Discuss the x-ray and endoscopic procedures listed.
Give an example of an infant who is diagnosed with “failure to thrive.” Discuss the pathophysiology regarding pruritus in relation to liver dysfunction.
What are nursing interventions for each topic listed?
Refer to Figure 28-2 on page 649.
What is the rationale for a colostomy?
Describe the symptom of projectile vomiting. Discuss the significance of an olive-shaped mass. Refer to Figure 28-3 on page 650.
Review Clinical Pathway 28-1 on pages 651-652.
What is the role of the villi in the intestines?
Refer to Figure 28-5 on page 653.
Discuss the barium enema and the nurse’s role in educating the parents about this procedure. Describe how anorectal manometry is performed.
Relate the signs and symptoms with the pathophysiology of this disease.
What is water intoxication?
Discuss the severity of this condition and the need for urgent medical treatment.
Currant jelly stools are the hallmark symptom of this condition.
What is the rationale for a barium enema as a treatment option for this condition?
Give examples of nursing interventions for a patient having surgical repair of a Meckel’s diverticulum.
Discuss the difference between inguinal versus umbilical hernias.
Define incarcerated and strangulated hernias.
Audience Response Question #1 Which acid-base imbalance is likely to develop secondary to diarrhea in a 6-month-old child? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis
Define sorbitol. How does sorbitol affect the GI system?
List some causes of gastroenteritis. Oral rehydrating solutions (ORS), such as Pedialyte, are used for infants in small, frequent feedings. Oral rehydrating therapy (ORT), can be accompanied by breastfeeding because of breast milk’s osmolarity, antimicrobial properties, and enzyme content. Contact and standard precautions should be followed to prevent the spread of the infection to others.
Give examples of some foods that contain these ingredients.
Give examples of improper feeding techniques.
Discuss and describe how to slowly introduce foods. Give an example of proper documentation of emesis. What other antiemetics might be administered?
Describe the pathophysiology of the symptom of apnea with gastroesophageal reflux.
Describe pH monitoring. What is the rationale for thickening feedings with cereal? Give examples of medications which may relax the pyloric sphincter.
Discuss the treatment of and nursing care for patients with diarrhea. Intestine rested by reducing intake of solid foods. ORS solutions, such as Pedialyte or Infalyte, in liquid or frozen form are given with gradual introduction of a soft, bland diet. Clear fluids, fruit juice (without pulp), gelatin, and carbonated drinks have a low electrolyte content and should be avoided. Caffeinated beverages act as a diuretic and worsen dehydration. Chicken broth is high in sodium and not advised. BRAT diet is not nutritionally sound enough to support growth and development.
Give an example of other disorders that could cause constipation. Why should enemas and laxatives not be used daily for constipation? Audience Response Question #2 A child is considered constipated if he or she does not have a bowel movement at least every 3 days. 1. True 2. False
Discuss Figure 28-9 on page 660.
Discuss surface area, metabolic rate, and heat production. Surface area of the infant is from 2 to 3 times greater than the adult.
Describe the signs and symptoms of dehydration in infants and children.
Isotonic dehydration: equal amounts of fluids and electrolytes have been lost Hypotonic dehydration: more electrolytes than fluid have been lost Hypertonic dehydration: More fluid than electrolytes have been lost Each form of dehydration is associated with different relative losses from intracellular fluid (ICF) and extracellular fluid (ECF). Each requires specific modifications of treatment.
Give an example of maintenance and deficit IV fluids.
Discuss areas in which edema might be present. Audience Response Question #2 What is an indication of overhydration of a 1-month-old infant on intravenous fluids? 1. Heart rate of 100 2. Lethargy 3. Bulging fontanel 4. Increased urine output
Discuss the rationale for IV therapy for overhydration. Why should tomato juice be avoided when a child is experiencing hypertonic dehydration? Discuss laboratory results the nurse should monitor for a child who is dehydrated.
Discuss Figure 28-10 on page 664.
Describe a situation of an infant who is diagnosed with failure to thrive and an impaired relationship with his or her mother. Describe some of the characteristics of developmental delay often seen in FTT: Apathy Hypotonia Stiff and unresponsive to cuddling What are some results of impaired mother and child relationship? Infants suffer from inability to establish a sense of trust in caregiver. Coping abilities are affected by lack of nurturing.
Discuss resources available for an infant with a diagnosis of failure to thrive.
Discuss Figure 28-10 on page 664.
Discuss the pathophysiology regarding abdominal edema, diarrhea, and skin infections. Protein is basis of melanin, a substance that provides color to hair. A white streak in the hair of the child is a sign of this protein malnutrition.
Describe rachitic rosary.
Give examples of foods which are rich in vitamin C. Audience Response Question #3 Complete the analogy. Rickets : vitamin D as scurvy : ________. 1. vitamin C 2. iron 3. vitamin K 4. vitamin B 6
Describe McBurney’s point and rebound tenderness.
What is the importance of the swish and swallow technique when administering nystatin? What are the physical manifestations of thrush? White patches that resemble milk curds appear on tongue, inner lips, gums, and oral mucosa Painless but cannot be wiped away Audience Response Question #4 Thrush is caused primarily by improperly cleaned baby bottles. 1. True 2. False
What is the Scotch tape test? Describe the pathophysiology regarding a chronic cough for the child with roundworms.
Discuss how to access the poison control center in your community.
Give examples of household products that could contain these poisons.
Discuss the rationale for not administering ipecac syrup. Discuss why charcoal or lavage is not effective after 1 hour following ingestion.
Discuss poisonous plants that are common in your climate.
How can a parent ensure these potentially harmful products are out of reach of children?
Discuss the issue of increased incidence in inner-city areas.
If an object is small enough to pass through a standard, cardboard roll of toilet paper, children should not be allowed to play with it.
Chapter 28 Power Point
Chapter 28Chapter 28
The Child with a GastrointestinalThe Child with a Gastrointestinal