Nursing Care of
the Child with
an Alteration in
Bowel
Elimination/
Gastrointestinal
Disorder
Ricci Textbook: Ch. 42
ATI Pediatric Review Module: Ch. 22 & 23
Course Instructor: Prof. Barretto Wansor
,Anatomy and Physiology of the
Gastrointestinal System of Child
• Mouth: highly vascular; entry point of infection.
• Esophagus: LES not fully developed until age 1, causing regurgitation/r
• Newborn stomach capacity only 10 to 20 mL.
• Intestines: small intestine not mature at birth.
• Biliary system: liver relatively large at birth; pancreatic enzymes develo
postnatally, not reaching adult levels until 2 years old.
• Fluid balance & losses: proportionately greater amount of body water
compared to adults. Increased risk for dehydration and electrolyte
imbalance!
, Fluid Balance and Losses
• Infants and young children differ physiologically from adults in way
make them vulnerable to fluid, electrolyte, and acid-base imbalanc
• BMR is higher in infants/young children to support growth.
• Greater insensible loss via lungs
• Young infant’s immature kidneys does not allow concentration of uri
• Body water percentage for weight varies with age.
• Newborns have highest percentage of water.
• Fever increases fluid loss at a rate of ~ 7 mL/kg/24-hour period for
1ºC rise in temp.
• The most common result of GI illness is dehydration, requiring fluid
therapy at home (ORT) or in a hospital setting (IVF)
,
the Child with
an Alteration in
Bowel
Elimination/
Gastrointestinal
Disorder
Ricci Textbook: Ch. 42
ATI Pediatric Review Module: Ch. 22 & 23
Course Instructor: Prof. Barretto Wansor
,Anatomy and Physiology of the
Gastrointestinal System of Child
• Mouth: highly vascular; entry point of infection.
• Esophagus: LES not fully developed until age 1, causing regurgitation/r
• Newborn stomach capacity only 10 to 20 mL.
• Intestines: small intestine not mature at birth.
• Biliary system: liver relatively large at birth; pancreatic enzymes develo
postnatally, not reaching adult levels until 2 years old.
• Fluid balance & losses: proportionately greater amount of body water
compared to adults. Increased risk for dehydration and electrolyte
imbalance!
, Fluid Balance and Losses
• Infants and young children differ physiologically from adults in way
make them vulnerable to fluid, electrolyte, and acid-base imbalanc
• BMR is higher in infants/young children to support growth.
• Greater insensible loss via lungs
• Young infant’s immature kidneys does not allow concentration of uri
• Body water percentage for weight varies with age.
• Newborns have highest percentage of water.
• Fever increases fluid loss at a rate of ~ 7 mL/kg/24-hour period for
1ºC rise in temp.
• The most common result of GI illness is dehydration, requiring fluid
therapy at home (ORT) or in a hospital setting (IVF)
,
