated pool/lake | Cryptosporidiosis; resistant to chlorine |
| TX for cryptosporidiosis | Nitazoxanide, fluids, antidiarrheal meds. |
| At what age would a umbilical hernia need treatment. | If it continues past the age of 3-4. |
| Sudden acute abd pain, vomiting, lethargic, jelly stools, palpable abd mass, tender,distended abd, signs of peritonitis possible | Intussusception |
| TX for Intussusception | *Barium or air enema can correct the telescoping intestine. If this works no further tx needed. *Surgery if the intestine is damaged or enema unsuccessful |
| cecum in place other than where it belongs. | Malrotation/Volvulus |
| Tx for malrotation/volvulus | *NG to suction *assess for bowel obstruction *Ladd's procedure to put bowel in correct position |
| Leftover tissue from structures in the unborn baby's digestive tract not fully reabsorbed at birth | Meckel diverticulum |
| S/S of Meckel diverticulum | Abd discomfort,pain ranging from mild-severe, blood in stool |
| RX for meckel diverticulum | Surgery to remove diverticulum if bleed develops |
| Ulcerative colitis occurs in | rectum/colon |
| Crohns disease occurs in..... | any area of GI tract |
| S/S of Ulcerative colitis or crohns? *Crampy, bloody diarrhea, L sided lower pain | Ulcerative |
| S/S of Ulcerative colitis or crohns? *watery diarrhea, R sided abd pain | Crohns |
Created by:
purpleapple87
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