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AC 4
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
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
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
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
3 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
2 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
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
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
Proton Pump Inhibitors (PPIs)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Inhibit H+/K+/ATPase
Side Effects
Hip fracture
Pneumonia
2 mins
H2 Receptor Blocker
"-tidine" Suffix
Indications
Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer
Mechanism
Block Histamine H2 Receptors
Parietal Cells
52 secs
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
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
2 mins
Ulcerative Colitis Characteristics
Autoimmune
Mucosal and Submucosal Only
Rectal Involvement
Stepwise Lesions
Friable Pseudopolyp
Crypt Abscess
Loss of Haustra
Lead Pipe Appearance
Bloody Diarrhea
2 mins
Ulcerative Colitis Assessment
Assessment
Cramping Abdominal Pain
Tenesmus
Bloody Diarrhea
Up to 10-20 / Day
Fever
Complications
Hemorrhage
1 min
Crohn's Disease Characteristics
Terminal Ileum and Colon
Rectal Sparing
Transmural Inflammation
Granulomas
Skip Lesions
Cobblestone Mucosa
Fissures
Fistulas
Perianal Disease
Creeping Fat
Lymphoid Aggregates
String Sign on Barium Swallow
2 mins
Crohn's Symptoms and Associations
Diarrhea
Malabsorption
Bile-Wasting
Pigment Gallstones
Oxalate Kidney Stones
Ankylosing Spondylitis
Erythema Nodosum
Uveitis
Migratory Polyarthritis
2 mins
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
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
Cataract
Mechanism
Age-related
Assessment
No Pain
Cloudy Opaque Lens
Decreased Visual Acuity
Occurs Gradually
Treatment
Surgery
1 min
Primary Open-Angle Glaucoma (POAG - Chronic)
Mechanism
Flow of Aqueous Humor Slowed
Signs and Symptoms
Slow Onset
No Pain
Tunnel Vision
IOP 22-32mm Hg
Considerations
Drug Therapy
1 min
Age-Related Macular Degeneration (AMD)
Mechanism
Dry (nonexudative)
Wet (exudative)
Signs and Symptoms
Scotomas
Blurred, Darkened Vision
Loss of Central Vision
Distortion of Vision
Considerations
Drug Therapy
Surgery
Low-vision Assistive Devices
2 mins
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