Her Spring
Ostomy care, incision care and dehydration s/s
What parent education must be done for Hirschsprung's disease
The preoperative nursing care to be done for pyloric stenosis
What is prepare child and family for surgery, IV fluids to correct dehydration and electrolyte imbalance, NG tube, NPO, I&O, daily weights
Pain may temporarily subside, then worsen, rebound tenderness, Guarding, Rigid board-like abdomen, Distended abdomen
What are the s/s of a ruptured appendix
Some degree found in 50% of all infants
What is the occurrence of GERD in infants
Unable to digest the gliadin component of gluten and toxic substances is damaging the mucosal cells and this damage leads to villous atrophy which leads to malabsorption, hyperplasia of the crypts, and infiltration of the epithelial cells with lymphocytes
What is celiacs disease
Newborn s/s of Hirschsprung's
Failure to pass meconium with 24 to 48 hours after birth, episodes of vomiting bile, refusal to eat, abdominal distention
The postoperative care for pyloric stenosis
What are vital signs, IV fluids, daily weights, I & O, monitor for infection, Start clear liquids 4-6 hours post op, advance as ordered and tolerated and document tolerance.
The labs for appendicitis
CBC, CRP, erythrocyte sedimentation rate
T/F. Place infants on their side to sleep for GERD
False. They should be supine
Causes are unknown though infection, genetic, and environmental factors that are known to be associated
What is PUD
Children s/s of Hirschsprung's
Undernourished, constipation, abdominal distention, anemic appearance, abdominal distention, visible peristalsis, palpable fecal mass, constipation, foul ribbon like stool
RUQ 7
Where the olive shaped mass can appear
heat to the abdomen, enemas or laxatives!!
What to avoid preoperatively for appendicitis
S/S of GERD in infants
Spitting up, forceful vomiting, irritability, excessive crying, blood in vomitus, arching of the back, stiffening, respiratory issues, FTT, & apnea
S/S of PUD
Chronic abdominal pain especially when the stomach is empty, recurrent vomiting, hematemesis, melena, chronic anemia, and abdominal tenderness
Infant s/s of Hirschsprung's
FTT, Constipation, Vomiting, & Explosive, watery diarrhea and vomiting, fever
The surgical intervention to be done for pyloric stenosis
What is a pyloromyotomy
The s/s of acute appendicitis
Abdominal pain in RLQ, rigid abdomen, decreased or absent bowel sounds, fever, diarrhea or constipation, lethargy, tachycardia, rapid shallow breathing, anorexia & possible vomiting
S/S of GERD in children
Heartburn, abdominal pain, difficulty swallowing, chronic cough, non-cardiac chest pain
CBC, stool studies for occult blood, LFT, ESR, or CRP, amylase and lipase, gastric acid measurement/ polyclonal and monoclonal
The labs for PUD
Resolving the inflammation, preventing bowel perforation, and maintaining hydration (Hirschsprung's disease)
What are the goals of treatment for Hirschsprung's disease
The s/s of pyloric stenosis
Vomiting that occurs following a feeding to several hours post feeding and is projectile in nature. There can be non-bilious blood-tinged emesis. Patients will show constant hunger and will have a failure to gain weight and symptoms of dehydration. They may also demonstrate an olive shaped mass in the RUQ 7 possible left to right moving peristaltic wave when lying supine.
Respiratory & airway, oxygen, V/S, pain medication, monitor site for bleeding & infection or abnormalities, check bowel sounds and function, IV fluids & abx, NPO, NG to low continuous sx, irrigations for open surgical site with antibacterial solution or saline soaked gauze, drain care, monitor for peritonitis (fever, chills, sudden relief from pain followed by severe diffuse pain, irritability, abdominal distention, rigid abdomen, tachycardia, rapid/shallow breathing, or pallor)
The treatment for GERD
Nissen Fundoplication (laparoscopic surgery), administer as prescribed a PPI or H2 receptor antagonist
Upper and lower esophagus (from the stomach) end in a blind pouch.
Upper esophagus ends in a blind pouch; the lower esophagus (from the stomach) connects to the trachea.
Upper esophagus is attached to the trachea; the lower esophagus (from the stomach) is also attached to the trachea.
Upper esophagus connects to the trachea; the lower esophagus (from the stomach) ends in a blind pouch
What are the four presentations of tracheoesophageal fistula