Care of the Child with
Gastrointestinal Dysfunction
This lesson provides an overview of pediatric gastrointestinal
(GI) disorders and how the nurse applies the nursing
process in caring for pediatric clients with GI disorders. The
primary function of the GI tract is the digestion and
absorption of nutrients. Thus, any dysfunction of the GI tract
can cause significant problems with the exchange of fluids,
electrolytes, and nutrients.
This lesson will focus on the nursing care of children with
constipation, Hirschsprung disease, gastroesophageal
reflux, appendicitis, pyloric stenosis, and intussusception.
Management of Care:
Preoperative
The nurse is caring for a child who will be having abdominal
surgery. Which nursing action(s) does the nurse anticipate
performing prior to surgery? Select all that apply.
Administer prescribed intravenous fluids.
Request services from child life specialist.
Administer prescribed preoperative
antibiotics.
In preparing a patient for surgery, the nurse would anticipate
inserting a peripheral intravenous line, administering
intravenous fluids, administering prescribed preoperative
antibiotics, preparing the surgical consent and witnessing
informed consent. The nurse would also request services from
a child life specialist to help the pediatric client cope with the
pending surgery and hospital experience.
,Management of Care:
Postoperative
The nurse is caring for a child who just returned to the pediatric unit after having an abdominal
surgery. Which nursing action(s) does the nurse anticipate performing? Select all that apply.
Monitor vital signs per post-operative
protocol. Advance oral intake as tolerated.
Assess surgical wound and/or dressing.
Assess for return of bowel sounds.
Administer pain medication as prescribed.
When caring for a pediatric client after abdominal surgery,
the nurse would anticipate the need to monitor vital signs per
post-operative protocol, assess for return of bowel sounds,
advance oral intake as tolerated, assess pain and administer
pain medication as prescribed, and to assess the surgical
wound and/or dressing.
Nursing Action: Postoperative
Care
The nurse is caring for a 6-year-old child who is 4 hours
post- operative from a ruptured appendectomy. Ibuprofen
was administered 2 hours ago and the child rates pain as 1
out of 10. The child’s intake includes water, crackers, a cup
of gelatin, and a bottle of juice. Review the health care
provider’s orders.
Which action should the nurse take next?
Saline lock the intravenous line.
The nurse has already advanced the diet as tolerated. Since
the client is tolerating oral intake, the intravenous fluids
should be discontinued. The peripheral intravenous line
should be saline locked and not removed because the client
still has intravenous antibiotics prescribed. The ibuprofen is
not due for administration and is not indicated at this time.
,Gastrointestinal Dysfunction
The most common consequences of gastrointestinal (GI)
dysfunction in children include malabsorption, fluid and
electrolyte disturbances, malnutrition, and poor growth. The
most important basic nursing assessments include
measurement of intake and output, height and weight,
abdominal examination, and simple stool and urine tests.
There are several types of GI dysfunction in children which
can be classified as general GI disorders, motility disorders,
inflammatory conditions, obstructive disorders, malabsorption
syndromes, and structural defects. Below are examples of
each classification of GI dysfunction.
This lesson will focus on constipation, Hirschsprung
disease, gastroesophageal reflux, appendicitis, pyloric
stenosis, and intussusception.
Malabsorption Syndromes
• celiac disease
• short-bowel syndrome
• gastrointestinal bleeding
General Gastrointestinal Disorders
• constipation
• diarrhea
• vomiting
Motility Disorders
• Hirschsprung disease
• gastroesophageal reflux
• irritable bowel syndrome
Inflammatory Conditions
• appendicitis
• inflammatory bowel disease
Structural Defects
, • esophageal atresia and tracheoesophageal fistula
• abdominal wall defects (omphalocele, gastroschisis)
• hernia
Gastrointestinal Function
Assessment
Common abnormal gastrointestinal assessment findings:
• abdominal distention
• hypoactive, hyperactive, or absent bowel sounds
• nausea/vomiting
• spitting up/regurgitation
• projectile vomiting
• typically associated with pyloric stenosis
• diarrhea/constipation
• fever
• common manifestation of illness in children
• usually associated with dehydration,
infection, or inflammation
• failure to thrive
• failure to maintain established growth pattern or
consistently remaining below the 5th percentile for
height and weight on standard growth charts
• sometimes accompanied by developmental delays
Nursing Care for
Gastrointestinal Surgery
Gastrointestinal Surgery Types
• Open Surgery: A large incision is made in the
abdomen to complete the surgery.
• Laparoscopic Surgery: Small incisions are made in
the abdomen and a small camera, light, and special
tools are used
Gastrointestinal Dysfunction
This lesson provides an overview of pediatric gastrointestinal
(GI) disorders and how the nurse applies the nursing
process in caring for pediatric clients with GI disorders. The
primary function of the GI tract is the digestion and
absorption of nutrients. Thus, any dysfunction of the GI tract
can cause significant problems with the exchange of fluids,
electrolytes, and nutrients.
This lesson will focus on the nursing care of children with
constipation, Hirschsprung disease, gastroesophageal
reflux, appendicitis, pyloric stenosis, and intussusception.
Management of Care:
Preoperative
The nurse is caring for a child who will be having abdominal
surgery. Which nursing action(s) does the nurse anticipate
performing prior to surgery? Select all that apply.
Administer prescribed intravenous fluids.
Request services from child life specialist.
Administer prescribed preoperative
antibiotics.
In preparing a patient for surgery, the nurse would anticipate
inserting a peripheral intravenous line, administering
intravenous fluids, administering prescribed preoperative
antibiotics, preparing the surgical consent and witnessing
informed consent. The nurse would also request services from
a child life specialist to help the pediatric client cope with the
pending surgery and hospital experience.
,Management of Care:
Postoperative
The nurse is caring for a child who just returned to the pediatric unit after having an abdominal
surgery. Which nursing action(s) does the nurse anticipate performing? Select all that apply.
Monitor vital signs per post-operative
protocol. Advance oral intake as tolerated.
Assess surgical wound and/or dressing.
Assess for return of bowel sounds.
Administer pain medication as prescribed.
When caring for a pediatric client after abdominal surgery,
the nurse would anticipate the need to monitor vital signs per
post-operative protocol, assess for return of bowel sounds,
advance oral intake as tolerated, assess pain and administer
pain medication as prescribed, and to assess the surgical
wound and/or dressing.
Nursing Action: Postoperative
Care
The nurse is caring for a 6-year-old child who is 4 hours
post- operative from a ruptured appendectomy. Ibuprofen
was administered 2 hours ago and the child rates pain as 1
out of 10. The child’s intake includes water, crackers, a cup
of gelatin, and a bottle of juice. Review the health care
provider’s orders.
Which action should the nurse take next?
Saline lock the intravenous line.
The nurse has already advanced the diet as tolerated. Since
the client is tolerating oral intake, the intravenous fluids
should be discontinued. The peripheral intravenous line
should be saline locked and not removed because the client
still has intravenous antibiotics prescribed. The ibuprofen is
not due for administration and is not indicated at this time.
,Gastrointestinal Dysfunction
The most common consequences of gastrointestinal (GI)
dysfunction in children include malabsorption, fluid and
electrolyte disturbances, malnutrition, and poor growth. The
most important basic nursing assessments include
measurement of intake and output, height and weight,
abdominal examination, and simple stool and urine tests.
There are several types of GI dysfunction in children which
can be classified as general GI disorders, motility disorders,
inflammatory conditions, obstructive disorders, malabsorption
syndromes, and structural defects. Below are examples of
each classification of GI dysfunction.
This lesson will focus on constipation, Hirschsprung
disease, gastroesophageal reflux, appendicitis, pyloric
stenosis, and intussusception.
Malabsorption Syndromes
• celiac disease
• short-bowel syndrome
• gastrointestinal bleeding
General Gastrointestinal Disorders
• constipation
• diarrhea
• vomiting
Motility Disorders
• Hirschsprung disease
• gastroesophageal reflux
• irritable bowel syndrome
Inflammatory Conditions
• appendicitis
• inflammatory bowel disease
Structural Defects
, • esophageal atresia and tracheoesophageal fistula
• abdominal wall defects (omphalocele, gastroschisis)
• hernia
Gastrointestinal Function
Assessment
Common abnormal gastrointestinal assessment findings:
• abdominal distention
• hypoactive, hyperactive, or absent bowel sounds
• nausea/vomiting
• spitting up/regurgitation
• projectile vomiting
• typically associated with pyloric stenosis
• diarrhea/constipation
• fever
• common manifestation of illness in children
• usually associated with dehydration,
infection, or inflammation
• failure to thrive
• failure to maintain established growth pattern or
consistently remaining below the 5th percentile for
height and weight on standard growth charts
• sometimes accompanied by developmental delays
Nursing Care for
Gastrointestinal Surgery
Gastrointestinal Surgery Types
• Open Surgery: A large incision is made in the
abdomen to complete the surgery.
• Laparoscopic Surgery: Small incisions are made in
the abdomen and a small camera, light, and special
tools are used
