The Child with Gastrointestinal Alterations

motility disorders include

-GERD -Constipation -encopresis -recurrent abdominal pain -IBS

what is Celiac crisis

-acute episodes of watery diarrhea, infection & emotional disturbance

what is the difference between esophageal atresia and TEF

-atresia is a general term to indicate blockage -fistula is an opening -TEF is a blockage of the esophagus with an abnormal connection to the trachea

therapy for GERD

-diet -positioning -medications -surgery

what happens with esophageal atresia

-esophagus can become combined or joined to the trachea

Hirschsprung disease

-ganglion in the distal part of the colon isn't working -decreased motility (mechanical obstruction) -stool will not pass

Obstructive disorders include

-hypertrophic pyloric stenosis -intussusception -volvulus -Hirschsprung's disease

manifestations for Celiac disease

-impaired fat absorption -impaired nutrient absorption: anemia, wt loss, abd distention, muscle wasting

behavioral changes associated with Celiac disease include:

-irritability -fretfullness -fussiness -apathy

Malabsorption diseases include

-lactose intolerance -Celiac disease: Gluten intolerance/allergy -short bowel syndrome

inflammatory bowel disease includes

-ulcerative colitis -crohn's disease

Inflammatory and infectious diseases include:

-ulcers -infectious gastroenteritis -appendicitis -Inflammatory bowel disease

what are S/S of Hirschsprung disease?

-vomiting -not eating

Celiac disease is an abnormal immune response to gluten which includes

-wheat -rye -barley

The nurse is caring for a child with probable intussusception. The child had diarrhea before admission, but while waiting for administration of air pressure to reduce the intussusception, the child passes a normal brown stool. What is the most appropriate nursing action? A. Notify the physician. B. Measure the abdominal girth. C. Auscultate for bowel sounds. D. Check vital signs, including blood pressure.

A

The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What should the nurse include in the teaching plan? A. Teach infection control measures to family members. B. Bed rest is important until 1 week after the icteric phase. C. The child should not return to school until 3 weeks after the icteric phase. D. Give reassurance that hepatitis A cannot be transmitted to other family members.

A

Which statement best describes Hirschsprung disease? A. The colon has an aganglionic segment. B. It results in frequent evacuation of solids, liquid, and gas. C. There is passage of excessive amounts of meconium in the neonate. D. It results in excessive peristaltic movements within the gastrointestinal tract.

A

The GI system is formed in the first _____________ weeks of embryonic development

4

The nurse assesses a neonate immediately after birth and suspects a tracheoesophageal fistula. Which assessment data would cause the nurse to suspect this defect? A. Sneezing B. Flat fontanels C. Absence of sucking and swallowing D. Excessive amount of frothy saliva in the mouth

D

Therapeutic management of the child with an inflammatory bowel disease (IBD) includes a diet that has which component? A. Low-protein B. Low-calorie C. High-fiber D. Vitamin supplements

D

pyloric stenosis is usually diagnosed between ____ to _________ weeks of life

5 to 6

Management of a peptic ulcer in a child often includes which component? A. Taking proton pump inhibitors B. Drinking milk at frequent intervals C. Coping with stress and adjusting to chronic illness D. Taking antacids 1 and 3 hours before meals and at bedtime

A

Which of the following should be included in teaching about GERD? A. offer frequent feedings B. thicken formula with rice cereal C. use a bottle with a one way valve D. potion the baby upright 1 hour after feeding E. use a wide based nipple for feeding

A, B, D

Which of the following are clinical manifestations of hypertrophic pyloric stenosis? Select all A. projectile vomiting B. dry mucus membranes C. currant jelly stools D. sausage-shaped abdominal mass E. constant hunger

A, B, E

A nurse is caring for a child who has Meckel's diverticulum, what are manifestations. Select all A. abdominal pain B. fever C. mucus, bloody stools D. vomiting E. rapid, shallow breathing

A, C

The nurse is caring for an infant immediately after returning from having a pyloromyotomy. What actions would the nurse to perform in the immediate post-operative period? (Select all that apply.) A. Maintain the infant’s head in an elevated position. B. Keep the infant on his left side with the head slight elevated. C. Irrigate the nasogastric tube with sterile water. D. Provide oral care frequently until the infant begins drinking. E. Assure bowel sounds are present before feeding the infant. F. Weigh diapers after oral feedings have been started.

A, D, E

A new mother calls the clinic to report that her infant has experienced weight loss, projectile vomiting and a small/firm abdominal mas. Your instincts tell you that the infant is likely suffering from A. hirschsprung's disease B. pyloric stenosis C. appendicitis D. Chron's disease

B

A nurse is caring for a child who has Hirschsprung disease. Which of the following is an appropriate action for the nurse to take? A. encourage a high-fiber, low-protein and low-calorie diet B. prepare a family for surgery C. place a NG for decmpression D. initiate bedrest

B

The physician suspects tracheoesophageal fistula in a 1 day old neonate. Which nursing intervention is most appropriate for this child. A. avoiding suctioning unless cyanosis occurs B. elevating the neonate's head and giving nothing by mouth C. elevating the neonate's head for 1 hour after feedings D. giving the neonate only glucose water for the first 24 hours

B

What is the most appropriate way to provide a feeding to an infant with a cleft palate? A. use a short nipple bottle B. use an extended nipple bottle C. use enteral nutrition only D. offer thickened formula

B

A nurse is caring for an infant who is postoperative following cleft lip and palate repair. Which of the following is an appropriate action for the nurse to take? A. remove the packing in the mouth B. place the infant prone C. offer a pacifier with sucrose D. assess mouth with tongue blade

B -facilitates draining

A child has a nasogastric tube (NG) after surgery for acute appendicitis. What is the purpose of the tube? A. To maintain electrolyte balance B. To prevent spread of infection C. To prevent abdominal distention D. To maintain an accurate record of output

C

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis A. abdominal rigidity and pain on palpation B. rounded abdomen and hypoactive bowel sounds C. visible peristalsis and weight loss D. Distension of the lower abdomen and constipation

C

Which food should the nurse serve to a child with celiac disease? A. Macaroni and cheese B. A turkey sandwich C. Cottage cheese with peaches D. Spaghetti and meatballs

C

Which phrase contains a component of the teaching plan for an adolescent with Crohn's disease? A. Adjusting to chronic illness and preventing spread of illness to others B. Preventing spread of illness to others and nutritional guidance C. Coping with stress and adjusting to chronic illness D. Nutritional guidance and preventing constipation

C

Which should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia? A. Death usually occurs by 6 months of age. B. Prognosis for full recovery is excellent. C. Liver transplantation may be needed eventually. D. Children with surgical correction live normal lives.

C

You are giving education to the family of a child who recently was diagnosed with Celiac disease. You tell the parents to avoid feeding their child (select all) A. steamed veggies B. fresh fruits C. oatmeal D. bread E. Chicken F. almonds

C, D

A newborn child who is vomiting after feedings and has a "full looking belly", and coughing so most likely suffering from A. ulcerative colitis B. imperforate anus C. umbilical hernia D. Esophageal Atresia

D

distention of the lower abdomen and constipation is a sign of ________________

Hirschsprung Disease

The nurse would suspect the presence of a ___________ if pain, bilious vomiting, and other signs of bowel obstruction are present.

Volvulus

abdominal rigidity and pain on palpation is a sign of _______________

appendicitis

Celiac causes

damage to the intestinal villae (blunts them) -nutrients cannot be absorbed

Celiac disease is an _______________ disorder

immune

with a pyloric stenosis you still have bowel, its ______________ for food so bowel sounds are ____________active

looking, hyper