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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed.
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Chapter 31. Gastrointestinal Problems

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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. | Practical Nurse (LPN) School Study Aid

Chapter 31. Gastrointestinal Problems
19 Picmonics to Learn | 35 mins
Cleft Lip or Palate Interventions
Considerations
Encourage Bonding
Prosthodontic Device
Modified Nipple
Burping
Surgical Repair
Normal Saline Rinse
Elbow Restraints
Avoid Rigid Eating Utensils
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2 mins
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
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2 mins
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Assessment
Mechanism
Hypertrophied Pylorus
Risk Factor
Macrolide Use
Assessment
3-6 Weeks of Age
Projectile Vomiting After Feeding
No Pain or Discomfort
Weight Loss
Dehydration
Hungry Baby
Olive Mass
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Interventions
Treatment
Pyloromyotomy
Preoperative Care
Stabilize Fluid and Electrolyte Balance
Nasogastric Tube
Monitor Feeding
Postoperative Care
Start Formula or Breastfeeding Within 24 Hours
Feedings Every 4-6 hours
Full Feeding Within 2 days
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2 mins
Celiac Disease
Cause
Intestinal Mucosa Damage
Ingestion Wheat, Barley, Rye
Assessment
GI Distress
Steatorrhea
Weight Loss
Dermatitis Herpetiformis
Interventions
Gluten-free Diet
Considerations
Screening
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2 mins
Appendicitis Assessment
Mechanism
Obstruction of Appendix
Signs and Symptoms
Periumbilical Pain
RLQ Pain
Nausea/Vomiting/Anorexia
Increased White Blood Cells
Rebound Tenderness
Fever
Complications
Peritonitis
Sepsis
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2 mins
Appendicitis Interventions
Treatment
Appendectomy
Preoperative Care
Antibiotics
IV Fluids
No Enema or Laxative
Postoperative Care
Semi-Fowler's Position
Nasogastric Tube
Diet as Tolerated
Pain Management
Early Ambulation
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2 mins
Hirschsprung's Disease
Mechanism
Congenital Aganglionic Megacolon
No Peristalsis
Assessment
No Meconium Within 24 Hours
Refusal to Feed
Abdominal Distention
No Stool on Rectal Exam
Forceful Expulsion of Fecal Material After Exam
Interventions
Surgical Resection
Colostomy
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2 mins
Intussusception
Pathophysiology
Telescoping of Bowel Segments
Lead Point
Assessment
Episodic Abdominal Pain
Diarrhea
Sausage-Shaped Mass
Red Currant Jelly Stools
Diagnosis
Ultrasound/CT
Target Sign
Considerations
More Common in Children
Rotavirus Vaccine Contraindicated
Management
Air or Hydrostatic Enema
Surgical Reduction
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3 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
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1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
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1 min
Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
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2 mins
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
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2 mins
Imperforate Anus
Mechanism
Congenital Anorectal Malformation
Signs and Symptoms
No Anal Opening
Absence of Meconium
Gradual Increase in Abdominal Distention
Considerations
Surgical Repair
Bowel Management
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2 mins
Hepatitis A
Characteristics
Picornavirus
4 Week Incubation Period
Fecal-oral
Day Care Centers
Travel to Developing Countries
Signs and Symptoms
Usually Asymptomatic
Acute Disease
Jaundice
Fever
Vomiting
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2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
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2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Pinworm (Enterobius Vermicularis)
Pathophysiology
Nematode (Roundworm)
Ingestion of Eggs
Intestinal Infection
Anal Pruritus
Diagnosis
Scotch Tape Test
Treatment
Albendazole
Pyrantel Pamoate
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2 mins

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