NUR 438 GI Study Guide
Extracellular fluid in peds - 75% of fluid stored for infants
45% stored for adolescents
In dehydration 60% is lost from ECF
Body Surface Area in peds - Infant has a higher loss through skin
Infant has higher loss from respiratory tract
Kidneys in Peds - Infant has immature kidney, which cannot assist with conservation
Fluid requirments depend on - Current hydration status
Disease State
Environment
Swallow for Peds - Poor control for first 6 weeks
Behavior is reflexive for first 3 months
Greater risk for aspiration
Stomach in Peds - Small stomach capacity at birth. Grows over 1st 2 years.
1st month cardiac sphincter not developed so regurgitation is common if persist think GER
Intestine in peds - Peristalsis is increased leading to increased feeding frequency. Bowel sounds are
reported as active.
Enzyme deficiencies that aid in digestion are not present for first 4-6 montsh. Concern for food allergies
and feeding intolerance.
, Stool in Peds - First stool is meconium should pass in the fist 24-36 hours of life
Failure could be due to Hischsprung disease, meconium plug, or ileus from cystic fibrosis.
Types of dehydration - Isotonic: Most common water=salt lost. Major loss is in the extracellular. Usual
cause is vomiting and diarrhea. It is the primary form in children and great risk = shock
Hypotonic: The loss of salt > water. Labs show a low Na+ lebel < 130. Causes include prolonged vomiting
and diarrhea, burns and renal disease.
Hypertonic: The loss of water > salt. Labs show a high Na+ level > 150. Causes include diabetes insipidus
or fluids/feeds with high electrolyte level. Concern here is resulting neuro changes and seizures.
Severity of dehydration - Mild: Tachycardia, increased thirst, and slightly dry mucous membranes
Moderate: Dry buccal mucous membranes, sunken eyes, and sunken fontanels.
Severe: Signs of moderate dehydration plus 1 of the following: Hypotension, decreased peripheral
pulses, CRT >4 seconds, and lethargy
Abdominal X-ray - Detects foreign body, bowel gas pattern, stool prescence, perforation, obstruction,
use radiation, check NG placement if gold standard.
Upper/Lower GI Cues - Uses barium, upper looks for reflux.
Lower used for intussusception with air/saline enema.
Child needs to drink all barium may require NG
Encourage fluids after procedure to help clear barrium
Abdominal Ultrasound - Uses sound waves to determine size and placement of abdominal contents.
Extracellular fluid in peds - 75% of fluid stored for infants
45% stored for adolescents
In dehydration 60% is lost from ECF
Body Surface Area in peds - Infant has a higher loss through skin
Infant has higher loss from respiratory tract
Kidneys in Peds - Infant has immature kidney, which cannot assist with conservation
Fluid requirments depend on - Current hydration status
Disease State
Environment
Swallow for Peds - Poor control for first 6 weeks
Behavior is reflexive for first 3 months
Greater risk for aspiration
Stomach in Peds - Small stomach capacity at birth. Grows over 1st 2 years.
1st month cardiac sphincter not developed so regurgitation is common if persist think GER
Intestine in peds - Peristalsis is increased leading to increased feeding frequency. Bowel sounds are
reported as active.
Enzyme deficiencies that aid in digestion are not present for first 4-6 montsh. Concern for food allergies
and feeding intolerance.
, Stool in Peds - First stool is meconium should pass in the fist 24-36 hours of life
Failure could be due to Hischsprung disease, meconium plug, or ileus from cystic fibrosis.
Types of dehydration - Isotonic: Most common water=salt lost. Major loss is in the extracellular. Usual
cause is vomiting and diarrhea. It is the primary form in children and great risk = shock
Hypotonic: The loss of salt > water. Labs show a low Na+ lebel < 130. Causes include prolonged vomiting
and diarrhea, burns and renal disease.
Hypertonic: The loss of water > salt. Labs show a high Na+ level > 150. Causes include diabetes insipidus
or fluids/feeds with high electrolyte level. Concern here is resulting neuro changes and seizures.
Severity of dehydration - Mild: Tachycardia, increased thirst, and slightly dry mucous membranes
Moderate: Dry buccal mucous membranes, sunken eyes, and sunken fontanels.
Severe: Signs of moderate dehydration plus 1 of the following: Hypotension, decreased peripheral
pulses, CRT >4 seconds, and lethargy
Abdominal X-ray - Detects foreign body, bowel gas pattern, stool prescence, perforation, obstruction,
use radiation, check NG placement if gold standard.
Upper/Lower GI Cues - Uses barium, upper looks for reflux.
Lower used for intussusception with air/saline enema.
Child needs to drink all barium may require NG
Encourage fluids after procedure to help clear barrium
Abdominal Ultrasound - Uses sound waves to determine size and placement of abdominal contents.
