Peds Exam 2 GI/Renal Intussesception : part of intestine folds in as a telescope blocking food from passing through the digestive system, cause is idiopathic, age 6 mo-3 yrs Risk: children, bugs, family hx, abnormal intestinal formation at birth S&S: N&V, diarrhea, fever, lethargy, lump in abdomen, jelly stool DX: ultrasound, CT, X-ray, barium enema TX: IV fluids, NG tube, enema, bowel reduction surgery, laparoscopically Care: pain med, clear liquids, I&O, teach S&S, pull knees to chest, no over the counter meds Prognosis: may go away w/ out tx, excellent if dx early, long term may reoccur, normal diet after surgery Intestinal Malnutrition : caused by malnutrition of the intestines as they don’t form the way they’re supposed to causing them to settle/lay wrong in the abdomen, abnormal twisting, 1 st yr of life S&S: abd tenderness, vomiting, nausea, bloody stool, constipation, shock, sudden crying, lethargy, rapid HR/RR DX: blood tests, occult blood, CT, sigmoidoscopy, barium x ray TX: IV fluids, NG tube, surgery, colostomy Care: prevent inf, fluids to prevent dehydration, NG tube, supplements, long term probs with nutritional absorption, small freq meals, avoid fibrous foods, increase fluids **if bowel is necrotic = poor outcome Gastroschesis : intestinal protrusion out of belly button bc abd muscles don’t form correctly, intestines aren’t covered in protective sac- exposed to amniotic fluid leading to intestinal irritation causing them to shorten, twist, swell Risk: young mothers, alcohol & tobacco use during pregnancy S&S: malabsorption r/t in utero exposure to amniotic fluid, mucosal/muscular dysfunction, bowel obstruction, GERD DX: in utero/birth, ultrasound, visualize after birth TX: TPN, abx, temp control, fundoplication surgery Care: temp, I&O, surgical wound care, S&S of inf, ostomy care Long term: malabsorption probs- tx with high calorie, high fat diet, skin issues if kid has ostomy, breathing probs Omphalocele
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- Spring '17
- Gastroenterology, Trigraph, Ulcerative colitis, Bowel obstruction