This document discusses disorders of the digestive system, including congenital disorders like cleft lip and pyloric stenosis, infectious disorders like appendicitis and peptic ulcers, and motility disorders like constipation. It describes diarrhea, including causes, symptoms, treatment, and risks of dehydration. Treatment for diarrhea includes oral rehydration therapy. For severe dehydration intravenous fluids may be needed. The document outlines assessment and nursing care for a child with gastrointestinal disorders or dehydration. It emphasizes teaching the family about signs of dehydration and how to manage diarrhea at home.

1. 2022-2021
University of Al-Qadisiyah
College of Nursing
Third Stage 7th lecture

2. Disorders that affect the digestive (gastrointestinal) system are called digestive
disorders. Some disorders simultaneously affect several parts of the digestive
system. The digestive system is responsible for breaking down food we eat into
smaller components so that nutrients can be easily absorbed by the body and the
waste discarded.
Several body parts, including the mouth, esophagus, stomach, small intestine,
large intestine, and anus, make up the digestive (gastrointestinal) tract. The
digestive process begins when food enters .

4. A-Congenital and structure disorders
Cleft lip and Palate.
-Esophageal Atresia & Tracheoesophageal
Fistula.
-Pyloric Stenosis.
-Intussusceptions.
-Hirschsprung’s Disease.
-Hernias.
Imperforated anus.

5. B-Infection and inflammatory Disorders:
Appendicitis.
Peptic Ulcer.
Diarrhea.
Gastritis.
Stomatitis.
C-Disorders of Motility:
-Constipation .
D- Allergic and Malabsorption disorders :
-Celiac Disease.

6. Enteritis: inflammation of the intestines and especially of the human ileum.
Gastroenteritis: means inflammation or irritation of the stomach and
intestines. is a very common and infectious illness involving vomiting and
diarrhea.
Oral rehydration therapy (ORT): The administration of special fluids by
mouth or by adding fluid and electrolytes directly into the blood stream.
Oral rehydration solution (ORS): a liquid specially formulated to be given
as a drink to correct the water, mineral, and nutritional deficiencies in an
individual, especially an infant, who is affected by dehydration.
Stomatitis :is inflammation of the mouth and lips.

7. Is defined either as watery stool or increased frequency (or
both) when compared to a normal amount. It is a common
problem that may last a few days and disappear on its
own.

8. • Acute (short-term, usually lasting less several days), which is
usually related to bacterial or viral infections.
• Chronic (long-term, lasting longer than four weeks), which is
usually related to functional disorders, such as irritable bowel
syndrome, or may be due to diseases such as ulcerative colitis,
Crohn's disease, celiac sprue, or Giardia.
• Bloody diarrhea (dysentery ).

9. Examples
Causes
Viral (Rotavirus), bacterial ( E. coli, Vibrio
cholera),fungal overgrowth ,parasites( Giardia )
Intestinal infection
Gluten ,cow's milk
Food sensitivity
Overfeeding ,introduction of new foods
Food intolerance
Iron ,antibiotics
medications
Ulcerative colitis ,cancer
Colon disease
Short bowel syndrome,
Surgical alteration
Anxiety ,fatigue
Emotional stress

10. 1. Cramping.
2. Abdominal pain.
3. Bloating.
4. Nausea.
5. Urgent need to use the restroom.
6. Fever.
7. Bloody stools.
8. Dehydration.

11. Warning Signs of Severe Diarrhea
• Abdominal pain.
• Blood in the stool.
• Frequent vomiting.
• Loss of appetite.
• High fever.
• Dry, sticky mouth.

12. • Weight loss.
• Urinates less frequently (wets fewer than 6 diapers per day).
• Frequent diarrhea.
• Extreme thirst.
• No tears when crying.
• Depressed fontanel (soft spot) on infant's head.

13. Throw up stomach contents: to expel the contents of the
stomach through the mouth as a result of a series of
involuntary spasms of the stomach muscles.
Types Of Vomiting:
1- Reflexive = infection or allergy
2- Central = central nervous system (projectile): head
trauma ,meningitis and brain tumor.

14. • Improper feeding technique.
• Infections (respiratory tract ,meningitis ).
• Food allergy and dietary protein intolerance.
• Intestinal obstruction (pyloric stenosis
intussusceptions.
• ICP.

15. • Moderately dehydrated: observe for 4–6 hours to ensure adequate
rehydration.
• Severely dehydrated or in shock: intravenous fluids are required.
• At high risk of dehydration: < 6 months old, high frequency of
watery stools or vomits, minimal oral intake, worsening
symptoms.
• At high risk of complications: children with significant underlying
disease (e.g., diabetes, renal failure), high fever, poor nutrition.
• Suspected of having another diagnosis (eg, appendicitis,
intussusceptions).

16. • Note: Children should also be admitted if the parent or care
giver is unable to manage the child at home.

17. Treatment of diarrhea depend on the cause. Treatment
usually involves replacing lost fluids. Antibiotics may be
prescribed when bacterial infections are the cause.

18. Is a loss of body fluids, which are made up of water and salts. When sick
children vomit or have diarrhea, they can lose large amounts of salts and
water from their bodies, and can become dehydrated very quickly.
dehydration can be very dangerous, especially for babies and toddlers.
Children can even die if they are not treated.

19. Isotonic : Water and salt are lost in equal amounts.
Hypotonic (hyponatremic): Electrolyte deficit exceeds water deficit.
Hypertonic (hypernatremic): Water loss exceeds electrolyte loss.
Severity of Dehydration:
Mild
Moderate (some)
Severe

20. Decreased urination (less than four wet diapers in 24 h).
no tears.
dry skin, mouth and tongue.
sunken eyes.
grayish skin.
sunken soft spot (fontanel) on infant’s head.

22. They are exact mixtures of water, salts, and sugar.
These solutions can be absorbed by the body,
even when infection is causing the child to vomit.

23. Severe
Moderate
cold, cyanotic extremities, drowsy
Lethargic or thirsty
General appearance
Feeble , impalpable, weak
rapid
Radial pulse
Deep and rapid
Deep
Respiration
Pinch retracts very slowly (>2 sec)
Pinch retracts slowly
Skin elasticity
Very sunken
Sunken
Anterior fontanel
Very sunken
Sunken
Eyes
Absent
Reduced, Absent
Tears
Very dry
Dry
Mucous membranes
None passed ,oliguria
Reduced
Urine output
Loss of body weight: > 10%
5%–10%
body weight

24. 1- give extra fluid more than usually to prevent dehydration such as
ORT.
2- increase breast feeding.
3- If the not breast feeding give ORT (50 ml/kg) in 4 hr. or food
based fluid (such as soup, rice water).
4- The mother should know how prepare and how much ORS give
for her child.
5- Take child to hospital when: the signs and symptoms of sever
dehydration appear.

25. 1-Extra fluid.
2-Contiuous feeding.
3-ORS (100 ml/kg) in 4 hr.
4- Take child to hospital when: the signs and symptoms of sever
dehydration appear.
Treatment Of Severe Dehydration:
1- Intravenous fluid will be given.
2- The child need to stay in hospital until the dehydration is
controlled.
3- Reassess the child every 1-2 hr.

26. Constipation is an abnormal pattern of bowel movements that
causes a person to pass stools less often than usual. The stools may
be difficult to pass or harder than usual.

27. Not drinking enough fluids and not having enough fiber from whole grains or
cereals, fruits and vegetables.
Eating too much junk food or other foods that promote constipation.
Withholding stools to avoid painful bowel movements if there are small tears
(fissures) at the bowel opening (anus)
Genetics: some children inherit a tendency toward constipation from their
parents

28. • Poor bowel routines, problems with toilet training.
• Illnesses that cause vomiting, diarrhea or fever and lead to a
loss of body fluids and dehydration and some medicines such
as morphine.
• Underactive thyroid gland (hypothyroidism).
• Hirschsprung's disease, a disease of the bowel that is usually
diagnosed in the first few weeks of life.

29. 1. Increase fluid intake.
2. Laxative fluids e.g. orange juice relives mild constipation.
3. Small soapy enema may be given.
4. Milk of magnesia may be used as a temporary measure.
5. Establish or maintain regular bowel action by nature means
rather than using purgatives.
6. Psychological support to express his fear and his own emotional
reactions.

30. Key points for Constipation
1. Constipation means bowel movements that are less frequent than usual, painful or
hard to pass.
2. Constipation can be caused by inadequate fiber in the diet, poor bowel routines,
fissures in the anus, medicines, and genetics or not drinking enough fluids.
3. Family bowel patterns may play an important role.
4. Changes in your child's diet may stop constipation.
5. See your doctor if your child has blood in their stool
loses control over bowel movements or has a fever.

31. A-Nurse and child
1.frequent monitor intake and output .
2.Monitor vital signs every 2-4 hr.
3.Observe and record the stool or vomiting contain (amount
,color ,consistency ,odor and frequency ).
4.Wash hand before and after contact with the child.
5.Give special care hygiene for child skin ,mouth).

32. 6. Daily measure body weight
7. Determine the causes of G.E.
8. Asses the level of consciousness
9. Provide and maintain fluid and electrolyte (ORT or I.V. fluid)
10.Promote child at rest and comfort.
11.When child become better a normal diet
for the child's age is slowly reintroduced.

33. 1. Teach family to seek care when child's vomiting or diarrhea
worsens.
2. Teach family the signs and symptoms of severe dehydration.
3. Encourage family to keep appropriate fluid at home to deal with
mild dehydration .
4. Teach family how prepare ors.
5. Encourage mother to continuous breast feeding in mild or
moderate dehydration.
6. Teach family to when child become better
a normal diet for the child's age is slowly reintroduced.