UNFOLDING REASONING CASE
STUDY PEDIATRIC
GASTROENTERITIS GUIDE WITH
DETAILED EXPLANATIONS
◉ GI Case Study 1: Assessment. Answer: Weight 4.3 kg - Weight a
month ago was 4.8 kg
Vital Signs:
Temp: 37.5 C ax
HR: 100 RRR s Murmur
RR: 16
BP: 74/P
Skin: Pale pink, cool and dry. Skin Turgor: Loose, some mottling
noted when infant cries
Capillary Refill: > 2 secs
Anterior Fontanel: Sunken
L.O.C.: Listless, requires a fair amount of stimulation to evoke a
response
,Lab Values:
Serum Electrolytes: Na+ 130, K+ 3.0, Cl- 92, CO2 31
Arterial Blood Gases: pH 7.50, pO2 50, pCO2 50, HCO3 45 meq/L
Urine Specific Gravity: 1.30
Blood Urea Nitrogen 15 mg/dl
◉ GI Case Study 1: What is this infant's medical diagnosis?. Answer:
Pyloric Stenosis
◉ GI Case Study 1: How much weight has this child lost and what
degree of dehydration is he exhibiting.. Answer: 4800 gms - 4300
gms = 500 gms ÷ 4.8 Kgs = 104 gms/mls per Kg
Severe Dehydration
◉ GI Case Study 1: What are the priority nursing diagnoses?.
Answer: Fluid Volume Deficit
Acid-Base Imbalance
◉ GI Case Study 1: What interventions does the nurse implement in
the preoperative period?. Answer: NPO Initiate IV - Replace Fluid
◉ GI Case Study 1: What interventions does the nurse implement in
the postoperative period?. Answer: Assess Vital Signs
, Check op Site
Initiate feedings slowly - Start with glucose water or Pedialyte
◉ GI Case Study 2. Answer: A 1 day-old infant in the special care
nursery is noted to have abdominal distention and has not passed
any meconium. The baby is refusing to nipple and has vomited what
little
formula the nurses were able to get her to nipple.
The physician noted upon his physical exam that the infant's internal
anal sphincter is tight.
◉ GI Case Study 2: What is this infant's medical diagnosis?. Answer:
Hirschsprungs
◉ GI Case Study 2: What are the priority nursing diagnoses?.
Answer: PC: Fluid Volume Deficit
Alteration in Elimination r/t inability to pass meconium
◉ GI Case Study 2: What interventions does the nurse implement
preoperatively. Answer: Place NPO
Initiate IV
Assess for abdominal distention
Prepare parents for possible colostomy
STUDY PEDIATRIC
GASTROENTERITIS GUIDE WITH
DETAILED EXPLANATIONS
◉ GI Case Study 1: Assessment. Answer: Weight 4.3 kg - Weight a
month ago was 4.8 kg
Vital Signs:
Temp: 37.5 C ax
HR: 100 RRR s Murmur
RR: 16
BP: 74/P
Skin: Pale pink, cool and dry. Skin Turgor: Loose, some mottling
noted when infant cries
Capillary Refill: > 2 secs
Anterior Fontanel: Sunken
L.O.C.: Listless, requires a fair amount of stimulation to evoke a
response
,Lab Values:
Serum Electrolytes: Na+ 130, K+ 3.0, Cl- 92, CO2 31
Arterial Blood Gases: pH 7.50, pO2 50, pCO2 50, HCO3 45 meq/L
Urine Specific Gravity: 1.30
Blood Urea Nitrogen 15 mg/dl
◉ GI Case Study 1: What is this infant's medical diagnosis?. Answer:
Pyloric Stenosis
◉ GI Case Study 1: How much weight has this child lost and what
degree of dehydration is he exhibiting.. Answer: 4800 gms - 4300
gms = 500 gms ÷ 4.8 Kgs = 104 gms/mls per Kg
Severe Dehydration
◉ GI Case Study 1: What are the priority nursing diagnoses?.
Answer: Fluid Volume Deficit
Acid-Base Imbalance
◉ GI Case Study 1: What interventions does the nurse implement in
the preoperative period?. Answer: NPO Initiate IV - Replace Fluid
◉ GI Case Study 1: What interventions does the nurse implement in
the postoperative period?. Answer: Assess Vital Signs
, Check op Site
Initiate feedings slowly - Start with glucose water or Pedialyte
◉ GI Case Study 2. Answer: A 1 day-old infant in the special care
nursery is noted to have abdominal distention and has not passed
any meconium. The baby is refusing to nipple and has vomited what
little
formula the nurses were able to get her to nipple.
The physician noted upon his physical exam that the infant's internal
anal sphincter is tight.
◉ GI Case Study 2: What is this infant's medical diagnosis?. Answer:
Hirschsprungs
◉ GI Case Study 2: What are the priority nursing diagnoses?.
Answer: PC: Fluid Volume Deficit
Alteration in Elimination r/t inability to pass meconium
◉ GI Case Study 2: What interventions does the nurse implement
preoperatively. Answer: Place NPO
Initiate IV
Assess for abdominal distention
Prepare parents for possible colostomy
