Families Exam 5
Celiac disease clinical manifestations *** Chronic autoimmune disorder of small intestine when
ingesting gluten leading to impaired absorption of fats & nutrients
Local
- Abdominal bloating, cramps
- Steatorrhea/Diarrhea
Systemic
- Anemia
- Small stature, delayed maturity
- Vitamin deficiencies
- Muscle wasting
- Rickets (vitamin B)
Celiac disease assessment *** - Vitamin A deficiency: vision problems
- Anemic: vitamin B12 deficiency, RBC
Celiac disease nursing interventions/plan of care *** Meds
· Vitamin & mineral supplements
· Iron, folic acid for anemia
· Vitamin k
· Corticosteroids
Celiac disease nutritional interventions *** Gluten-free diet
· NO wheat, rye, barley
· CAN have rice, corn, potatoes, eggs, fruits/veggies, dairy without malt, nuts, beans
,· High protein, high calorie, low fat
· Decrease dairy/lactose intake
· IV nutrition for refractory disease
Meckel diverticulum clinical manifestations *** · Rectal bleeding: usually painless
· Abdominal pain
· Bloody, mucus stools: monitor Hgb/Hct
Meckel diverticulum nursing interventions/plan of care *** · Meckel's scan: most effective dx test
· Prep child & family for surgery: surgical removal of diverticulum
Meckel diverticulum pre-post op care *** Pre Op --> Blood transfusion, IVF to correct hypovolemia, IV
abx, monitor blood loss in stools
Post op --> NPO, Assess bowel sounds, NG tube to low continuous suction
Meckel diverticulum teaching *** Monitor for signs of infection
Rotavirus clinical manifestations *** Viral infection transmitted via fecal-oral route & is most common
cause of diarrhea in ages < 5 yrs (but affects all ages)
· Fever
· Diarrhea for 5-7 days: foul-smelling, watery stools
· Vomiting for 2 days
Rotavirus nursing interventions/plan of care *** · Stool sample
· Baseline height & weight
· Daily weights, monitor I/O
, · Avoid rectal temp.
· IVF
Rotavirus nutritional interventions *** Avoid: high carb, sugary, high-sodium, or caffeine and:
- Fruit juice, carbonated soda, gelatin
- Chicken/beef broth
- Undercooked or under-refrigerated foods
Rotavirus priority *** 1. Start with oral rehydration solution (ORS) of 75-90 mEq of sodium/L at 40-50
mL/kg over 4 hr
2. Initiate maintenance ORS of 40-60 mL/kg/day
- Give ORS alternatively with intake of other fluids: breastmilk, formula, milk
- Give infants lactose free formula
- Older children may resume regular diets
Replace diarrhea stool: 10 mL/kg of ORS
Rotavirus teaching *** - Transmission: fecal-oral
- Incubation: 48 hr
- Parents should inform child's school: stay home during incubation period
- Use commercially prepared ORS when child experiences diarrhea
- Change bed linens & clothes/underwear daily: avoid shaking linens
- Clean toys & keep away from other children & do not share dishes/utensils
- Hand hygiene: after toilet or changing diaper
Mild dehydration clinical manifestations *** · Weight loss: 3-5 % (infants) & 3-4% (children)
· Capillary refill > 2 sec
Celiac disease clinical manifestations *** Chronic autoimmune disorder of small intestine when
ingesting gluten leading to impaired absorption of fats & nutrients
Local
- Abdominal bloating, cramps
- Steatorrhea/Diarrhea
Systemic
- Anemia
- Small stature, delayed maturity
- Vitamin deficiencies
- Muscle wasting
- Rickets (vitamin B)
Celiac disease assessment *** - Vitamin A deficiency: vision problems
- Anemic: vitamin B12 deficiency, RBC
Celiac disease nursing interventions/plan of care *** Meds
· Vitamin & mineral supplements
· Iron, folic acid for anemia
· Vitamin k
· Corticosteroids
Celiac disease nutritional interventions *** Gluten-free diet
· NO wheat, rye, barley
· CAN have rice, corn, potatoes, eggs, fruits/veggies, dairy without malt, nuts, beans
,· High protein, high calorie, low fat
· Decrease dairy/lactose intake
· IV nutrition for refractory disease
Meckel diverticulum clinical manifestations *** · Rectal bleeding: usually painless
· Abdominal pain
· Bloody, mucus stools: monitor Hgb/Hct
Meckel diverticulum nursing interventions/plan of care *** · Meckel's scan: most effective dx test
· Prep child & family for surgery: surgical removal of diverticulum
Meckel diverticulum pre-post op care *** Pre Op --> Blood transfusion, IVF to correct hypovolemia, IV
abx, monitor blood loss in stools
Post op --> NPO, Assess bowel sounds, NG tube to low continuous suction
Meckel diverticulum teaching *** Monitor for signs of infection
Rotavirus clinical manifestations *** Viral infection transmitted via fecal-oral route & is most common
cause of diarrhea in ages < 5 yrs (but affects all ages)
· Fever
· Diarrhea for 5-7 days: foul-smelling, watery stools
· Vomiting for 2 days
Rotavirus nursing interventions/plan of care *** · Stool sample
· Baseline height & weight
· Daily weights, monitor I/O
, · Avoid rectal temp.
· IVF
Rotavirus nutritional interventions *** Avoid: high carb, sugary, high-sodium, or caffeine and:
- Fruit juice, carbonated soda, gelatin
- Chicken/beef broth
- Undercooked or under-refrigerated foods
Rotavirus priority *** 1. Start with oral rehydration solution (ORS) of 75-90 mEq of sodium/L at 40-50
mL/kg over 4 hr
2. Initiate maintenance ORS of 40-60 mL/kg/day
- Give ORS alternatively with intake of other fluids: breastmilk, formula, milk
- Give infants lactose free formula
- Older children may resume regular diets
Replace diarrhea stool: 10 mL/kg of ORS
Rotavirus teaching *** - Transmission: fecal-oral
- Incubation: 48 hr
- Parents should inform child's school: stay home during incubation period
- Use commercially prepared ORS when child experiences diarrhea
- Change bed linens & clothes/underwear daily: avoid shaking linens
- Clean toys & keep away from other children & do not share dishes/utensils
- Hand hygiene: after toilet or changing diaper
Mild dehydration clinical manifestations *** · Weight loss: 3-5 % (infants) & 3-4% (children)
· Capillary refill > 2 sec
