1
Q
When does the GI tract fully mature in children?
A
Around age 2
Infants have immature GI function until toddlerhood.
2
Q
What is the infant mouth a common entry site for?
A
Infectious agents
3
Q
What is the function of the lower esophageal sphincter (LES)?
A
Prevents regurgitation
Immature LES increases reflux in infants.
4
Q
When does esophageal muscle tone fully develop?
A
By about 1 month old
Limited tone contributes to infant spit-ups.
5
Q
Newborn stomach capacity?
A
10–20 mL
Limits feeding volume.
6
Q
Stomach capacity at 2 months?
A
About 200 mL
Most cannot tolerate 200 mL
7
Q
When do hydrochloric acid levels reach adult levels?
A
Around 6 months
Supports improved digestion.
8
Q
Why is the infant liver considered large at birth?
A
It is proportionally larger relative to body size
Reflects fetal hematopoiesis role.
9
Q
When do pancreatic enzymes reach adult levels?
A
By about 2 years old
Digestive capability develops gradually.
10
Q
Why do infants require more fluid intake than adults?
A
Higher body water %, higher metabolic rate
Increased losses with illness.
11
Q
Why do infants dehydrate faster?
A
More water in extracellular space
ECF is lost quickly during illness.
12
Q
Why can infants not concentrate urine well?
A
Renal immaturity
13
Q
What may pallor indicate?
A
Anemia or dehydration
Poor perfusion affects skin color.
14
Q
Distended abdominal veins suggest?
A
Vascular obstruction or distention
Venous congestion becomes visible.
15
Q
What does jaundice indicate?
A
Liver dysfunction
Elevated bilirubin levels.
16
Q
What does absence of tears mean?
A
Possible dehydration
Reduced fluid limits tear production.
17
Q
Flat abdomen when supine is normal; what does deviation suggest?
A
Ascites (fluid retention/distention) or tumor
18
Q
RUQ tenderness suggests?
A
Liver enlargement
Local inflammation increases pain.
19
Q
RLQ rebound tenderness suggests?
A
Appendicitis
Peritoneal inflammation creates pain on release.
20
Q
Mental status changes may indicate?
A
Severe dehydration or elevated ammonia
Electrolyte imbalance affects brain function.
21
Q
How to collect stool from a diaper?
A
Scrape with tongue blade
Ensures uncontaminated sample.
22
Q
How can runny stool be collected?
A
Application of urine bag or plastic wrap may catch the specimen
Keeps sample separate from diaper material.
23
Q
Why avoid urine contamination when obtaining a stool specimen?
A
Dilutes or changes stool composition altering test results
24
Q
Why are infants at higher dehydration risk?
A
Higher metabolic rate and insensible losses cause rapid water loss
25
Most important goal in **dehydration treatment**?
Restore fluid balance
## Footnote
Prevents hypovolemic shock.
26
Common **dehydration risk factors**?
* Vomiting
* Diarrhea
* Fever
* Decreased intake
27
What happens to **HR in moderate dehydration**?
It increases
## Footnote
Compensatory mechanism for volume deficit.
28
What happens to blood pressure when **dehydrated**?
Stays normal until severe
## Footnote
Children compensate well.
29
What is included in a physical assessment for dehydration?
* Skin turgor
* Fontanels
* Oral mucosa
* Eyes
30
Oral rehydration solution should include?
75 mmol/L sodium chloride and 13.5 g/L glucose
## Footnote
EX: pedialyte, infalyte, ricelyte
31
Why should juice or milk be avoided for oral rehydration?
Do not have the right mix of electrolytes and can make diarrhea worse
32
What is required for **mild–moderate dehydration**?
50–100 mL/kg of oral rehydration over 4 hours
## Footnote
Restores ECF deficit safely.
33
What is the intitial treatment for severe dehydration?
NS or LR at 20 mL/kg bolus
## Footnote
Rapid intravascular expansion needed.
34
How should dehydration be treated once fluid balance is restored?
IVF given at maintenance or as much as 1.5 times maintenance
35
Why monitor for **overhydration**?
Infants’ bodies regulate poorly; risk of fluid overload
36
What do **hypoactive or absent bowel sounds** suggest?
Possible obstruction
## Footnote
Motility stops when blocked.
37
What causes **thrush**?
Candida albicans
## Footnote
Fungal infection of oral mucosa.
38
What is the appearance of **thrush**?
White patches that resemble curdled milk
## Footnote
Do not wipe off easiliy
39
Who is at **risk for thrush**?
* Newborns and infants
* Antibiotic use
* Inhaled steroid use
* Immunocompromised
## Footnote
Conditions promote fungal growth.
40
What are treatments for **thrush**?
* Nystatin
* Fluconazole
## Footnote
Antifungals eradicate yeast.
41
What must be monitored for when taking **fluconazole** for thrush?
Risk of liver toxicity
## Footnote
Metabolized hepatically.
42
Why can **thrush affect feeding**?
Causes pain and discomfort for mom and baby
## Footnote
Can be transmitted in breastfeeding
43
Why treat **breastfeeding mothers** for thrush?
Prevents reinfection
## Footnote
Yeast transfers between mother/infant.
44
Why check **diaper area for fungal rash**?
Often co-occurs with thrush
## Footnote
Yeast thrives in moist areas.
45
Primary concern with **oral lesions**?
Pain and hydration
## Footnote
Pain can interfere with ability to eat
46
Define **diarrhea**
Increased stool frequency or decreased stool consistency
## Footnote
Indicates altered motility/fluid balance.
47
What is the most common cause of **acute diarrhea**?
Viruses
## Footnote
Rotavirus and others predominate.
48
What are risk factors for acute diarrhea?
* Recent ingestion of undercooked meats
* Foreign travel
* Day care attendance
* Well water use
49
Most common reason for **emergent abdominal surgery** in children?
Appendicitis
## Footnote
High risk for perforation.
50
What is the classic **pain pattern** in appendicitis?
Vague abdominal pain → RLQ rebound tenderness (McBurney point)
## Footnote
Localizes as inflammation worsens.
51
Nausea and vomiting occurs when during appendicitis?
After onset of pain
## Footnote
Helps differentiate from gastroenteritis.
52
What is the stool pattern in appendicitis?
Small-volume, frequent soft stools
## Footnote
Often confused with diarrhea.
53
What does sudden relief of **pain** in suspected appendicitis indicate?
Possible perforation
## Footnote
Pressure release stops pain.
54
What is hypertrophic pyloric stenosis?
Hypertrophy of pyloric muscle causing thickness in the mulinal side of the pyloric canal
## Footnote
Creates gastric outlet obstruction
55
What does hypertrophic pyloric stenosis causes?
Nonbilious, projectile vomiting (usually between 3-6 weeks)
## Footnote
Obstruction occurs before bile duct.
56
What are symptoms of hypertrophic pyloric stenosis?
* Hunger soon after vomiting
* Weight loss and dehydration
57
What can be palpated in hypertrophic pyloric stenosis?
Hard, moveable “olive-like” mass RUQ
## Footnote
Represents enlarged pylorus.
58
What is the pre-op **priority** in hypertrophic pyloric stenosis?
Correct dehydration/electrolytes
## Footnote
Frequent vomiting causes imbalance.
59
What is **intussusception**?
A proximal segment of bowel “telescopes” into a more distal segment
## Footnote
Causes obstruction and ischemia
60
What is the typical **age** for intussusception?
1–2 years
## Footnote
Common in toddlers.
61
Classic **stool finding** in intussusception?
Currant-jelly stools
## Footnote
Blood + mucus.
62
Classic **abdominal finding** in intussusception?
Sausage-shaped mass
## Footnote
Represents telescoped segment.
63
First-line **diagnostic & therapeutic method** for intussusception?
Air (pneumatic) enema
## Footnote
Reduces obstruction in 90% of cases.
64
What causes intestinal malrotation?
Twisting of abnormally attached intestine on itself (volvulus)
## Footnote
Congenital defect
65
What is the common **symptoms** of volvulus?
* Bilious vomiting (main symptom)
* Abdominal pain or distention
* Tachycardia
* Bloody stools
66
What is the treatment for intestinal malrotation?
Surgical intervention to prevent necrosis
67
What is Gastrosophageal reflux disorder?
Backflow of gastric contents into esophagus
## Footnote
LES laxity contributes.
68
What are treatment options for **GERD**?
* Upright for feeding
* Meds
* Nissen fundoplication
## Footnote
Nissen fundoplicaiton = Wraps top of the stomach around the lower esophagus to reinforce sphincter
69
What does functional **constipation criteria** include?
* <3 stools/week
* Fecal incontinence
* Hard or painful stools
* Rectal mass
* Withholding behaviors
70
What is the key **parent teaching** for constipation?
Increase fiber and fluids
## Footnote
Improves stool consistency.
71
What is the primary defect in **Hirschsprung disease**?
Absence of ganglion cells in the intestine; without these nerves the bowels can't relax and move stool forward (peristalsis)
72
What is Hirschsprung disease characterized by?
Failure to pass meconium in 24 hours
73
How is a definitive **diagnosis** for Hirschsprung disease obtained?
Rectal suction biopsy
## Footnote
Barium enema may reveal intestinal narrowing
74
What is the treatment for **Hirschsprung disease**?
Surgery to bypass or remove the diseased part of the colon
75
Why is **dehydration a risk after surgery** for Hirschsprung?
High stool output
## Footnote
Rapid dehydration without colon absorption.
76
What is a celft lip?
Split or opening in the upper lip that happens when the tissue doesn’t join correctly before birth
## Footnote
Repair done at ~3 months
77
What is a cleft palate?
Opening in the roof of the mouth (hard or soft palate) because the tissues don’t fuse together properly
## Footnote
Repair done ~12 months needed for speech development.
78
Why do infants with cleft lip have difficulty feeding?
Poor seal around nipple causes excessive air intake and fatigue
## Footnote
May need to be fed with special cleft lip nipple
79
What needs to be monitored with feeding an infant with a cleft palate?
Aspiration risk due to gagging, choking and nasal regurgitation of milk
80
Why is **otitis media** a risk in cleft palate?
Muscles that open eustatician tubes are connected to the palate and don't work properly preventing normal fluid drainage
81
Why may **breastfeeding work better** for mild cleft lip or palate?
Breast tissue contours and may create a better seal for sucking
82
What devices used for **cleft palate feeding**?
* Prosthodontic devices
* Special nipples
83
What is **biliary atresia**?
Absence of major bile ducts → bile obstruction
84
What does biliary atresia cause?
Cholestasis resulting in jaundice and eventual progressive fibrosis
85
What surgery treats **biliary atresia**?
Kasai procedure connects the bowel to the bile duct
## Footnote
Most successful in infants < 45 days
86
If Kasai procedure fails, treatment for biliary atresia is?
Liver transplantation
## Footnote
Prevents end-stage liver disease.
87
What are signs and symptoms of biliary atresia?
* Jaundice
* Pale/white stools
* Dark colored urine
* Swollen belly
* Enlarged spleen or liver
88
What is encopresis?
Soiling of fecal contents into the underwear beyond the age of expected toilet training (4 to 5 years of age)
89
What does short bowel syndrome cause?
Nutrient malabsorption
Pediatrics
flashcards
Decks in class (24)
# Cards
-
Infant Growth and Development160
-
Toddler Growth and Development118
-
Preschooler Growth and Development77
-
School-Age Growth and Development59
-
Adolescent Growth and Development55
-
Atraumatic Care95
-
Health Supervision54
-
Health Assessment55
-
Special Healthcare Needs102
-
Nursing Interventions93
-
Pain Management and Assessment76
-
Care for an Infection56
-
Growth and Development Practice130
-
Practice Questions301
-
Care for Neurologic Disorders107
-
Care for Musculoskeletal Disorders107
-
Care for Cardiovascular Disorders108
-
Care for GI Disorders89
-
Care for Genitourinary Disorders98
-
Care for Respiratory Disorders116
-
Care for Integumentary Disorders66
-
Care for Alterations in Cellular Regulation83
-
Care for Endocrine Disorders81
-
Care for Pediatric Emergencies60
