Exam (elaborations) Peds Study Guide Exam 2 (GI, GU, Endocrine, Neuro, Heme/Immune)

Kim 1. Dehydration – diarrhea and vomiting (from powerpoint) a. Dehydration i. Clinical Manifestations: 1. CRT greater than 3 seconds, dry mucous membranes, absence of tears, sunken fontanels, lethargy, weight loss, rapid weak pulse (1st to respond), low BP (last to respond) ii. Urine output needs to be 1mL/kg per hour for anyone under 30kg. iii. Dehydration Criteria (% of body weight lost) 1. Mild dehydration=5% of total body weight 2. Moderate=10% of total body weight 3. Severe=15% of total body weight iv. Nursing Interventions 1. Assessment should include body weight, skin color, temp & turgor, CRT, presence of thirst sensation, fontanels in infants v. Vomiting: 1. So there is nothing really in the powerpoint or ATI specifically on vomiting….I guess just know that it can cause dehydration and to monitor I&O and F&E status. Can be associated with metabolic alkalosis. vi. TB (chapter 26) 1. Question #: 20 2. ATI book (chapter 22): question 1 2. Inflammatory bowel disease – Ulcerative Colitis and Crohn’s a. Kaur said she’s taking this topic out since it wasn’t in the powerpoint or discussed in lecture. 3. Necrotizing enterocolitis (NEC) (from Powerpoint) a. Acute inflammatory disease of the bowel. Usually occurs 4-10 days after initial feeding. Seen in preterm and high risk infants! b. Due to stasis in the GI tract, decreased blood supply leads to ischemia →bacterial proliferation (HUGE PROBLEM!) c. S/S i. Distended abdomen, bloating, gastric residual that is bile tinged, occult blood in stool, lethargy, poor feeding, pale skin, and bradycardia and hypotension (which are s/s of sepsis!) d. Treatment i. DC the feedings to rest the bowel ii. Gastric tube used to decompress iii. Abx used to treat sepsis iv. Sx may be indicated to remove necrotizing tissue