Depends on severity medications Ranitidine (zantac), special nipples (slow flow), formula

Defect herniation of the abdominal contents into the umbilical cord week 11 of gestation sac made of Wartons Jelly 50-70% additional anomaly Rupture = emergency

GI / GU Flashcards by Ellery Isenstein

Stomach Capacity

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Newborn: 20 mL or ping pong ball

30 Day old: 90 mL (3 oz)

1 Year: 360 mL

Adult: 2-3 mL

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Cleft Lip or Palate

Failure of the maxillary processes to fuse by 6 weeks gestation & failure of the tongue to move down at the correct time prevents the palatine process from fusing

unknown cause (smoking, EtOH, folate)

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Cleft Lip

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Noticable at birth
unilateral or bilateral can occur alone

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Cleft Palate

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Hard palate clefts from a continuous opening; may involve hard palate, soft palate, or both

Less obvious than cleft lip
may not be detectable at birth
unilateral or bilateral

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Cleft Lip / Palate Tx

KNOW THE TIMING FOR EACH SURGERY!!!!!

Surgical repair, dental on board, increased risk of speech delay or hearing impairment

Lip: surgery between 3-5 months
Palate: before 12 months

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Cleft Lip / Palate Post-Op

Obtain vitals
Monitor I&Os
Place upright for feedings = aspiration
Use special feeder / nipples
Cleanse sutures with NS
Supine to avoid rubbing face on floor
Avoid utensils & straws
Elbow immobilizers to prevent touching incision = restraints

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GERD (Gastroesophageal Reflux Disease)

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Return of gastric contents into the esophagus

1.) lower esophageal relaxations
2.) incompetent lower sphincter
3.) anatomic disruption fo esophagogastric junction

Other Causes: overfeeding, prematurity, small stomach

Nursing Considerations: clear airway (suction), I&Os, nutrition, daily weight, respiratory

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Signs & Symptoms of GERD

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Regurgitation
Spitting up
Vomiting
Frequently hungry
Irritable

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GERD Treatment

Depends on severity

medications Ranitidine (zantac), special nipples (slow flow), formula

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Pyloric Stenosis

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Hypertrophy of pyloric muscle leading to obstruction of pyloric sphincter

S/S: felt like an olive in the epigastric region & projectile vomiting

Tx: NPO + surgery

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Signs & Symptoms of Pyloric Stenosis

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Projectile Vomiting & it feels like an olive in the epigastric region

hypochloremia
hypokalemia
metabolic alkalosis (pH > 7.45)

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Pyloric Stenosis Nursing Considerations

Avoid oral feeds
IV rehydration
Education
I&Os
NG tube
Daily weights

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Omphaloceale

Defect herniation of the abdominal contents into the umbilical cord

week 11 of gestation
sac made of Wartons Jelly
50-70% additional anomaly

Rupture = emergency

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Gastroschisis

A defect in the abdominal wall lateral, usually right-sided, with protrusion of the intestines

no sac around the intestines

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Intussusception

Abdominal emergency

Telescoping of a segment of the intestine leading to inflammation, edema, & decreased blood flow

most common site is ileocecal valve

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Intussusception Signs & Symptoms

Intermittent abdominal pain
Currant jelly stools (blood & mucus)
Vomiting

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Intussusception Tx

Air enema, two attempts; then surgery

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Hirschsprung Disease

KNOW THIS!!!!! (know the bold)

Congenital absence of ganglion cells in the wall of the colon or rectum

Causes colon to become a “megacolon”

S/S: Failure to pass meconium in first 48 hours of life, abdominal distention, feeding intolerance, bilious emesis

DX: hx, bowel pattern, barium enema, rectal suction biopsy

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Intussusception

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Tutoring Notes

Study These Flashcards

Occurs when a portion of the intestine invaginates into another leading to inflammation, edema, & decreased blood flow

Triad of Symptoms: intermittent abdominal pain, currant jelly stools (blood & mucus) & vomiting

Enterocolitis

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Inflammation fo the small & large intestine

complication fo Hirschsprung disease

S/S: fever, foul smelling stool, bloody diarrhea

TX: antibiotics

Enterocolitis is a complication fo what disease?

KNOW THIS!!!!!

Study These Flashcards

Hirschsprung disease

What is gastroenteritis?

KNOW THIS!!!!!

Study These Flashcards

Inflammation of the stomach & intestines from:

e. coli
food sensitivty (gluten, dairy)
emotional stress
medications (iron, abx)
colon disease

Mild Dehydration

KNOW THE BOLD!!!!!

Study These Flashcards

Loss of < 5% of body weight

alert, restless
BP = normal
HR = regular
turgor = regular
moist membranes
normal urine output
sligihtly increased thirst
normal fontanelles
RR = regular
normal eyes
cap refill < 3 seconds

Moderate Dehydration

KNOW THE BOLD!!!!!

Study These Flashcards

Loss of 6-9% of body weight

lethargic, irritable, alert, restless
BP normal or low
HR = rapid
Turgor = poor
Dry membranes
decreased urine output
moderately increased thirst
sunken fontanelles
RR = regular or rapid
eyes slightly sunken
delayed cap refill > 2 seconds

**Oral Rehydration Solution (ORS)**

Solutions containing glucose, sodium, potassium, chloride, & citrate are given orally to replace those lost in mild to moderate dehydration

**ORT** (oral rehydration therapy) **for mild dehydration** | **KNOW THIS!!!!!**

* If weight is **less than 22 lb (10 kg) = give 60-120 mL ORS** for each diarrheal stool or vomiting episode * * If weight is **over 22 lb (10 kg) = give 120-240 mL ORS** for each diarrheal stool or vomiting episode

**ORT** (oral rehydration therapy) **for Moderate Dehydration** | **KNOW THIS!!!!!**

Give **50 - 100 mL/kg ORS in 3-4 hours** in addition to replacing fluids lost in minimal ORT

**ORT** (oral rehydration therapy) **for Severe dehydration** | **KNOW THIS!!!!!**

Treated with IV fluids * When hydrated adequately or concurrently with IV rehydration, begin ORT with **100 mL/kg of fluid in 4 hours** & stool replacement as described above. Recalculate fluid needs after first 4 hours & adjust as needed.

**Appendicitis**

**Inflammation of the appendix** * ages 10-19 are most at risk for perforation **DX:** *ultrasound = gold standard*

**Signs & Symptoms of Appendicitis** | **KNOW THIS!!!!!**

* **P**ain (Mcburneys, Rovsing's, Psoas, Obturator) * **A**norexia * **N**ausea * **T**emperature * increased WBC, neutrophils, C-reactive protein

**What is McBurney's Point?** | **KNOW THIS!!!!!**

**RLQ pain upon palpation** * 2/3 between umbilicus & hip bone * *+ McBurneys = appendicitis*

**Rovsing's Sign**

RLQ pain upon LLQ palpation; **referred pain** * *+ Rovsing's = appendicitis*

**Obturator Sign**

RLQ pain on internal rotation of thigh * *+ Obturator = appendicitis*

**Treatment of Appendicitis**

Surgical removal of appendix * perforation = emergency * IV fluids, prophylactic antibiotics, pain medications, NPO, incision care, NG for perforation (decompresses abdomen)

**What is Hyperbilirubinemia?** | **KNOW THIS!!!!!**

**Elevated bilirubin level of > 5 g/dL** * affects 84% of newborns

**Signs & Symptoms of Hyperbilirubinemia** | **KNOW THIS!!!!!**

* **jaundice** * **lethargy** * **decreased PO intake**

**Treatment for Hyperbilirubinemia** | **KNOW THIS!!!!!**

**phototherapy**

**Hyperbilirubinemia Nursing Considerations** | **KNOW THIS!!!!!**

* **Identify jaundice** (soles, palms, sclera) * Obtain TSB * Plot TSB on normogram * **Strict I&Os** * IV hydration * Phototherapy * Vitals

**3 Nursing Diagnoses associated with Hyperbilirubinemia** | **KNOW THIS!!!!! (per tutor)**

* **Fluid volume deficit** * Risk for **impaired attachment** * Risk for **imbalanced body temperature**

**Hyperbilirubinemia** | **KNOW THE BOLD!!!!!**

**↑ bilirubin > 5 g/dL** **S/S: jaundice, lethargy, ↓ PO intake** * Tx = phototherapy **Nursing Diagnoses** * **Fluid volume deficit** * Risk for **impaired attachment** * Risk for **imbalanced body temperature**

**Urinary tract infection**

**Infection of the lower or upper urinary tract that can be viral, bacterial, or fungal** * E. coli is the most common cause Dx: urine culture, UA, CBC, CT or US Tx: IV abx

**Acute Post-Infectious Glomerulonephritis (APG)** | **KNOW THIS!!!!!**

**Inflammation of the glomeruli in the kidneys** Commonly caused by **group A beta-hemolytic strep** * **+ protein & blood in urine** * provide supportive care * common in 2-6 year old boys * manifests 10-21 days *after* strep infection recovery **do NOT need to have current infection for this to occur**

**Signs & Symptoms of APG (acute post-infectious glomerulonephritis)** | **KNOW THE BOLD!!!!!**

* ↓ GFR * ↑ BUN / Cr * ↑ WBC * **Proteinuria** = ↓ serum & ↑ in urine * **Hematuria** * Oliguria * Dysuria * low grade **fever** * **facial edema** * flank pain * lethargy * acute hypertension * HA * N/V * seizures (severe)

**Hypospadias** | **KNOW THIS!!!!!**

Urethral meatus (opening) located on the **ventral** (bottom) **surface of the penis** ## Footnote assess every newborn male * Nursing Considerations: patient education, I&Os, pain management, incision care

**Epispadias** | **KNOW THIS!!!!!**

Urethral opening on the **dorsal** (top) **surface of the penis**

**Nephrotic Syndrome** * What is it? * Signs & symptoms * Treatment | **KNOW THE BOLD!!!!!**

Clinical state of being**; alteration in kidney function** due to ↑ membrane permeability to proteins * **S/S:** * **Periorbital edema** * **+ proteinuria** * hematuria & ↓ urine output * irritability, malaise/anorexia * **HTN** **Tx: steroids & BP meds** * prednisone = 2 mg/kg/q12 hr

**Testicular Torsion**

**Twisting of the spermatic cord causing ↓ blood flow to the testes** * *S/S:* severe pain, erythema, N/V, swelling * *Tx:* surgical emerrgency untwisting (orchiopexy)

GI / GU Flashcards

(47 cards)