Assessment findings of Pyloric stenosis
- Projectile vomiting w/o nausea
- Visible peristaltic wave
- Mass over epigastric area in RUQ
- Dehydration and malnutrition
Assessment findings for GERD
- Failure to gain weight
- Extreme irritability/fussiness
- Respiratory symptoms: aspiration, coughing, choking
Assessment findings for dehydration
Increased thirst, dry mucous membranes, sunken anterior fontanelle, sunken eyes, decreased skin turgor, normal to decreased BP, Increased HR, decreased to anuria, normal to lethargic or comatose
S/S of esophageal atresia
Very hungry, severe vomiting, failure to thrive,
S/S of Hirschsprung’s
- Distended abdomen
- Failure to pass first stool (meconium)
- Sausage shaped mass felt in LLQ
Chrons S/S
Diarrhea, malnutrition, weight loss
UC S/S
- Stool urgency, increased BM, mucus stool, nocturnal BM
- Bloody stool
What happens to wall thickness, where is this located, and is it intermittent or continuous? Chrons
- Thickens
- Patchy/intermittent
- Large and small intestine
What happens to wall thickness, where is this located, and is it intermittent or continuous? UC
- Thins
- Continuous
- Large intestine
Cleft lip post op care regimen
- Protect suture line
- Prevent from touching sutures, soft arm restraints
- Specialized feeding equipment due to aspiration risk from insufficient suck
- Haberman feeder
- Oral hygiene
Intussusception therapeutic regimen
- Contrast enemas under imaging often reduce defect
- Surgery if enema not effective
TE fistula therapeutic regimen
- Surgical intervention
- G-tube or TPN for nutrition
- Gastrostomy Button
Appenditicits therapeutic regimen
- IV antibiotics, fluid replacement, NGD compression, pain control
- Surgery
If ruptured do appendicitis patients stay in hospital longer
Yes
Nursing plan of care with gastroschisis?
- NPO on TPN and lipids
- Cover with sterile saline soaked dressing
- Position to protect defect
What position is contraindicated with gastroschisis?
Prone
Does it take many surgeries to treat gastroschisis?
Yes
What diet does a patient with celiac need?
Gluten free diet
What does the BROW diet consist of?
Barley
Rye
Oats
Wheat
Fluid replacement for mild to moderate dehydration
Use electrolyte solution such as pedialyte
Should plain water, Gatorade, or soda be given for dehydrated patients?
No
Fluid replacement for severe dehydration
IV replacement
LR and NS bolus
Cleft Lip/Palate nursing plan
- Protect suture line post op
- Require special feeding equipment
- Haberman feeder
- Oral hygiene
What are the most common complications of cleft lip/palate?
- Feeding
- Dental
- Speech
