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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers Nursing (RN) School Study Aid


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25 - The Child with Gastrointestinal Dysfunction
31 Picmonics to Learn | 54 mins

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Stomach Digestion
Characteristics
Chief Cells Secrete Pepsinogen
Pepsinogen Turned to Pepsin By H+
Protein Breakdown Begins
Mucous Cells Secrete Mucus and Bicarbonate
G Cells Secrete Gastrin
Gastrin Stimulates Parietal Cell HCl Release
Parietal Cells Secrete Intrinsic Factor
1 min
GI Absorption
Stomach
Alcohol
Duodenum
Iron
Jejunum
Folate
Terminal Ileum
Vitamin B12
Bile Resorption
1 min
Small Intestine Digestion
Brush border enzymes
Pancreatic Enzymes are secreted via a Duct
Pancreas secretes bicarbonate
Brush Border activates Pancreatic Trypsin
Trypsin activates Chymotrypsin
Trypsin and Chymotrypsin digest Proteins
Gallbladder Releases Bile
Pancreatic Lipase breaks down Lipids
Goblet cells secrete mucus
Pancreatic Amylase breaks down Carbohydrates
Pancreatic Nucleases breakdown DNA/RNA
Digestion occurs in the Duodenum
1 min
Small Intestine Absorption
Characteristics
Carbohydrates Undergo Active Transport
Amino Acids Undergo Active Transport
Small Lipids Undergo Passive Diffusion
Epithelial Cells
Intestinal Capillaries
Hepatic Portal Transports Nutrients
Liver
Large Lipids Transported as Chylomicrons
Lacteals Transport Chylomicrons
1 min
Large Intestine
Characteristics
Colon
Electrolyte Reabsorption
Water Reabsorption
Microflora Produce Vitamins
Rectum Stores Feces
1 min
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
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
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
1 min
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)
1 min
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
1 min
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
1 min
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
2 mins
Ulcerative Colitis Assessment
Assessment
Cramping Abdominal Pain
Tenesmus
Bloody Diarrhea
Up to 10-20 / Day
Fever
Complications
Hemorrhage
1 min
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
1 min
Colorectal Cancer Interventions
Interventions
Surgical Colon Resection
Radiation
Chemotherapy
Considerations
Bowel Cleansing
Screening
Colostomy
Dietary Consult
Body Image
2 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
2 mins
Cimetidine and Ranitidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
1 min
Omeprazole (Prilosec)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Proton Pump Inhibitor (PPI)
Inhibit H+/K+/ATPase
Side Effects
Hip Fracture
Pneumonia
1 min
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
Intestinal Obstruction
Partial/Early Obstruction
Severe Abdominal Pain
Vomiting
High Pitched Bowel Sounds
Abdominal Distention
Increased Peristalsis
Total/Neurogenic Obstruction
Absent Bowel Sounds
Paralytic Ileus
1 min
Types of Intestinal Obstruction
Mechanical
Adhesions
Hernia
Volvulus
Intussusception
Tumor
Non-Mechanical
Mesenteric Artery Occlusion
Spinal Injury
Paralytic Ileus
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
1 min
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
1 min
Intussusception
Assessment
Episodic Abdominal Pain
Diarrhea
Sausage-Shaped Mass
Red Currant Jelly Stools
Considerations
Air or Hydrostatic Enema
Surgical Reduction
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
2 mins
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
1 min
Hepatitis A (HAV) Assessment
Transmission
Fecal-Oral
Ingestion of Contaminated Food or Water
Incubation
4 Weeks
Assessment
Fever
General Malaise
Hepatomegaly
Considerations
Self-Limiting
Proper Hand Washing
1 min
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
IV Drug Abusers
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
1 min
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
1 min
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min

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