N414 Unit 4 questions with correct answers
What are some of the differences in children for the GI system? Correct
Answer-The sphincter causes them to spit up quite a bit. The have
immature absorption and enzymes so they don't tolerate foods like we do
and requires them to have breast milk or formula.
Altered dentition.
Immature cardiac sphincter.
When they are first born, they don't have a voluntary suck and swallow
so they gulp and swallow lots of air.
They don't have good motility so stuff goes in and comes right back out.
Volume capacity is lower
They don't have bacterial colonization or enzymes to break down bad
stuff, so we have to be super careful about what we give them to eat.
Lastly, they have immature liver function.
When we assess GI function what do we look for? Correct Answer-
History of the problem: signs, symptoms, onset, duration, acute vs.
chronic, aggrevators, alleviators.
Intake and output: feeds, toleration, hydration status, emesis, urine
Look at the growth chart and check for significant weight changes (gain
or loss)
Look at nutrition: what are they eating, how much, and what can they
tolerate well/ what do they tolerate poorly.
Stool patterns: consistency, frequency, change in pattern, appearance.
Stools will initially be yellow and then change to normal brown
,Abdominal exam: Look at it first and then listen before you palpate.
Look at color for jaundice, girth of abdomen, distension, bowel tones,
tenderness, rebound tenderness, and masses.
Are they passing gas? Are they uncomfortable?
Other: presence of NG gastrostomy, incision. Are they patent, in the
correct position, swollen, healing, intact, etc
What are the nursing interventions for GI? Correct Answer-Trauma-
informed care means treating a whole person, taking into account past
trauma and the resulting coping mechanisms when attempting to
understand behaviors and treat the patient
Describe cleft lip and palate Correct Answer-It's a central line defect
where it just fails to fuse in the lips and nose. It tends to be genetic and
is linked to maternal smoking, drugs, and alcohol use. Palates usually
occur further along than lip defects.
What else do you often see with cleft lips or palates? Correct Answer-
Poorly formed ears, nose, hearts, etc.
How is cleft lip and palate diagnosed? Correct Answer-Prenatal
ultrasound or it will be apparent when they are born.
There are surgical options for treating it, depending on the nature of the
deformity. The lip will be treated withing 6 months and the palate within
18 months
Folic acid is useful for prevention
,What are some of the issues prior to surgical correction? Correct
Answer-It is a choking hazard
They required adequate nutrition for growth because it is really easy for
milk to go into the ear and lead to ear infections. So, feeding techniques
will become really important
What are some of the feeding techniques for cleft lip? Correct Answer-It
is often difficult for the baby to get a good seal around the nipple. They
may need special bottles in order to feed properly. The three types of
bottles used in these cases are Mead-Johnson Cleft Palate Nurser,
Haberman Feeder and the Pigeon nipple.
It is helpful to keep the baby up right. They tolerate small feeds with
frequent burping the best
This takes lots of patience. Parents need to support the strengths of the
baby, and help them to bond well.
What is postoperative care? Correct Answer-ABCs: airway (choking
hazards and suture lines that are friable require less suctioning),
Comfort,
Maintenance of the suture line:
assess and clean
elbow restraints
rinse after feedings
antibiotic ointment
, avoid straws, metal utensils, pacifiers
Nutrition: start with clear liquids or diluted breast milk, progress to
regular feeds.
why do they tie the tongue down after the surgery? Correct Answer-So
that they don't mess with the sutures
What are the implications of cleft lip and palate, long-term? Correct
Answer-Dental care is important because of altered dentition, which
might require and orthodontist.
Speech and hearing might be impaired. Ear infections might lead to
hearing issues, and you may also see plastic surgery. Self-image is a
huge issue for these kids
Describe tracheo-esophageal fistulas Correct Answer-The esophagus is
no longer a continuous tube and gets connected to the lungs instead of
the stomach.
This is an emergency. Classic signs are that the baby immediately starts
coughing, drooling, and spitting food up from the nose and mouth. You
might also see choking and cyanosis. So they will stick an NG tube in to
remove the tube and prepare for surgery
What are the nursing implications> Correct Answer-Have suction ready
Use IV fluids and antibiotics
Respiratory management
What are some of the differences in children for the GI system? Correct
Answer-The sphincter causes them to spit up quite a bit. The have
immature absorption and enzymes so they don't tolerate foods like we do
and requires them to have breast milk or formula.
Altered dentition.
Immature cardiac sphincter.
When they are first born, they don't have a voluntary suck and swallow
so they gulp and swallow lots of air.
They don't have good motility so stuff goes in and comes right back out.
Volume capacity is lower
They don't have bacterial colonization or enzymes to break down bad
stuff, so we have to be super careful about what we give them to eat.
Lastly, they have immature liver function.
When we assess GI function what do we look for? Correct Answer-
History of the problem: signs, symptoms, onset, duration, acute vs.
chronic, aggrevators, alleviators.
Intake and output: feeds, toleration, hydration status, emesis, urine
Look at the growth chart and check for significant weight changes (gain
or loss)
Look at nutrition: what are they eating, how much, and what can they
tolerate well/ what do they tolerate poorly.
Stool patterns: consistency, frequency, change in pattern, appearance.
Stools will initially be yellow and then change to normal brown
,Abdominal exam: Look at it first and then listen before you palpate.
Look at color for jaundice, girth of abdomen, distension, bowel tones,
tenderness, rebound tenderness, and masses.
Are they passing gas? Are they uncomfortable?
Other: presence of NG gastrostomy, incision. Are they patent, in the
correct position, swollen, healing, intact, etc
What are the nursing interventions for GI? Correct Answer-Trauma-
informed care means treating a whole person, taking into account past
trauma and the resulting coping mechanisms when attempting to
understand behaviors and treat the patient
Describe cleft lip and palate Correct Answer-It's a central line defect
where it just fails to fuse in the lips and nose. It tends to be genetic and
is linked to maternal smoking, drugs, and alcohol use. Palates usually
occur further along than lip defects.
What else do you often see with cleft lips or palates? Correct Answer-
Poorly formed ears, nose, hearts, etc.
How is cleft lip and palate diagnosed? Correct Answer-Prenatal
ultrasound or it will be apparent when they are born.
There are surgical options for treating it, depending on the nature of the
deformity. The lip will be treated withing 6 months and the palate within
18 months
Folic acid is useful for prevention
,What are some of the issues prior to surgical correction? Correct
Answer-It is a choking hazard
They required adequate nutrition for growth because it is really easy for
milk to go into the ear and lead to ear infections. So, feeding techniques
will become really important
What are some of the feeding techniques for cleft lip? Correct Answer-It
is often difficult for the baby to get a good seal around the nipple. They
may need special bottles in order to feed properly. The three types of
bottles used in these cases are Mead-Johnson Cleft Palate Nurser,
Haberman Feeder and the Pigeon nipple.
It is helpful to keep the baby up right. They tolerate small feeds with
frequent burping the best
This takes lots of patience. Parents need to support the strengths of the
baby, and help them to bond well.
What is postoperative care? Correct Answer-ABCs: airway (choking
hazards and suture lines that are friable require less suctioning),
Comfort,
Maintenance of the suture line:
assess and clean
elbow restraints
rinse after feedings
antibiotic ointment
, avoid straws, metal utensils, pacifiers
Nutrition: start with clear liquids or diluted breast milk, progress to
regular feeds.
why do they tie the tongue down after the surgery? Correct Answer-So
that they don't mess with the sutures
What are the implications of cleft lip and palate, long-term? Correct
Answer-Dental care is important because of altered dentition, which
might require and orthodontist.
Speech and hearing might be impaired. Ear infections might lead to
hearing issues, and you may also see plastic surgery. Self-image is a
huge issue for these kids
Describe tracheo-esophageal fistulas Correct Answer-The esophagus is
no longer a continuous tube and gets connected to the lungs instead of
the stomach.
This is an emergency. Classic signs are that the baby immediately starts
coughing, drooling, and spitting food up from the nose and mouth. You
might also see choking and cyanosis. So they will stick an NG tube in to
remove the tube and prepare for surgery
What are the nursing implications> Correct Answer-Have suction ready
Use IV fluids and antibiotics
Respiratory management
