Gastrointestinal alterations.docx - Gastrointestinal...

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Gastrointestinal Alterations & Dysfunctions Colic (pg 100-103) Unexplained paroxysmal crying or fussing. Infants pull up arms and legs. May occur at the same time each day or night, usually during late afternoon or evening. Typically outgrow by 3-4 months. NOT LIFE THREATENING BUT VERY STRESSFUL ON CAREGIVER Unknown cause but several theories: Allergies, cow’s milk intolerance, maternal anxiety, familial stress, too rapid feeding or overfeeding. More common in “needy babies” Common characteristics: Loud continuous crying lasting several hours typically same time each day. Flushed face Pulls in legs and arms Appearance of being in pain Clenched fists Distended abdomen (sucking air while crying) Gassy Continues to gain weight. Family hx of asthma Irritability when put to bed and after feedings. MANAGEMENT HISTORY OF FOOD, ENVIRONMENT AND STIMULI ARE OF GREAT IMPORTANCE. Assessment to rule out other issues. (allergies, intussusception, otitis media) Fennel extract and sucrose solutions most effective. Probiotics- lactobacillus reuteri (not as effective) Provide rhythmic movements Reduce stimuli Provide tactile stimuli (soft blankets, cuddling) Alter feeding intake Breast feed. Swaddling swing WORRY ABOUT MOM. VERY STRESSFUL. PROVIDE SUPPORT AND EDUCATION.
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DIARRHEA (pg 897-900) Rapid emptying of the intestines resulting in impaired absorption of nutrients and water and electrolyte imbalance. Diarrhea occurs when there is excess fluid in the small intestines due to: Bacterial toxins Allergies, lactose intolerance, overfeeding, medications Organism that invade and destroy mucosal lining decreasing surface area Inflammation which decreases intestines ability to absorb fluids, electrolytes and nutrients. MALABSORPTION SYNDROME Increased motility, resulting in impaired absorption. MANIFESTATIONS Dry hot skin Cramps Nausea Vomiting Large volume of stools Foul smelling, light in color, loose to watery stool Urge to defecate Mushy or jelly like stool Bloody fecal matter, or dark in color stool Increased heart & respiratory rate Decreased tearing Fever DIAGNOSIS MOST CASES ARE SELF LIMITING AND TESTING IS NOT DONE TO FIND CAUSATIVE AGENT. Stool cultures- check for bacteria, parasites or ova Guaiac test- check for blood. Blood test – if an infectious agent is suspected X-ray to check for bowel anomalies- intussusception, obstructions MANAGEMENT Maintain/restore fluid & electrolyte balance (NEVER GIVE POTASSIUM BY IV PUSH) Prevent the spread of infection
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Prevent dehydration- primary issue in management. GIVING PLAIN WATER ALONE OR IN LARGE AMOUNTS CAN BE EXTREMELY DANGEROUS. DOES NOT CONTAIN ELECTROLYTES! Use oral rehydration solutions such as pedialyte.
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  • Fall '17
  • Julie Gwin

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