RNSG 1412 Exam 3
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Terms in this set (437)
INFANTS HAVE:
○ high percentage of body weight comprised of
water, especially extracellular fluid (lymph fluid,
plasma, CSF, pericardial, pleural, synovial, sweat,
digestive), which is lost from the body easily
Why is dehydration more
○ increased body surface area
common and more
○ small stomach size which limits ability to rehydrate
severe in an infant?
quickly
○ increased metabolic rate
○ less able to concentrate urine due to immature
renal
system
What is oral re-hydration providing oral solution or IV fluids that replace and
therapy support fluid balance
fluids high in sugar content (high osmotic load can
for hydration in children,
worsen diarrhea) ie soft drinks, jello, gatorade, juice,
what should be avoided?
tea
what can be used to lactobacillus (yogurt or supplement)
restore normal bowel
flora
Failure of maxillary and median
nasal processes to fuse during
Cleft Lip and Palate
embryonic development
Cleft lip and palate prenatal ultrasound
diagnosis postnatal assessment
clinical manifestation of ○ opening in the lip and/or palate
cleft lip and palate ○ milk or formula coming out of the nose
, ○ inadequate intake
potential complications
○ aspiration
of cleft lip and palate
○ otitis media
Management is based on severity multidisciplinary
approach pre-op care by family
○ Surgical repair
Cleft lip and palate
lip at ~3 to 6 m/o
treatment
palate at ~6-24 m/o
reconstruction begins in infancy and can continue
through childhood and adulthood
facilitate bonding, easier feeding, speech
Earlier cleft lip and palate development
repair can
REMINDER parents that the defect is operable
○ prevent trauma to suture line
prevent rolling & grabbing
maintain Logan's Bow
no hard objective in oral cavity
○ pain control
○ prevent infection
cleanse suture line after each feeding and prn
Post op cleft lip and give small amounts of water following milk
palate repair keep suture line dry
○ promote nutrition
feedings can resume ~6 h post-op, advancing as
ordered and tolerated over weeks
no sucking for 10 days post-op
feeding w/ syringe + rubber tubing, then special
nipple that does not rest on suture
aspiration precautions
, otitis media and hearing loss
speech difficulties
inadequate intake → Failure to Thrive, growth &
cleft lip and palate repair development delays
possible complications scarring
aspiration → pneumonia, respiratory distress
altered dentition
emotional impact
A congenital malformation where the esophagus
Esophageal atresia: fails to develop as a continuous tube, resulting in a
blind pouch
Tracheoesophageal A congenital malformation where the esophagus is
fistula: connected with the trachea
Esophageal atresia and
tracheoesophageal
combinations
What is the nurse's major Aspiration & Feeding Problems
concerns related to the
child with
tracheoesophageal
fistula & esophageal
atresia?
○ Three “C’s” - coughing, choking, cyanosis
Esophageal Atresia &
○ rattling respirations
Tracheoesophageal
○ inability to pass suction catheter at birth
Fistula Clinical
○ gastric distention, if fistula
Manifestations
○ maternal history of polyhydramnios
○ if suspected prenatally, diagnosis can be made
Esophageal Atresia &
immediately at birth
Tracheoesophageal
○ otherwise, diagnosis made after infant presents
Fistula Diagnosis and
with clinical manifestations of EA/TEF
Management
○ surgical repair: thoracotomy and anastomosis
, Incomplete development or
absence of anus in its normal
Imperforate Anus
position in perineum.
●Commonly diagnosed during newborn assessment
●Clinical Manifestations
Imperforate Anus
● failure to pass meconium
diagnosis and
● absent anorectal canal
manifestations
● presence of anal membrane
● external fistula
● anal stenosis is treated with repeated anal dilation
imperforate anus
● surgery if no opening is present w/ possible
treatment
colostomy
● monitor for stool in urine
imperforate anus nursing ● assess for anal patency
care ● facilitate bonding
● colostomy care
GS - malformation of anterior
abdominal wall, intestines
exposed
Gastroschisis vs
omphalocele O - herniation of bowel into
umbilical cord - intestines
covered by peritoneum and
amnion
○ early diagnosis is key to mitigate morbidity and
Gastroschisis & mortality
Omphalocele Diagnosis ○ alpha-fetoprotein
○ ultrasound
Save
Terms in this set (437)
INFANTS HAVE:
○ high percentage of body weight comprised of
water, especially extracellular fluid (lymph fluid,
plasma, CSF, pericardial, pleural, synovial, sweat,
digestive), which is lost from the body easily
Why is dehydration more
○ increased body surface area
common and more
○ small stomach size which limits ability to rehydrate
severe in an infant?
quickly
○ increased metabolic rate
○ less able to concentrate urine due to immature
renal
system
What is oral re-hydration providing oral solution or IV fluids that replace and
therapy support fluid balance
fluids high in sugar content (high osmotic load can
for hydration in children,
worsen diarrhea) ie soft drinks, jello, gatorade, juice,
what should be avoided?
tea
what can be used to lactobacillus (yogurt or supplement)
restore normal bowel
flora
Failure of maxillary and median
nasal processes to fuse during
Cleft Lip and Palate
embryonic development
Cleft lip and palate prenatal ultrasound
diagnosis postnatal assessment
clinical manifestation of ○ opening in the lip and/or palate
cleft lip and palate ○ milk or formula coming out of the nose
, ○ inadequate intake
potential complications
○ aspiration
of cleft lip and palate
○ otitis media
Management is based on severity multidisciplinary
approach pre-op care by family
○ Surgical repair
Cleft lip and palate
lip at ~3 to 6 m/o
treatment
palate at ~6-24 m/o
reconstruction begins in infancy and can continue
through childhood and adulthood
facilitate bonding, easier feeding, speech
Earlier cleft lip and palate development
repair can
REMINDER parents that the defect is operable
○ prevent trauma to suture line
prevent rolling & grabbing
maintain Logan's Bow
no hard objective in oral cavity
○ pain control
○ prevent infection
cleanse suture line after each feeding and prn
Post op cleft lip and give small amounts of water following milk
palate repair keep suture line dry
○ promote nutrition
feedings can resume ~6 h post-op, advancing as
ordered and tolerated over weeks
no sucking for 10 days post-op
feeding w/ syringe + rubber tubing, then special
nipple that does not rest on suture
aspiration precautions
, otitis media and hearing loss
speech difficulties
inadequate intake → Failure to Thrive, growth &
cleft lip and palate repair development delays
possible complications scarring
aspiration → pneumonia, respiratory distress
altered dentition
emotional impact
A congenital malformation where the esophagus
Esophageal atresia: fails to develop as a continuous tube, resulting in a
blind pouch
Tracheoesophageal A congenital malformation where the esophagus is
fistula: connected with the trachea
Esophageal atresia and
tracheoesophageal
combinations
What is the nurse's major Aspiration & Feeding Problems
concerns related to the
child with
tracheoesophageal
fistula & esophageal
atresia?
○ Three “C’s” - coughing, choking, cyanosis
Esophageal Atresia &
○ rattling respirations
Tracheoesophageal
○ inability to pass suction catheter at birth
Fistula Clinical
○ gastric distention, if fistula
Manifestations
○ maternal history of polyhydramnios
○ if suspected prenatally, diagnosis can be made
Esophageal Atresia &
immediately at birth
Tracheoesophageal
○ otherwise, diagnosis made after infant presents
Fistula Diagnosis and
with clinical manifestations of EA/TEF
Management
○ surgical repair: thoracotomy and anastomosis
, Incomplete development or
absence of anus in its normal
Imperforate Anus
position in perineum.
●Commonly diagnosed during newborn assessment
●Clinical Manifestations
Imperforate Anus
● failure to pass meconium
diagnosis and
● absent anorectal canal
manifestations
● presence of anal membrane
● external fistula
● anal stenosis is treated with repeated anal dilation
imperforate anus
● surgery if no opening is present w/ possible
treatment
colostomy
● monitor for stool in urine
imperforate anus nursing ● assess for anal patency
care ● facilitate bonding
● colostomy care
GS - malformation of anterior
abdominal wall, intestines
exposed
Gastroschisis vs
omphalocele O - herniation of bowel into
umbilical cord - intestines
covered by peritoneum and
amnion
○ early diagnosis is key to mitigate morbidity and
Gastroschisis & mortality
Omphalocele Diagnosis ○ alpha-fetoprotein
○ ultrasound
