xamee2
1.DifferenceseeineetheeepediatriceeGIeesystem:ee-
Decreasedeeresistanceeetoeebacterialeeandeeviraleeinfections
-Easilyeedehydrate
-Increasedeenutritionaleeneeds
-Immatureeehepaticeefunction
2.FluideeandeeElectrolyteeeimbalance:ee-
Dehydration:eeExcessiveeelosseeofeebodyeewateree--
>eeMild,Moderate,eeandeesevere
-Increasedeerisk:eeLesseethanee2eeyearseeofeeage
3.NursingeeAssessmenteeFindingseeforeedehydrationeeandeehypovolemia
:ee-De-
eehydration:eeExtremity,color,urineeeoutput,BUNeeandeespecificeegravi
ty,Mucouseemem-eebranes,Lethargy,Turgor,Pulse,Fontanels,eeTears
-
HypovolemiceeShock:eeRapideeweakeepulse,Mottling,Hypotension,eeChange
seeineeLOC
4.DehydrationeeNursingeeCare:eeAssessment:eeMonitor,eeAdmineefluidseeeit
hereebyeePOeeoreeIV,eeAdmineeIVeepotassium
MonitoreeLabeeValues:eeSerumeepH;eemetaboliceeacidosiseevseealkalosis,eeEl
ctrolytes:eeNA,K,Cl,Ca,Mg,eeHcteelevels,eeBUNeelevelseeandeespecificeegravi
y
5.NursingeeCare:eeVomiting:ee-HoldeePOeeintake
-
Electrolyteeeenrichedeedrink:eeInfanteebreakeefeeding;eefeedeethrougheeshor
ereemoreeefrequenteesessions
-Appropriateeefoodseeandeefluids
-Dehydrationeenursingeecare
-
AdministereemedicationseeaseeorderedeebyeePCP:eeZofran,eePhenergan,eema
keeesureeetheeechildeeisee3eeoreeolder
6.NursingeeCare:eeDiarrhea:ee-Standardeeprecautions/Transmission-based
-Feedeethrougheediarrheaeeepisode
-
Childreneecomplexeecarbs:eeRice,Potatoes,Wheat,bread,leaneemeats,yogu
,fruitseeandeevegetables
-Refereetoeenursingeeassessment/careeeforeedehydration
-Rehydrate:eeFluidseetoeeavoid/Fluidseetoeeinclude:ee-
isotonicee(theeepatienteehaseelostee=eeamountseeofeefluidseeandeeelectrolyte
s)-hypotonicee(theeechildeehaseelosteemoreeeelectrolyteseethaneefluid)
1ee/
, NUee171eeMaternaleeChildeeNursingeeE
xamee2
-Hypertonicee(Theeechildeelosteemoreeefluideethaneeelectrolytes)
-Brateediet
-Admineeantibioticseeifeeneeded
-lactoseeefreeeediet
-
Educateeeparent:eeAvoideeantidiarrhealeemedications,Obtaineetemperature
appropriateeefoodseeandeefluids,knoweewheneetoeecall,eepreventeespreadeeo
eeinfection
-collecteestooleespecimens
7.NursingeeCare:eeVomitingee&eeDiarrhea:ee-
Educateeetheeeparents:eeAvoideeOTCeemedica-
eetions,eeAppropriateeefoodseeandeefluids,eePreventingeetheeespreadeeofeei
nfection
2ee/
, NUee171eeMaternaleeChildeeNursingeeE
xamee2
8.WheneedoeseetheeeparentseeneedeetoeecalleetheeeHCPeewheneethereeechildeeisee
vomitingeeoreehaseediarrhea?:ee-Bileee(green)eeoreeblood-
tingedee(redeeoreebrown)eevomit
-
Anyeeepisodeeeofeeforcefuleevomitingeeineeaeenewborneeoreevomitingeethatee
ontinueseeforeemoreeethaneeaeefeweehours
-
Ifeeaneeinfanteerefuseseetoeeeateeoreedrinkeeanythingeeforeemoreeethaneeaeefe
weehours
-
Moderateeetoeesevereeedehydration:eedryeemouth,eenoeetearseewhileeecryi
ng,eenoteeurinatingeeinee4-6hrsee(babies)ee6-8ee(oldereekids)
-Abdominaleepaineethateeiseesevere,eeeveneeifeeiteecomeseeandeegoes
-Bloodyeeboweleemovements
-
Fevereehighereethanee102eeonceeeoreefevereehighereethanee101eeforeemoreee
hanee3eedays
-
Behavioraleechanges,eeincludingeelethargyeeoreedecreasedeeresponsivenes
9.TracheosophogealeeFistulaee(TEF)/
eeEsophagealeeAtresiaeeDetection:eeAeecongenitaleeanomalyeeineewhicheethee
etracheaee&eeesophaguseeareeeconnectedeeoreefaileetoeeseperate
-
Duringeepregnancy:eePolyhydramnioseeoreegastriceebubbleeenotedeeoneethe
eUS
-
Aftereebirth:eeFeedingeeproblemsee(3eec'seeCoughing,choking,cyanosis),Abd
minaleedisten-eetion,Drooling
10.TEFeeandeeesophagealeeatresiaeetreatment:ee-
EmergencyeeSurgeryeetoeebeeedoneeeimmediatelyeeineestageseeforeesu
rvival
-G~Tube
11.Pre-
operativeeenursingeecareeeforeeTEFeeandeeesophagealeeatresiaeetreatment:ee
-Feedingeestatuseeprioreetoeesurgery
-Removaleeofeesecretions
-Positioningeeforeedrainageeeofeesecretionseeprioreetoeesurgery
-Monitor:ForeerespiratoryeedistresseeandeeprovideeeO2eeaseeneeded
12.imperforateeeanus:ee-
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, NUee171eeMaternaleeChildeeNursingeeE
xamee2
TheeelowereeendeeofeeGIeetracteeandeeanuseecogentiallyeemalformed
-NursingeeDiagnosis:eeConfirmedeebyeex-rayeeoreeMRI
-Treatment:eeColostomy,surgery
13.ImperforateeeAnuseePre-opeeCare:ee-
assesseeappearanceeeofeeanus;lackeeofeemusculareeanus
-Failureeeof;eemeconiumeestool
-Assessment;ee(eeaeewinkeeandeeaeestink)
-IVFs
-Feedingeestatus;NPO
14.pyloriceestenosis:ee-
Narrowingeepyloriceesphincteree(lowereeendeeofeetheeestomach)
-Pyloriceemuscleseeenlarges
-
Preventseestomacheefromeeemptyingeeproperlyeemayeeleadeetoeeobstructio
-2-->3eeweekseeold
-Firsteeborneemales
4ee/