Gastro Disorders

• Vomiting:

  • B_ which is G_
  • F_ V_ L_
  • E_ I_
  • A_
  • Watch out for B_ or C_ G_ and B_ R_
  • E_ F_
  • S_ F_ M_
  • P_ A_
  • B_ T_ or R_ M_ after vomiting
  • M_ F_ and E_ I_?

  bilious, green, fluid volume loss, electrolyte imbalances, anti-emetics, blood, coffee ground, bright red, encourage fluids, small frequent meals, prevent aspiration, brush teeth, rinse mouth, monitor fluid, electrolyte imbalances
• Diarrhea:

  • Spread through C_ F_ or W_ or P_ to P_
  • Viral is R_
  • Bacterial is E_, S_, C_
  • F_ V_ D_ and D_
  • M_ A_
  • S_
  • S_ B_?

  contaminated food, water, person, person, rotavirus, ecoli, salmonella, cdiff, fluid volume deficit, dehydration, metabolic acidosis, shock, skin breakdown
• Diarrhea:

  • Therapeutic Management
  • O_ R_
  • I_ F_
  • P_
  • Prevention
  • R_ V_
  • P_ W_ S_
  • C_ F_ P_
  • H_
  • Management
  • Monitor D_
  • S_ C_
  • Avoid R_ T_?
  • oral replacement, iv fluids, probiotics, rotavirus, protecting water supply, careful food prep, hygiene, dehydration, skin care, rectal temp
• Dehydration:

  • Manifestations
  • G_ S_
  • C_ S_
  • S_ E_ and F_
  • R_ P_ and R_
  • A_ of T_
  • L_ B_
  • P_ C_ R_
  • D_ W_ D_?
  • gray skin, cold skin, sunken eyes, fontanels, rapid pulse, rr, absence, tears, low bp, poor cap refill, decreased wet diapers
• Dehydration:

  • Therapeutic Management:
  • O_ R_
  • M_ D_
  • Assess V_ every _ to _ mins
  • T_ may be L_
  • T_, T_, L_ B_ with Dehydration
  • Cap refill
  • M_ with L_ than _ seconds
  • S_ with M_ than _ seconds
  • oral rehydration, monitor dehydration, vitals, 15, 30, temp, low, tachycardia, tachypnea, low bp, mild, less, 2, severe, more, 4
• Dehydration:

  • Nursing Management
  • D_ W_
  • W_ D_ including U_, V_, and S_
  • Assess
  • M_ M_
  • S_
  • F_ are S_ with dehydration
  • T_?
  • daily weights, weigh diaper, urine, vomitus, sweating, mucous membranes, skin, fontanels, sunken, thirst
• Dehydration:

  • Conditions when dehydration happens quickly
  • D_ and V_
  • S_ and F_
  • D_ and R_ D_
  • D_ and S_
  • T_
  • C_ A_
  • diarrhea, vomiting, sweating, fever, dka, renal disease, diuretics, steroids, trauma, cardiac anomalies
• Constipation:

  • T_ G_ for more than _ W_
  • D_ and S_ S_
  • M_ that is M_
  • E_
  • I_ F_ and F_
  • B_ in S_ report right away?

  trouble going, 2, weeks, diet, stool softeners, Miralax, mixed, enema, increase fiber, fluid, blood, stool
• Intussusception:

  • _ months and _ yrs
  • M_
  • S_ of B_ into A_ S_ pulling with it
  • Manifestations
  • C_ T_
  • A_ P_ that is C_
  • D_ K_ to C_
  • S_ S_ M_
  • R_ J_ S_?
  • 3, 6, males, section, bowel, another segment, classic triad, abdominal pain, colicky, drawing knee, chest, sausage-shaped mass, red jelly stool
• Intussusception:

  • Therapeutic Management:
  • S_ R_
  • U_ E_
  • I_ F_, N_ D_ and A_ T_ that may be used before U_ E_
  • If unsuccessful S_?
  • spontaneously reduce, ultrasound edema, iv fluids, naso decompression, antibiotic therapy, ultrasound edema, surgery
• Intussusception:

  • Nursing Management
  • H_
  • Pre-op
  • N_
  • C_
  • M_ S_ but if R_, N_ M_ to cancel S_
  • E_ I_
  • I_ F_ due to risk for P_ and B_
  • B_ R_ or N_ S_
  • Post-op
  • W_ A_
  • C_ and D_ B_
  • R_ when S_ A_ P_
  • E_ W_ C_ for W_ I_
  • S_ B_
  • C_?
  • hospital, npo, consent, monitor stool, reduced, notify md, surgery, electrolyte imbalance, iv fluids, perforation, bleeding, blood replacement, ng suctioning, wound assessment, coughing, deep breathing, ROM, soon as possible, elevated white count, wound infection, skin breakdown, constipation
• Appendicitis:

  • Peritonitis symptoms
  • F_, S_ R_ of P_ with peforation
  • A_ D_
  • T_
  • S_ B_
  • P_
  • C_
  • I_
  • S_ B_ I_ you would N_?
  • fever, sudden relief, pressure, abdominal distention, tachycardia, shallow breathing, pallor, chills, irritable, small bowel ileus, notify
• Appendicitis:

  • Manifestations:
  • F_
  • P_ in R_
  • R_ A_
  • I_ P_ with M_
  • G_ and V_
  • Diagnosis
  • E_ W_C_ and C_?
  • fever, pain, rlq, rigid abdomen, increase pain, movement, guarding, vomiting, elevated white count, crp
• Appendicitis:

  • Therapeutic and Nursing Management
  • R_
  • A_ and R_
  • R_ is S_ P_ R_
  • IV F_ and A_, N_ S_
  • A_ L_, E_, or H_ to the A_
  • N_
  • Assess P_
  • Non-verbal: R_ M_ S_ P_ with K_ F_ on the abdomen?
  • rehydration, antibiotics, removal, rupture, sudden pain relief, fluids, antibiotics, ng suction, avoid laxatives, enemas, heat, abdomen, npo, pain, rigid motionless side position, knees flexed
• Congenital Diaphragmatic Hernia:

  • Manifestations
  • T_, D_, C_
  • Diagnosis
  • X_ and as early as _ gestation
  • Management
  • T_ R_ D_
  • M_ V_ and G_ D _
  • B_ P_ S_
  • S_, P_, I_, S_
  • Watch for C_?
  • tachypnea, dyspnea, cyanosis, x-ray, 25, treat respiratory depression, mechinal vent, gi decompression, blood pressure support, sedatives, paralytics, inotropes, slidenafil, complications
• Cleft Lip and Palate:

  • _ to _ wks
  • F_ D_ unable to create S_
  • A_ to S_ is N_
  • C_ of clefs
  • Cleft lip correction
  • _ to _ months
  • F_ and M_ technique
  • N_ M_ that is N_ S_?
  • Cleft Palate Correction
  • B_ _ months to enhance N_ S_
  • V_ P_
  • F_ D_ P_
  • S_ and L_ problems if wait too long?

  13, 14, feeding difficulty, suction, ability, suck, normal, closure, 2, 3, fisher, millard, naso molding, non-surgical, before 12, normal speech, veau procedure, Furlow double plasty, speech, language
• Cleft Lip and Palate:

  • CL
  • Interferes with F_ due to S_
  • Able to B_
  • W_ B_ N_ and C_ S_
  • CP
  • Reduces ability to S_ which interferes with B_ and B_ F_
  • Position U_ with head S_
  • S_ B_ due to S_ impaired
  • P_ during F_ for B_?

  feeding, seal, breastfeed, wide base nipple, check support, suck, breastfeeding, bottle feed, upright, support, special bottle, suction, pause, feedings, burping
• Cleft Lip and Palate:

  • Management
  • Parents taught A_ F_ S_ several days B_ S_
  • P_ J_ to S_ for several days
  • E_ I_ to prevent D_ S_ for _ to _ days including S_ F_
  • A_ S_ and O_ O_ in M_
  • No B_ or S_ foods
  • Avoid H_ foods?
  • alternative feedings systems, before surgery, petroleum jelly, site, elbow immobilizer, disturbing site, 7, 10, syringe feedings, avoid suction, other objects, mouth, blended, soft, hard
• Esophageal Atresia and Tracheoesophageal Fistula:

  • B_ W_, P_ B_, and P_
  • Manifestations
  • E_ F_ M_
  • C_, C_, C_
  • A_
  • I_ R_ D_ during F_
  • A_ D_ which you C_ M_?
  • birth weight, preterm birth, polyhydramnios, excessive frothy mucus, coughing, choking, cyanosis, apnea, increased respiratory distress, feedings, abdominal distress, check measurements
• Esophageal Atresia and Tracheoesophageal Fistula:

  • Management
  • Maintain A_
  • Prevent P_
  • D_
  • N_ and I_ F_
  • P_ to facilitate D_ and S_ F_
  • D_ L_ C_
  • A_?
  • airway, pneumonia, decompression, npo, iv fluids, position, drainage, suction frequently, double lumen catheter, antibiotics
• Esophageal Atresia and Tracheoesophageal Fistula:

  • Nursing Care Management
  • A_
  • S_
  • P_
  • B_ P_
  • Careful observations with _ O_ F_
  • S_ T_ O_ when L_ S_ with _ degrees E_?
  • airway, suction, positioning, blind pouch, first oral feed, shut tub off, lying supine, 30, elevated
• Hypertrophic Pyloric Stenosis:

  • O_ O_, H_ and H_ of the S_
  • Manifestations
  • O_ like M_
  • V_ for _ to _ mins after F_ that are P_
  • I_ H_ and A_ F_
  • W_ L_ or F_ to G_
  • V_ P_?
  • outlet obstruction, hypertrophy, hyperperistalsis, stomach, olive, mass, vomiting, 30, 60, feeding, projectile, infant hunger, avid feeder, weight loss, failure, gain, visible peristalsis
• Hypertrophic Pyloric Stenosis:

  • Management
  • R_
  • F_ of C_ _ to _ hrs P_
  • S_ F_ F_
  • C_ R_ for _ hrs F_ is started in S_ S_
  • R_ R_ with I_ F_ with G_ and E_ but no O_ F_
  • D_ W_
  • V_ is C_ for the first _ to _ hrs
  • F_ begin with C_ and A_ A_ T_
  • M_ A_ correction?
  • rehydration, feeding, clears, 4, 6, post-op, small frequent feeds, clears retained, 24, formula, small, serving, restoring rehydration, IV fluids, glucose, electrolytes, oral feeds, daily weights, vomiting common, 24, 48, feeds, clears, advanced as tolerated, metabolic alkalosis
• Omphalocele:

  • Intraabdominal into B_ of U_ C_
  • S_ covered with P_ without S_
  • S_ R_
  • Protect from D_ and T_
  • No P_
  • M_ with S_ D_
  • M_ T_
  • N_
  • Monitor for R_ of B_ F_?

  base, umbilical cord, sac, peritoneum, skin, surgical repair, drying, trauma, pressure, moist, saline dressing, maintain thermoregulation, npo, return, bowel function
• Gastroschisis:

  • Intra-abdominal through the A_ W_ L_ to the U_
  • S_ R_
  • K_ C_ with B_ to prevent T_ and D_
  • M_ T_
  • N_
  • Monitor site for I_
  • Monitor L_ E_ for P_ and C_ and R_ to B_
  • Kept P_ C_?

  abdominal wall lateral, umbilical, surgical repair, keep clean, bag, trauma, drying, maintain thermoregulation, npo, infection, lower extremities, pulses, circulation, return, bowel, pouch clean
• Hernias:

  • Dangers occurs with C_, I_ C_, or P_
  • I_
  • _ to _ yrs of age
  • Persists beyond then S_ is done
  • D_ is not H_
  • D_ T_ or S_ to F_ P_
  • Watch for I_
  • H_
  • Can resume N_ D_ and A_
  • S_ A_ should be avoided _ to _ wks?

  constriction, impaired circulation, protrusion, infants, 3, 5, surgery, defect, harmful, don't tape, strap, flatten protrusion, infection, hematomas, normal diet, activity, strenuous activity, 2, 3
• Inguinal Hernia:

  • G_ than B_
  • A_
  • P_ S_
  • D_ during periods of R_
  • R_ by G_ C_
  • Appears when C_ or S_ for infants
  • Appears when S_, C_, or S_ for L_ T_ in older child
  • Variable Symptoms
  • I_, T_
  • A_, A_ D_
  • D_ D_?
  • girls, boys, asymptomatic, painless swelling, disappears, rest, reducible, gentle compression, crying, straining, strains, coughs, stands, long time, irritability, tenderness, anorexia, abdominal distention, difficulty defecating
• Inguinal Hernia:

  • Management
  • Can become I_ which is I_ and S_
  • S_ R_
  • Keep C_ and D_
  • O_ D_ if not T_ T_
  • N_ A_ R_ for I_ or T_
  • O_ C_ are cautioned against L_, P_, W_, F_, B_ R_ or S_ for _ wks
  • If Surgery postponed
  • Teach S_
  • W_ B_
  • A_ of U_ position
  • C_ M_ to reduce C_?
  • incarcerated, irreducible, strangulated, surgical repair, clean, dry, occlusive dressing, toilet trained, no activity restriction, infants, toddlers, older children, lifting, pushing, wrestling, fighting, bike riding, sports 3, signs, warm bath, avoid, upright, comfort measure, crying
• Femoral Hernia:

  • R_
  • G_ than B_
  • S_ in the G_, S_ A_ P_ and C_?

  rare, girls, boys, swelling, groin, severe ab pain, cramping
• Anorectal Malformations:

  • R_ A_
  • C_ O_ which needs S_ I_
  • R_ S_
  • Hx of D_ S_, A_ D_, R_ S_
  • P_ C_
  • R_, V_, U_ opening in perineum
  • I_ A_
  • Without O_
  • F_
  • A_ communication to D_ R_ to P_?
  • rectal atresia, complete obstruction, surgical intervention, rectal stenosis, difficulty stooling, abdominal distention, ribbon-like stools, persistent cloaca, rectum, vagina, urethra, imperfect anus, opening, fistula, abnormal, distal rectum, perineum
• Anorectal Malformations:

  • A_ D_
  • V_
  • A_ of M_ or P_ of M_ in U_
  • Management
  • S_, N_ and I_ F_
  • G_ D_
  • A_
  • A_ D_ which return for _ wks C_ U_
  • May require C_ or T_
  • Discharge
  • T_ T_ D_, S_ achieved at usual age, P_ C_?
  • abdominal distention, vomiting, absence, meconium, passing, meconium, urine, surgery, npo, fluids, gi decompression, anoplasty, anal dilations, 2, check-up, colostomy, temporary, toilet training delayed, seldom, prevent constipation
• GERD:

  • N_ I_, C_ R_ D_, E_, O_
  • _ hr I_ E_ P_ M_
  • Manifestations
  • Infant
  • S_ U_ and R_
  • A_ B_ I_ and R_ P_ such as C_ and C_ with F_
  • Older Children
  • H_ and A_/C_ P_
  • D_ and H_
  • A_?
  • neurological impairment, chronic respiratory disease, ea, obesity, 24, intra-esophageal, ph monitoring, spit up, regurgitation, arching back irritability, respiratory problems, coughing, choking, feeding, heartburn, abdominal, chest pain, dysphagia, hoarseness, activity
• GERD:

  • Management
  • A_ F_ that exacerbate A_ R_
  • C_, C_, T_, A_, P_, S_ or F_
  • L_ M_
  • W_ R_, S_ F_ M_
  • T_ F_ to E_ N_ for easier S_
  • Elevate H_ _ degrees or I_ S_ for _ hrs A_ feeds
  • Meds _ mins B_ M_
  • A_ V_ P_ A_ F_ and before B_?
  • avoid foods, acid reflux, coffee, citrus, tomatoes, alcohol, peppermint, spicy, fried foods, lifestyle modifications, weight reduction, small frequent meals, thickened formula, enlarged nipple, sucking, hob, 30, infant seat, 1, after, 30 before meals, avoid vigorous play after feeds, bedtime
• Hirschsprung Disease:

  • M_ O_ from I_ M_ of I_
  • _ F_ M_ of L_
  • Manifestations
  • Newborn
  • F_ to P_ M_ within _ to _ hrs
  • R_ to F_
  • B_ V_
  • Infant
  • A_ D_
  • D_
  • V_
  • R_ F_ S_ S_
  • V_ P_?
  • mechanical obstruction, inadequate motility, intestine, 1st, few months, life, failure, pass meconium, 24, 48, refuse, feed, bilious vomiting, abdominal distention, diarrhea, vomiting, ribbon foul smelling stools, visible peristalsis
• Hirschsprung Disease:

  • Management
  • S_
  • L_ F_ and H_ C_ and P_ D_
  • Watch G_ and S_
  • Signs of E_
  • E_ W_ D_, F_, I_ A_
  • Signs of P_
  • F_, A_ D_, V_, I_ T_, I_
  • A_ C_
  • D_ B_ D_ to avoid W_ C_
  • C_ C_?
  • surgery, low fiber, high calorie, protein diet, glucose, site, enterocolitis, excessive water diarrhea, fever, ill appearance, perforation, fever, abdominal distention, vomiting, increased tenderness, irritability, abdominal circumferences, diapers below dressing, wound contamination, coly care
• Celiac Disease:

  • W_, B_, R_, and O_ G_
  • Manifestations
  • C_ G_ typically ages _ to _
  • F_ S_ S_ which is L_ and B_
  • M_ and A_
  • M_ W_
  • I_
  • Diagnosis
  • A_ E_ A_ in children _ months and older?

  • wheat, barley, rye, oat grain, containing grains, 1, 5, foul smelling steatorrhea, large, bulky, malnutrition, anorexia, muscle wasting, irritability, ant-endomysial antibodies, 18
• Celiac Disease:

  • Management
  • G_ F_ D_ of eliminating W_, R_, B_ and O_
  • May have L_ I_ if left U_
  • Foods to Avoid
  • B_, C_, C_
  • C_, D_, P_
  • S_, P_, P_ S_
  • P_ I_ C_, H_ D_, L_ M_
  • Need to M_ L_ while in school
  • May need T_ L_ F_ D_
  • C_ I_?
  • gluten-free diet, wheat, rye, barley, oats, lactose intolerance, untreated, bread, cakes, cookies, crackers, donuts, pies, spaghetti, pizza, prepared soups, processed ice cream, hot dogs, lunch meat, monitor lunch, temporary lactose free diet, compliance issues
• Biliary Atresia:

  • Manifestations
  • J_
  • D_ U_
  • L_ S_
  • H_ and S_
  • I_
  • Diagnosis
  • E_ D_ is key
  • Management
  • H_ P_
  • Maybe L_ T_
  • N_ S_
  • S_ F_ S_ V_ and M_
  • T_?
  • jaundice, dark urine, light stool, hepa, splenomegaly, itching, early dx, hepatic portenterostomy, liver transplant, nutritional support, supplement fat-soluble vitamins, minerals, tpn
• Biliary Atresia:

  • U_ can lead to D_ by age _
  • Watch G_ B_ of D_ T_ S_ and H_
  • A_
  • T_ and T_
  • S_ S_
  • S_
  • A_ C_
  • R_ I_ C_
  • Management
  • B_ in O_ and T_ of F_ to A_ S_?
  • untreated, death, 3, gi bleeding, dark tarry stools, h/h, ascites, tight, taunt, shiny skin, striae, ab circumferences, respiratory issue concern, bath, oatmeal, trimming, fingernails, avoid scratching
• Food Allergies:

  • Common Food Allergies
  • W_, E_, F_, M_, M_, F_
  • Manifestations
  • A_, V_, C_, D_
  • C_, W_, R_
  • R_, A_ D_
  • Diagnosis
  • F_ C_
  • S_ T_ with A_ A_ E_ available
  • Management
  • A_ U_ R_
  • B_ good
  • A_ B_
  • I_ E_?

  • wheat, egg, fish, meat, milk, fruit, abdominal, vomiting, cramping, diarrhea, cyanosis, wheezing, rhonchi, rash, atopic dermatitis, food challenge, skin test, advance airway equipment, avoid unfamiliar restaurant, breastfeed, alert bracelet, iv epinephrine