NSG 6435 Quiz 2 with Complete Solutions
Constipation 2nd to disorders of GI tract - ANSWER-Structural (Hirschsprung's)
Systemic (hypothyroidism)
2nd to meds (narcs, antihistamines)
neurogenic (spinal cord lesions)
Constipation etiologies - ANSWER-NB: iron in formula
overzealous toilet training
fear of using bathroom 2nd to lack of privacy or cleanliness
personality/emotion
diet
Constipation tx - ANSWER-NB: water with prune juice, glycerin suppository
Older: stool softeners, miralax, lactulose
daily maintenance fluid requirements - ANSWER-100ml/kg for first 10kg
50 ml/kg for second 10mg
20ml/kg for remaining body wt
dehydration levels - ANSWER-mild- weight loss 5%
moderate: wt loss 10% infants, 6-8% children
severe: 15% infants 10% children
diagnostic test of choice for appy - ANSWER-ct
Encopresis - ANSWER-constipation with fecal soiling, partial stool incontinence
Encopresis criteria - ANSWER-must occur once a month for at least 3 months
chronological or developmental age of child must be at least 4 years
fecal incontinence must not be due to physiologic effects of meds or medical condition
Encopresis male vs female - ANSWER-occurs more commonly in MALES than females
encopresis tx - ANSWER-aggressive bowel cleansing
daily stool softeners
bathroom times/star chart
GERD - ANSWER-peaks at 4 months, sharply declines at 6 months
hirsch diagnosis - ANSWER-gastro graphin enema- shows transition zone bt
megacolon and aganglionic distal segment
dx confirmation= RECTAL BIOPSY
hirsch s/sx - ANSWER-NB: failure to pass meconium stool within 24-48 hours after birth
poor feeding, vomiting, abd distention
Constipation 2nd to disorders of GI tract - ANSWER-Structural (Hirschsprung's)
Systemic (hypothyroidism)
2nd to meds (narcs, antihistamines)
neurogenic (spinal cord lesions)
Constipation etiologies - ANSWER-NB: iron in formula
overzealous toilet training
fear of using bathroom 2nd to lack of privacy or cleanliness
personality/emotion
diet
Constipation tx - ANSWER-NB: water with prune juice, glycerin suppository
Older: stool softeners, miralax, lactulose
daily maintenance fluid requirements - ANSWER-100ml/kg for first 10kg
50 ml/kg for second 10mg
20ml/kg for remaining body wt
dehydration levels - ANSWER-mild- weight loss 5%
moderate: wt loss 10% infants, 6-8% children
severe: 15% infants 10% children
diagnostic test of choice for appy - ANSWER-ct
Encopresis - ANSWER-constipation with fecal soiling, partial stool incontinence
Encopresis criteria - ANSWER-must occur once a month for at least 3 months
chronological or developmental age of child must be at least 4 years
fecal incontinence must not be due to physiologic effects of meds or medical condition
Encopresis male vs female - ANSWER-occurs more commonly in MALES than females
encopresis tx - ANSWER-aggressive bowel cleansing
daily stool softeners
bathroom times/star chart
GERD - ANSWER-peaks at 4 months, sharply declines at 6 months
hirsch diagnosis - ANSWER-gastro graphin enema- shows transition zone bt
megacolon and aganglionic distal segment
dx confirmation= RECTAL BIOPSY
hirsch s/sx - ANSWER-NB: failure to pass meconium stool within 24-48 hours after birth
poor feeding, vomiting, abd distention
