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Terms in this set (49)A nurse is caring for an infant who is postoperative following cleft lip and palate repair. Which of the following actions should the nurse take? Place the infant in an upright position. upright
positon A nurse is caring for a child who has Meckel diverticulum. Which of the following manifestations should the nurse expect? (3) Rapid, shallow, breathing. abd pain vomiting Currant jelly-like stools A nurse is teaching a parent of an infant about gastrointestinal reflux disease. Which of the following should the nurse include in the teaching? Position baby upright after feedings. Use a wide-based nipple for feedings. Use a bottle with a one-way valve. Thicken formula with rice cereal. Offer frequent feedings. Position baby upright after feedings. Thicken formula with rice cereal. Offer frequent feedings Meconium is usually passed between 24-36 hours after birth. Does lack of meconium confirm that the GI tract is not patent? this could indicate what possible problems? Yes hirschprungs Infants stomach lies _____ which is why they have a small stomach capacity, need frequent feedings, and should be sat upright during and after feedings. horizontally In infant, peristalsis is (increased/decreased)? increased; Infants have enzymes in their tummy to help break down food but they depend on a specific pH to work properly which is more alkaline, less acidic *Most common cause of serious diarrhea in children <5 years and diarrhea-associated hospitalization rotavirus Most common parasitic infection in U.S. Eggs are _______ or ingested pinworm inhaled (eggs float in air!) intervention for mild & moderate dehydration? Severe? any kind of oral liquid, pedialyte or breast milk IVF Taking _____ decreases chance of getting cleft lip/pallet folic acid You are going to check baby's hard and soft palates to see if it is cleft or not. How do you proceed? palpate it w/ gloved hand Baby has cleft lip and palate, how will this problem be resolved? surgical closure CP repair usually occurs between 6-12 months. Why is timing important for the fix, not too early & not too late? too early may restrict growth of the skull too late, after baby has began talking, may impair their speech fine line with/in 6-12 mos. What is an important piece of education to give babys parents about feeding after surgery? nothing should go into mouth, so no bottle, spoons feed with open cup Besides surgery for cleft lip/palate, what are your nursing priorities? maintain airway adequate nutrition You are going to feed baby with cleft lip/pallate, what 3 considerations will you take into account? -position upright Babys with cleft lip/pallate have problems maintaining suction for adequate intake. How should a baby with a cleft lip be fed? Cleft palate?
baby with cleft lip can make suction with breast or nipples that are like breasts (Nuk nipple) cleft palate Long term mgmt of cleft lip/palate includes interventions that address common comorbidities of this problem which include ear infections In Hirschsprung Disease BM is altered because there is a lack of ganglionic cells that make rectum and anus narrow, thus fecal matter is backed up in colon, making it distended Parents come in bc their baby is having bilious vomiting. You go through your assessment and guess they may have Hirschsprung Disease. What other assessment findings besides bilious vomiting leads you to Hirschsprung? FTT BM: Baby has suspected Hirschsprung Disease, what diagnostics tests are you going to look out for to validate this? barium enema w/ xray rectal biopsy to check for absence of ganglion cells Baby has been dx with Hirschsprung Disease. How will this DO be fixed? surgery to remove aganglionic portion of bowel What education can you give to babys parents who is going into surgery for Hirschsprung Disease about what to expect post op? baby may have temporary colostomy if surgery will be done in 2 stages if only 1 stage, no colostomy bag Baby came in with mom bc baby is vomiting blood (hematemesis), is refusing feedings, and poop has changed to a very dark color (melena). You do your assessment and see baby looks like it is FTT and has some respiratory symptoms. Does baby have GER or GERD? GERD Baby came in with mom for intermittent vomiting. Baby has passive regurgitation, is hungry, and irritable. Does baby have GER or GERD? GER Mom of baby recently dx with GER asks what may have predisposed baby to this, you respond immature GI tract: feeding: positioning: Gold standard dx evaluation of Ger/Gerd? 24-hour intraesophageal pH monitoring study looking at es Mom of baby with GER/GERD asks what she can do to prevent DO, you respond diet: -keep baby upright meds: Parent brings in child c/o colicky, cramping pain around umbilicus that just started today. You look into it more b/c this is an early sign of appendicitis McBurney's point tenderness is described as and is correlated with what problem? right lower quadrant pain appendicitis Child with Meckel Diverticulum will be undergoing surgery, but first, if needed, you need to correct hypovolemic shock r/t hemorrhage Hypertrophic Pyloric Stenosis is the narrowing of pyloric sphincter Mom brings baby in for projectile vomiting shortly after feeding and wants to feed again right after, super hungry. You do assessment and you see visible peristalsis on babys abd and an olive shaped mass. Also, baby has dry mucous membranes. What does baby have? Hypertrophic Pyloric Stenosis (HPS) Management of Hypertrophic Pyloric Stenosis (HPS) is a Pyloromyotomy (loosen narrowed pylorus), what post op education will be given to parents about introduction of feedings? (study guide) will be put on IVF then A nurse is assessing an infant who has hypertrophic pyloric stenosis. Which of the following findings should the nurse expect? (3) Dry mucus membranes Dry mucus
membranes This problem is characterized as one portion of the bowel slides into the next, much like the pieces of a telescope. Intussusception Intusspetion is occasionally r/t what other GI problem that manifests lesions? Meckel diverticulum This disorder is characterized by a *sudden onset of crampy abdominal pain. intussesception A baby comes in with bilious vomiting, currant jelly-like stools, crampy abd pain, and a *sausage shaped and mass. These are manifestations of Intussusception *sausage shaped and mass Baby has Intussusception, what interventions are you planning to carry out? air or saline enema Baby who has Intussusception is ordered to have surgery, what event would make the surgery unecessary? if baby has normal BM, bc this can resolve on own This disease is characterized by an absence of ganglion cells. Hirschsprung dz This is a characteristic of Hirschsprung's Disease. ribbon like stools This is the primary method of nutrition for SBS following surgery. TPN A nurse is caring for a child who has Hirschsprung's Disease. Which of the following actions should the nurse take? Initiate bed rest.
Prepare the family for surgery. Surgery is required to remove the defective segment of intestine. This disease is a typical cause of Short Bowel Syndrome (SBS). necrotizing enterocolitis (The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel) 1. Baby is post op from surgery to correct Short Bowel Syndrome, they are initially put on TPN and the second phase of feeding includes _______. 2. Oral feedings should be attempted if enteral feedings are tolerated. Why is this important and what can happen if either is delayed for too long following surgery? enteral feedings oral aversion- baby doesnt want to eat orally Why are children with SBS prone to nutritional deficiencies and diarrhea once parenteral nutrition is discontinued? shortened bowel = Sets with similar terms
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Which feeding practices should be used for the infant with a cleft lip or palate quizlet?Most babies born with a cleft lip (and no cleft palate) feed well without any special equipment. They usually can breastfeed or use a regular bottle-feeding system. The only change needed might be positioning the nipple so the baby can latch.
Which of the following is the proper technique used to feed an infant with cleft lip quizlet?Use a specialized cleft palate bottle as demonstrated by your baby's medical team. Place your baby in an upright, sitting position to prevent the formula from flowing back into the nose area. Keep the bottle tilted so the nipple is always filled with milk and pointed down away from the cleft.
Which postoperative goal is most important following surgical repair of a cleft lip and palate quizlet?The goal after surgery is to protect the new repair and stitches. For this reason there will be some changes in the child's feeding, positioning, and activity for a short time. Remember, these are only temporary! Infants will not be able to suck on a nipple/bottle or pacifier for 10 days after surgery.
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A nurse is caring for a 2 month old infant who is postoperative following repair of a cleft lip
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