Peds GI.txt

dehydration

vomiting followed by onset of watery stools, fever; mild to severe symptoms

N/V, colicky ADB pain, bloody diarrhea, fever, mild to severe symptoms, headache, drowsiness, confusion, seizures

dehydration, acidosis and shock due to severe dehydration

no rectal temps, no fruit juices, no caffeine or carbonated drinks, no brat diet

absence of ganglion cells in the affected areas of the intestine resulting in a loss of rectosphincteric reflex and abnormal microenvironment of the cells of the affected intestine

megacolon

feeding intolerance with bilious vomiting, distended ABD, delay in passage of meconium

growth failure, constipation, ABD distention, diarrhea and vomiting, fever, explosive watery diarrhea

constipation, ribbonlike foul smelling stools, ABD distention, visible peristalisis, easily palpable fecal mass, undernourished and anemic appearance

surgery after pt has stabilized; pull through procedure

constipation and fecal incontinence

help parents adjust to congenital defect in child, foster bonding, prepare for surgery, assist in colostomy care

enterocolitis

signs of shock, vitals, fluid and electrolyte replacements, fever, ABD distention, vomiting, cyanosis, dyspnea; measure ABD circumference at umbilicus or widest part of ABD

temporary

inappropriate relaxation of lower esophageal sphincter; factors that increase ABD pressure (coughing, sneezing, scoliosis and overeating)

24 hour intraesophageal pH monitoring, upper GI series helps show anatomic abnormalities, endoscopy with biopsy

vomiting (may be forceful), excessive crying, irritability, respiratory problems, weight loss; in children-heartburn, ABD pain, chest pain, cough, dysphagia, nocturnal asthma, recurrent pneumonia

esophagitis, esophageal stricture, laryngitis, recurrent pneumonia, anemia, barrett esophagus

avoid certain foods, lifestyle modifications (wt control, smaller more frequent meals), feedings in infants (thickened feedings is 1tsp to 1T of rice cereal per ounce of formula, upright positioning)

identifying children with symptoms, educating parents, caring for child with surgical interventions

a fibrous band connecting the small intestine to the umbilicus; most common congenital malformation of GI tract; often exists without symptoms

bleeding, obstruction or inflammation; gastric mucosa

history, physical exam and radiographic studies; meckel scan used most often, but less reliable in the presence of bleeding

painless rectal bleeding, ADB pain or signs of obstruction, currant jelly stools, sometimes severe anemia, shock, hypotension, caused by peptic ulceration/perforation

surgical removal of diverticulum, might need blood replacement, IV fluids, O2 if severe hemorrhage

frequent monitoring of vitals including BP, bed rest, recording the amount of blood in stools

IV fluids and NG tube for decompression and evacuation of gastric secretions, onset of illness is usually sudden

increased familial incidence and in type O people; h pylori weakens gastric mucosal barrier and allows acid to damage mucosa; acquired by fecal oral route

epigastric pain, nocturnal pain, oral regurg, heartburn, weight loss, hematemesis and melena; may have causative substances like NSAIDS, corticosteroids, alcohol and tobacco; labs of CBC, stool analysis, LFTs, lactose breath test, upper GI

relieve discomfort, promote healing, prevent complications, prevent recurrence

antacids, h2 receptors (zantac, Pepcid), PPI (omeprazole), mucosal protective (sucralfate and bismuth)

acetaminophen (NOT NSAIDS or aspirin)

H2 blockers to prevent stress ulcers

failure of maxillary and median nasal processes to fuse; defect in cell migration

midline fissure of the palate that results from failure of the two palatal processes to fuse

genetic and environmental (alcohol, smoking, anticonvulsants, steroids and retanoids) and folate deficiency

unable to create suction

2-3 months of age; rule of “10s”-10 pounds, 10 wks old, HgB 10

6-12 months

ok to breastfeed as boob conforms to cleft lip, bottle with wide base of nipple; feed kid upright

protect operative site, may need to apply petroleum jelly; avoid objects in the mouth

altered nutrition, pain, altered parenting, risk for trauma

causes projectile nonbilious vomiting, dehydration, metabolic acidosis and growth failure, genetic predisposition

occurs when the circumferential muscle of the pyloric spincter becomes thickened resulting in elongation and narrowing of the pyloric channel; produces obstruction and compensatory dilation, hypertrophy and hyperperistalsis of the stomach

olivelike mass in upper ABD; not congenital

vomiting 30-60 minutes after feeding and becomes projectile as obstruction progresses, nonbilious consisting of stale milk; may become dehydrated and appear malnourished if early DX is not established; chronicly hungry, distended ABD; peristalsis waves move left to right

nurse makes sure it’s patent

fatty, foul, frothy and bulky stools; general malnutrition; ABD distention and vitamin deficiencies

75-90 nEq/L of Na; 40-50 ml/kg over 4 hours; don’t exceed 150 ml/kg/day; 5-10 ml every 2-3 minutes