GI Anatomy
Long passageway that is not developed completely until 1 year of age
Esophagus
Loperamide
Antidiarrheal (Side Effects: drowsiness & constipation)
Nursing implications for a child needing a small bowel series
Increase fluid intake to prevent constipation. Test is used to check for inflammatory bowel conditions & intussusception
GFR is faster or slower in children
Slower
Medications to decrease systemic resistance and vasodilation of arterioles
Vasodilators-Hydralazine & Minoxidil
Nursing interventions: Monitor BP, Apical Pulse, safety concerns (fall risk), monitor weight (increases)
Ca Channel Blockers (nifedipine)- work on coronary circulation
Components of a complete blood count (CBC)
HGB, HCT, RBC, PLT, WBC
Indications of anemia, clotting /bleeding concerns, and infection
Stomach capacity of newborn
10-20 mL
Used to suppress immune responses & inflammatory bowel conditions
Corticosteroids (Prednisone)
Test for cholangitis
ERCP- Endoscopic retrograde cholangiopancreatography Invasive procedure to view the hepatobiliary system
Urinary output is 0.5-2 mL/kg/hr
Average output for infant & child
1 year old-400-500 mL/day
By 3 years old (similar to adults 3-8 times/day)
Smooth muscle relaxants to reduce spasms/contraction of bladder
Anticholinergics- Oxybutynin, Propantheline Bromide, Belladonna, opium
Intake mostly daily
Not used with febrile kids
Laboratory testing related to renal function and urinary health
BUN, Creatinine (serum, urine), Electrolytes (Potassium, Sodium, Chloride), Urinalysis (Clean catch Specimen or 24 hr urine), Culture & Sensitivity, Calcium, Phosphorus, Lipids, Protein/Albumin (serum & U/A)
Condition that results in vomiting or spitting up
Regurgitation or Reflux
Class of medications that work on CNS to prevent or stop nausea & emesis & an example
Antiemetics-Promethazine (Phenergan), Metoclopramide (Reglan)
Measures pressure and acid levels in the GI tract
Esophageal Manometry & Ph probe
Being unable to concentrate urine & fluid loss can result in this
Dehydration
Common antibiotics used for UTIs
Typically sulfa drugs such as Bactrim DS. Also can use Cipro, Macrobid, Cephalexin, etc. Increase fluid intake to promote elimination and keep kidneys perfused.
Diagnostic testing for urinary conditions
Cystoscopy, ultrasound, KUB, pyelogram (IVP), urodynamic studies, lithotripsy, VCUG, renal biopsy
Liver is ________ relative to other organs in newborn
Larger
Dissolvable medication used for child with vomiting or NPO
Ondansetron (Zofran ODT)
Hemoccult
Checks for occult blood in stool (not seen or visible)
Kidneys are _____ and ______ insulated than adults
less
ACE Inhibitors (ending with -pril) indications and actions
Potent vasoconstrictors enzyme blocked to prevent conversion of angiotensin I to angiotensin II; used to treat renal causes of hypertension
Increased osmolarity in diagnostic testing is interpreted as a sign of what conditions
High urine osmolality, meaning a more concentrated urine, can be caused by dehydration, high blood sugar (hyperglycemia), high sodium levels, or conditions like Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Age when GI tract is mature
2 years old
True or false
Children can take PeptoBismol.
True. Kids PeptoBismol can be given from 2-12 years of age. Adult version can be given after 12 years old. (IMPORTANT: It is vital to contact the PCP if parents are considering giving ANY medication, prior to administration.)
Used to assess ejection fraction of gallbladder & check for biliary atresia, neonatal hepatitis, and congenital malformations
HIDA scan- radionuclide given IV
Assess pain at IV site during administration
Define enuresis
Urinating or bed-wetting at night
Immature bladders, UTI, regression
High dose immunosuppressive therapy with corticosteroids is indicated for what syndrome to promote remission & diuresis
Nephrotic Syndrome
Monitor for Cushing's syndrome and do not abruptly stop therapy (acute adrenal insufficiency)
Indications for KUB or U/S of renal system
Anatomical structures, congenital anomalies, function concerns
Common causes for fluid loss in children
Vomiting & diarrhea
Calculate daily and hourly fluid volume maintenance for child weighing 23 kg.
1560 mL daily
65 mL/hr
Pancreatic enzymatic testing
Amylase & Lipase
Bladder capacity of newborn
30 mL
Cyclophosphamide therapy is used with which conditions
Nephrotic Syndrome
Bone marrow & organ transplant patients
Side effects: HTN, hematuria (cystitis)
Increase fluid intake to flush GU system
Surgical diversion of ureters to the abdominal wall
Urinary diversion
These enzymes break down fat, fully develop after birth & do not reach adult levels until 2 years old
Pancreatic
Definition of oral rehydration therapy
Treatment given to children to replace fluids and minerals lost through dehydration. Solution may contain water, electrolytes (such as sodium and potassium) & glucose
Diagnostic testing for liver conditions such as hepatitis, liver disease/damage
Liver function tests-LFTs (AST/ALT/GGT)
Liver Biopsy
These should be descended and palpable in the male newborn
Testes or Testicles
Indication/Actions for furosemide (Lasix) & hydrochlorothiazide (HCTZ)
Inhibit resorption of sodium and chloride leading to increased excretion of water and electrolytes (monitor electrolytes-K, Na, Cl)
Used in nephrotic syndrome, acute glomerulonephritis, hemolytic uremic syndrome, or other instances of fluid overload with renal sufficiency
Used with stenosis or urinary blockages with kidney stones
Urinary stents
Narrowing of a passageway such as pyloric sphincter
Stenosis
Medication used to evacuate bowels for diagnostic testing
Golytely (bowel prep) osmotic laxative
Provide two indications for lower & upper endoscopic procedures
Upper: Pain, Dysphagia, Foreign Body, Celiac Disease
Lower: Pain, Bleeding, Foreign Body, Tumors
Requires bowel prep, consent, sedation & monitoring for complications
Uremic crystals (rust or orange colored stains in diaper)
Normal finding in newborn diaper with initial voiding after birth
Antidiuretic for enuresis
Desmopressin-Hormone reabsorb water to decrease urine output
Nephrostomy tube
Tube placed directly into kidney for drainage with hydronephrosis
Time during embryonic development when the GI tract is formed
Between weeks 5-10. Fully formed by week 12
Barium oral solution/enema is used to visualize
GI tract & Large intestine
Bacteria known to cause GI problems & peptic ulcers
Helicobacter Pylori (H. Pylori)
Urea breath test or antibody testing to confirm
Treated with 2-3 of medications (Antibiotic therapy)
A birth defect where the bladder develops outside the body, protruding through an opening in the lower abdomen
Bladder Exstrophy-requires surgical intervention and monitoring of bladder function
Human Chorionic Gonadotropin (hCG) is indicated for this male condition
Undescended testicles-Stimulate gonadal steroids to precipitate testicular descent
Monitor for precocious puberty (early)
Procedure for urinary anomalies and neurogenic bladder
Vesicostomy-Stoma in the abdominal wall to the bladder
At what age is HCL being produced & functioning similar to adult GI
At 6 months old
Alternative therapy used for colic
Gripe water (Fennel, Ginger, Chamomile, Lemon balm, and Sodium bicarbonate)
Procedure to collect stool specimen
Label all collection containers prior to obtaining sample. Used clear wrap or toilet "hat" to capture stool sample. Obtain one specimen from an area of inside of solid stool sample and repeat from another area. After collecting samples place in provide bag and refrigerate if unable to take specimens immediately.
Often checking for bacteria/ova/parasites. 48 hr growth but can be up to days or weeks
True or False
Deep palpation of affected kidney is required when a child has suspected kidney cancer.
False. Wilm's tumor is an encapsulated cancerous growth on the kidney. It can be spread or metastasized throughout the peritoneal cavity if ruptured by clinician performing deep palpation.
Immunosuppressive medications to prevent transplant rejection
azathioprine, tacrolimus, mycophenolate
Monitor complete blood count, serum creatinine, potassium, and magnesium. Monitor blood pressure and observe for signs of infection. Give on empty stomach.
Most common type of urinary procedure
Indwelling foley catheter