Ch 22 part 2

•The nurse is reviewing the health record of an infant with a diagnosis of gastroesophageal reflux. Which signs/symptoms of this disorder should the nurse expect to note documented in the record? •1. Excessive oral secretions •2. Bowel sounds heard over the chest •3. Hiccupping and spitting up after a meal •4. Coughing, wheezing, and short periods of apnea

3

what is the difference between GER and GERD?

GER: is temporary, the child usually grows out of it GERD: is a disease that is causing complications

what is a complication of Nissen fundoplication?

breakdown of wrap small bowel obstruction gas- bloat syndrome infection retching dumping syndrome ​

what are some complications of GERD? see pg 707

esophagitis esophageal stricture aspiration of gastric contents that cause resp problems upper GI bleeding Dysphagia FTT

what confirms a UTI in a urinalisis?

pretense of nitrites in the urine because most species of bacteria convert nitrates to nitrites

when a infant has GER, and the mother is breastfeeding it, who should avoid foods that exacerbate GER, the baby or the mother?

the mother

if the pt has GER and is being fed via NGT or OGT , in what position should the child be during feedings?

upright positioning

Interventions for GER

•Avoid offending foods -Small frequent meals •H2 receptor antagonist 30 before eating •Thickening feedings with rise serial or formula -NG tube or OG tube •Encourage breastfeeding •Thickening formula •Avoid Vigorous play after feeding

what foods should be avoided when the child has GER?

•Citrus, caffeine, spicy

what is the intervention for worst case scenario (i.e pt is at high risk of aspiration or has aspirated already) in a case with GER?

•Surgical intervention—Nissen fundoplication that tightens the esophageal sphincter, done as early as infancy

some children with GER experience

•Weight loss in some cases