gastroenteritis
The most common complication of gastroenteritis is (2)
dehydration and electrolyte imbalances
A normal phenomenon that nearly all infants experience, really just infants spitting up
GER
what is colic?
Recurrent crying and inability to be consoled
NG tube test, Xray
Most often, Gastroenteritis is due to
rotavirus
weight
what is the diagnostic test for GERD?
Esophageal pH probe/monitoring
a soft pH probe is placed into the esophagus to measure the pH of the acidity of the contents in the esophagus and the stomach. The probe requires brief hospitalization for 12-24 hour monitoring.
Colic is most common in infants at ____ months of age
patho of EA
esophagus ends before reaching the stomach; It may end in a ”blind pouch.”
Colic treatment is primarily focused on supportive measures including
avoidance of overfeeding
music, rhythmic movement (swing, front pack, car ride)
wrapping snuggly (swaddling); tummy massage; warm bath
reduce environmental stimuli
Children are usually not hospitalized with viral gastroenteritis unless.....
they become severely dehydrated
pathophysiology of GER
the lower esophageal sphincter at top of stomach is frequently “loose” or under-developed in young
Rule of 3s for colic
3 hours per day - in afternoon or eve
> 3 days per week
lasts for > 3 weeks
polyhydramnios
excess amniotic fluid
2 antiemetics given for gastroenteritis
Zofran (ondansetron)
Phenergan (promethazine)
nonpharmacological methods for GERD treatment include....
Small, frequent feedings (over-feeding fills tummy and encourages back-flow)
Frequent burping every 1–2 ounces
Elevation after feeds – about 45 degrees
why should you ensure you are completing a good, thorough history to ensure nothing is being missed?
Colicky babies may resemble babies that present with intestinal obstructions
3 Cs of EA and TEF
Coughing, choking, cyanosis
What foods should be avoided with gastroenteritis?
what foods are encouraged?
Avoid carbonated beverages, spicy, oily, and dairy
BRAT diet recommended
if there is no improvement with nonpharmacological treatments for GERD....
Pharmacological interventions
H2 blockers (Pepcid) – decrease acidity
PPIs (Prilosec, Prevacid) – decreases production of acid
NISSEN FUNDOPLICATION AND G TUBE SUPPLEMENT FEEDINGS
what does PURPLE stand for?
P = peak of crying → around 2 months; It starts to lessen at 3-5 months..
U = Unexpected → comes and goes, with no known cause
R = resists soothing
P = pain like facials
L = Long lasting → episodes last as much as 5 hours
E = evening
EA and TEF treatment
Several stages of repair – usually 3, one within first week of life