NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
- high incidence in african americans According to the national digestive
Which ethnicity is more prone to lactose
diseases information clearing house there is a "50-90% incidence in Asians,
intolerance?
American indians, Arabs, Jews, African Americans, and Southern Europeans
Not getting enough calcium so some dairy products people can usually to
What are nutritional concerns for
are hard cheeses and yogurt (Fresh not frozen) and take Vitamin D and K
children with lactose intolerance?
-bone density; causes problems with bone growth
potential causes of clefting- maternal smoking, advanced maternal age,
What multifactorial causes are related to
fever,diabetes, prenatal infection, AMA, use of certain drugs - anticonvulsa
clefting
steroids, and other medications early in pregnancy
Infants with cleft palate are generally fitted with a removable orthopedic d
(Latham device) to facilitate closure of palate. This device serves as a feedin
feeding with cleating
plate. Special bottles with nipples (Habermas feeder, Mead Johnson Cleft
Feeder) are also used to facilitate feedings
. Explain teaching for care of the feeding Put medication on mouth piece for thrush, can't LATCH well so a Breastfeed
plate, treatment of thrush, and consultant needs to be contacted, and with the Haberman feeder you nee
precautions with compressible squeeze line the lines up with the nose
bottles
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Normal Saline to cleanse the suture line q shift and PRN
"No-No restraints at all times
order following a cleft repair Feeding plate
will include- Special nipples/bottles (Haberman Feeder or Mead Johnson Cleft Feeder)
Tylenol 15 mg/kg/dose and Codeine 1 mg/kg/dose q 4 - 6 hours PRN for p
for central incisional pain
How long must a child with repair to the -2-4 weeks
mouth have nothing put in their mouth? - Brek feeders
and what kind of feeder do we use for
these children?
-seek care at agency where they do multidisciplinary care; one place where
Therapeutic management of cleft
look at everything Plastic surgeon, craniofacial specialist, oral surgeon, den
lip/palate involves a multidisciplinary
and/or orthodontist, prosthodontist, psychologist, otolarygologist, nurse, s
team. Which professionals are members
worker, audiologist, and speech-language pathologist
of this team?
OT, PT, Dietary
Why should crying be prevented and -crying pulls on suture line; pulls on sutures and can cause repair to break
how is this accomplished post-op -Avoid damage to repair and have parents request pain medication before
surgical repair of cleft lip and palate? pain gets bad,comforting
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Generally done about 1 year of age-because this is when speech productio
normally happens.
Done before speech production
Cleft Palate Repair
Infants generally say "mama and dada" around 1 year of age
-want to wait a year because they have time to grow and can tolerate anes
better and more tissue for the repair.
Explain the difference between EA is a blind pouch of the esophagus and TEF is where there is a hole betw
Esophageal Atresia (EA) and the esophagus and the trachea
Tracheoesophageal Fistula (TEF)
-parenting,risk for impaired
- knowledge, deficient
- imbalanced nutrition less than
cleft lip/palate nursing diagnoses - impaired gas exchange
- ineffective airway clearance
- ineffective breathing pattern
-pain(acute- post surgical)
Second most common defect ( 6-8%)
ESOPHAGEAL ATRESIA WITHOUT
Blind pouch
FISTULA
No communication to the trachea
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Two-Stage Repair
ESOPHAGEAL ATRESIA WITHOUT 1. Gastrostomy to keep the bowel empty of secretions and cervical
FISTULA repair esophagostomy to handle the excessive oral secretion
2. Connect the esophagus-reconnect the esophagus.
-excess oral secretions
ESOPHAGEAL ASTRESIA WITHOUT -regurgitation of feedings; undigested food
FISTULA ;what happens -blind pouch with no communication to trachea
-no hole
Excessive salivation and drooling from inability of secretions to pass throug
ASSESSMENT OF esophagus
ESOPHAGEAL ATRESIA (EA) Regurgitation of undigested formula immediately after feeding
NG tube or SXN catheter cannot be passed
Postoperatively
Change gauze dressing to cervical esophagostomy to prevent skin breakd
EA post-op and prevent infection
Administer gastrostomy feedings only by gravity- this is to protect the surg
repair- so don't add extra pressure to the site
- high incidence in african americans According to the national digestive
Which ethnicity is more prone to lactose
diseases information clearing house there is a "50-90% incidence in Asians,
intolerance?
American indians, Arabs, Jews, African Americans, and Southern Europeans
Not getting enough calcium so some dairy products people can usually to
What are nutritional concerns for
are hard cheeses and yogurt (Fresh not frozen) and take Vitamin D and K
children with lactose intolerance?
-bone density; causes problems with bone growth
potential causes of clefting- maternal smoking, advanced maternal age,
What multifactorial causes are related to
fever,diabetes, prenatal infection, AMA, use of certain drugs - anticonvulsa
clefting
steroids, and other medications early in pregnancy
Infants with cleft palate are generally fitted with a removable orthopedic d
(Latham device) to facilitate closure of palate. This device serves as a feedin
feeding with cleating
plate. Special bottles with nipples (Habermas feeder, Mead Johnson Cleft
Feeder) are also used to facilitate feedings
. Explain teaching for care of the feeding Put medication on mouth piece for thrush, can't LATCH well so a Breastfeed
plate, treatment of thrush, and consultant needs to be contacted, and with the Haberman feeder you nee
precautions with compressible squeeze line the lines up with the nose
bottles
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Normal Saline to cleanse the suture line q shift and PRN
"No-No restraints at all times
order following a cleft repair Feeding plate
will include- Special nipples/bottles (Haberman Feeder or Mead Johnson Cleft Feeder)
Tylenol 15 mg/kg/dose and Codeine 1 mg/kg/dose q 4 - 6 hours PRN for p
for central incisional pain
How long must a child with repair to the -2-4 weeks
mouth have nothing put in their mouth? - Brek feeders
and what kind of feeder do we use for
these children?
-seek care at agency where they do multidisciplinary care; one place where
Therapeutic management of cleft
look at everything Plastic surgeon, craniofacial specialist, oral surgeon, den
lip/palate involves a multidisciplinary
and/or orthodontist, prosthodontist, psychologist, otolarygologist, nurse, s
team. Which professionals are members
worker, audiologist, and speech-language pathologist
of this team?
OT, PT, Dietary
Why should crying be prevented and -crying pulls on suture line; pulls on sutures and can cause repair to break
how is this accomplished post-op -Avoid damage to repair and have parents request pain medication before
surgical repair of cleft lip and palate? pain gets bad,comforting
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Generally done about 1 year of age-because this is when speech productio
normally happens.
Done before speech production
Cleft Palate Repair
Infants generally say "mama and dada" around 1 year of age
-want to wait a year because they have time to grow and can tolerate anes
better and more tissue for the repair.
Explain the difference between EA is a blind pouch of the esophagus and TEF is where there is a hole betw
Esophageal Atresia (EA) and the esophagus and the trachea
Tracheoesophageal Fistula (TEF)
-parenting,risk for impaired
- knowledge, deficient
- imbalanced nutrition less than
cleft lip/palate nursing diagnoses - impaired gas exchange
- ineffective airway clearance
- ineffective breathing pattern
-pain(acute- post surgical)
Second most common defect ( 6-8%)
ESOPHAGEAL ATRESIA WITHOUT
Blind pouch
FISTULA
No communication to the trachea
, NURS 2346: GI Disorders of Pediatric Patients, NURS 2346 Peds GI, 2345 - Exam 1
Two-Stage Repair
ESOPHAGEAL ATRESIA WITHOUT 1. Gastrostomy to keep the bowel empty of secretions and cervical
FISTULA repair esophagostomy to handle the excessive oral secretion
2. Connect the esophagus-reconnect the esophagus.
-excess oral secretions
ESOPHAGEAL ASTRESIA WITHOUT -regurgitation of feedings; undigested food
FISTULA ;what happens -blind pouch with no communication to trachea
-no hole
Excessive salivation and drooling from inability of secretions to pass throug
ASSESSMENT OF esophagus
ESOPHAGEAL ATRESIA (EA) Regurgitation of undigested formula immediately after feeding
NG tube or SXN catheter cannot be passed
Postoperatively
Change gauze dressing to cervical esophagostomy to prevent skin breakd
EA post-op and prevent infection
Administer gastrostomy feedings only by gravity- this is to protect the surg
repair- so don't add extra pressure to the site
