A
What is the most common cause of gastroenteritis?
Rotavirus is the most common cause in kids under 5 years.
What is the pathophysiology of Hirschsprungs disease? Please name the cell type involved.
Lack of ganglionic cells in the colon which causes decreased motility and obstruction. (AKA megacolon).
This is associated with a family history and congenital defects.
Name three methods/forms/actions/interventions of treatment for gastroenteritis.
Clear liquid rehydration
Electrolyte replacement
Withhold solid foods no more than 1 day
Hospitalization if severe
IV fluids if severe
No antidiahhreals or antiemetics
Continue breastfeeding infants
Teach hand hygiene and risk factors.
What is the pathophysiology of pyloric stenosis?
The pyloric sphincter muscle hypertrophies, causes edema, and the thickened tissue blocks the drain opening from the stomach.
Discuss methods of helping parents handle cleft lip/palate in their newborn.
Great job.
Tell them it wasn't their fault
Assist with breastfeeding-speech therapy consult
Show before-and-after pics of successful repairs
Encourage bonding-emphasize baby's other characteristics
Acute gastroenteritis is the leading cause of death in children worldwide. How does gastroenteritis kill kids? What about this causes the pt to die?
DEHYDRATION
What two stool characteristics change with/are caused by gastroenteritis?
Increased frequency or decreased consistency of stool.
Name 3 S&S of pyloric stenosis.
PROJECTILE VOMITING
Vomit only contains breastmilk-no digestive enzymes/bile
Baby is fussy/irritable
Don't gain, or can even lose weight if isn't caught quickly
Smaller and less frequent stools
Dehydration
Gastro enteritis can be:
A) Viral
B) Bacterial
C) Parasitic
D) A and B
E) All of the above
E) all of the above.
Acute gastroenteritis can be viral, bacterial, or parasitic.
Please list 3 nursing responsibilities for a pt with appendicitis.
Monitor for peritonitis-if the pain suddenly goes away
Help prep pt for surgery
Help answer questions
Post-op: get them up and walking asap as possible, ask if patient is passing gas/has a BM to assess for abdominal function, watch for infection, pt and family education, etc
Please list 3 nursing responsibilities for a pt with Hirschsprung's diagnosis.
STOMA CARE and education
Ask for stoma specialist consult
Abdominal assessment
Infection assessment (esp bc surgery)
Assess for returning gut function and presence of stool
After a cleft lip is repaired surgically, what are the two main nursing concerns (you will teach parents about both, so "teaching" is not one of the answers)
Infection
Protecting the suture line-give pain meds, never allow the infant to be prone, keep them from touching it!
How is pyloric stenosis diagnosed and treated?
Dx: Ultimately by ULTRASOUND, but initially by S&S and palpation of a "olive-shaped mass" in the URQ of the abdomen.
Tx: Surgery. Make sure kid is eating well and keeping feeds down. Throwing up one feed is probably okay-call dr to notify- but more than one is a bad sign.
What is the classic sign of intussuception?
The "jelly-like stool" or "black currant jelly"
Stool looks like that because it has mucous and blood.
S&S also include a fussy baby, abdominal pain, vomiting, and a often palpable mass.
How is intussuception treated? Please state both main treatment and backup method.
First by rectal air enema which is usually successful, and then by surgery if the enema fails.
Name 4 nursing responsibilities for a pt with intussuception
Abdominal assessment frequently both before and after surgery
Can spontaneously resolve, so if baby starts pooping before surgery call surgeon (doesn't need surgery)
Watch for return of normal gut function post-surgery
Assess for infection
Teach parents about risk for a prevention of infection
Teach parents about possibility of recurrence and how to identify
List the three major treatment methods for GE reflux other than surgery.
Thicken formula
Smaller, more frequent feeds
Position baby upright especially after feedings
(remember to teach family how to bulb suction!)
How is Hirschsprungs diagnosed and treated?
Dx: failure to pass meconium causes suspicion, dx upon rectal biopsy showing lack of ganglionic cells.
Tx: Resection of affected bowel tissue and 1 year temp colostomy.
What is the most common emergency surgery in kids?
Appendectomy-removal of appendix bc of appendicitis.
What are three S&S of appendicitis? Please include the type of pain as one of your three.
REBOUND pain
Fever
Vomiting
RLQ pain
What are the 5 physiologic/anatomical pediatric differences that contribute to GE reflux.
A short, narrow esophagus
Small stomach capacity
Liquid diet
Immature lower LES
Frequently horizontal
What two functions does an un-repaired cleft lip/palate threaten in a developing infant? Hint-this is one reason they try to repair before age 1 year.
Hearing-because the muscles of the palate help open the middle ear
Speech-because duh
(Remember this also can harm teeth coming in and pose a risk for ear infection)
Name the favorite food of one person present. Someone who is NOT you.
Idk, ask them if you're right.
When do S&S of pyloric stenosis generally appear?
Age 3-6 weeks.
Remember this IS congenital, but the S&S don't develop until the blockage is 100%, which typically hits around the infants 3-6th week.
What two pediatric GI disorders pose a risk for aspiration?
GE reflux
Cleft palate