Pediatric GI Disorders.docx

Pediatric GI Disorders.docx - NUR 323 Professional Nursing...

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NUR 323 Professional Nursing II Study Guide for 1/18/19 Pediatric Ingestion Readings from Hockenberry, et al: Failure to Thrive: 856-858, GE Reflux: 1185-1187, Pyloric Stenosis: 1213-1215, Gastroenteritis: 1172-1176, Celiac Disease: 1218-1219. Failure to Thrive (FTT) 856-858 Also known as growth failure and is a sign of inadequate growth from an inability to utilize or obtain calories for adequate growth Pathophysiology A. Inadequate calories : incorrect formula preparation, neglect, food fads, excessive juice consumption, lack of food, breastfeeding problems, behavioral problems affecting eating, central nervous system problems affecting intake o Inadequate Calories – Could be putting in too much water o Neglect – Not feeding the baby enough o Excessive Juice – Babies in their first year of life shouldn’t have juice o Breast feeding issues – Baby might not be latching o Behavioral Problems – Some children cannot sit still when eating B. Inadequate absorption : food allergy, malabsorption, pyloric stenosis, GI atresia, inborn errors of metabolism o Food Allergies – Gluten intolerance o Malabsorption – unable to absorb correctly o GI Atresia – abnormal formation of the GI tract C. Excessive calorie expenditure : linked to other disorders - hyperthyroidism, malignancy, congenital heart disease, chronic pulmonary disease, or chronic immunodeficiency Infants who are born prematurely or low or very low birth weight infants often referred for FTT Premature babies usually take 2 years in order to catch up to a normal increase in weight Other factors leading to inadequate caloric intake: poverty, health or childrearing beliefs such as fad diets, child neglect, inadequate knowledge, family stress, feeding resistance, and insufficient breastmilk ingestion. Breastfeeding problems of infants less than 8 weeks are usually related to difficulties with latch and sucking or swallowing problems. Ankyloglossia (tongue tie) is a problem associated with feeding difficulties. (NOT GOING TO ASK ABOUT THIS)
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Diagnosis of Failure to Thrive Evidence of growth failure if recent only weight affected, chronic malnutrition reduction in height and weight o Charts are usually according to weight and stature o Normal average is around 7lbs Physical assessment (apathy, withdrawn behavior, minimal smiling, stiff and unyielding, or flaccid and unresponsive, wide-eyed gaze and continual scan of the environment, avoidance of eye contact, undernutrition, no fear of strangers, feeding or eating disorders, vomiting, anorexia pica, rumination, feeding resistance) o Anorexia Pica – ingesting non-food substances Developmental assessment (delays in social, motor, adaptive, language) Family assessment o See who is with the baby all day Dietary assessment o Want to know what they are eating Activity level o Want to know when the child sleeps and when they get up Food allergies o Is anyone else in the family allergic to something Dietary restrictions o Cultural limitations
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  • Spring '14
  • DianeM.Tomasic
  • Gastroesophageal reflux disease, Vomiting, Pyloric stenosis

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