What are some clinical manifestations of gastrointestinal dysfunction?
- failure to thrive
- spitting up, regurgitation
- nausea, vomiting
- diarrhea, constipation
- abdominal pain, distension, GI bleeding
What are some key assessment questions to ask if a child is vomiting?
- how long, when?
- how much, often?
- color?
- green bilious?
- projectile?
- fever present?
- abdominal pain?
If vomiting persists it can lead to what?
metabolic alkalosis
What are some common feeding intolerances in children?
- cow’s milk allergy, lactose intolerance
- food allergies= formula or something mom is eating
what are some manifestations and management of feeding intolerances?
- reflux, colic, diarrhea
- small, frequent feeds and change formula
- increase Burbank (reflux)
what is lactose intolerance in the management for it?
- genetic deficiency of lactase
- reduce Dairy consumption, but do not cut it out completely because it helps with growth and development
- use probiotics to help tolerate formula
- eat hard cheese, cottage cheese, yogurt
true or false: Food allergies are common and can change or disappear as the child gets older.
true
what disease is caused by soy allergy?
celiac disease
what are some manifestations of gastroesophageal reflux?
- happy spitters (common in preemies)
- painless emesis
- immature esophageal sphincter
- no failure to thrive ( typically won’t see changes in weights)
what are some manifestations of gastroesophageal reflux disease (GERD)?
- failure to thrive
- aspiration pneumonia
- greater volume of emesis
what are some treatment options for gastroesophageal reflux?
- small, frequent feeds
- increase burping after every ounce given
- Elevate head at all times
- reflux precautions
what is one particular thing we do when caring for a child who has gastroesophageal reflux disease (GERD)?
thicken feeds
what pharmacological interventions are used for gastroesophageal reflux disease(GERD)?
- H2 receptor antagonist ( drug of choice in Pediatrics)
- proton pump inhibitors
what are some nursing considerations for histamine 2 antagonists when giving to patients with GERD?
- interferes with skin test using allergen extracts (cannot give within two weeks of allergy test)
- Don’t give within an hour of antacids
- give without regard to meals but best before meals or at bedtime
- may cause drowsiness or dizziness
what is a nursing consideration when administering proton pump inhibitors to patients who have GERD?
give with first meal of the day; ideally, administer 30 minutes before breakfast
If a patient who has GERD is not improving with interventions or medication which surgery will be done?
Nissen fundoplication
If a patient is experiencing prolonged constipation/encopresis what are some interventions that can be done?
- fluids, fiber, exercise
- re-establish a normal bowel regimen
- pharmacological interventions
- Chait tube/MACE
Chait tubes/MACE are commonly used in which type of patients to relieve constipation issues?
immobile patients
What are two common symptoms of celiac crisis?
- profuse watery diarrhea
- vomiting
what are some common dietary guidelines for celiac disease?
- high-calorie, high-protein, low-fat
- allowed it to eat corn, rice, millet
- temporary lactose free diet
- high fiber foods initially until inflammation of bowel has subsided
- supplement fat soluble vitamins, folic acid, iron
- risk of developing intestinal lymphoma
when is it common to have cleft lip repairment surgery?
3 months
when is it common to have cleft palate repairment surgery?
9 to 12 months
-typically takes multiple revisions
what are two concerns that we have if a child has a cleft lip or cleft palate?
- Dental concerns
- developmental delays in speech
risk factors are increased if a child has a cleft lip or cleft palate?
- aspiration
- otitis media
- upper respiratory disease
