Unit 5 OB/Peds Exam
Physical assessment steps review - inspection, auscultation, percussion, palpation
high pitched loud tinkling sounds in bowel - obstruction
when can we claim absent bowel sounds? - 5 mins no sound
tympanic sound - gas
dull sound - organ
celiac disease: clinical manifestations - abdominal bloating, diarrhea, vomiting, thin extremities with
normal-appearing face, flatulence, foul-smelling stools and steatorrhea, dermatitis herpetiformis
celiac disease: treatment - gluten-free diet
gluten-free diet - no: wheat, rye, barley
yes: rice, corn, oats
dermatitis herpetiformis location - on elbows, knees, shoulders, neck area
definitive diagnosis for celiac disease - blood test to see if gluten antibodies
appendicitis clinical manifestations - initial pain in the periumbilical area, moves to right lower quadrant
(McBurney's point), low-grade fever, n/v, positioning, rebound tenderness, pain
,Pre-op care for appendicitis - NPO, IV access, consent!
treatment for appendicitis - surgery
Post-op care for appendicitis - monitor for infection, bowel sounds, bleeding
if emergency ruptured appendectomy - JP drain post-op
Gastroesophageal reflux disease (GERD): clinical manifestations - -recurrent vom, coughing, choking
-slow or no weight gain
-excessive irritability or crying
-arching
-throat clearing
older children: heart burn, sore throat
GERD treatments - feeding precautions, Nissen fundoplication, gradual increase in feeding after surgery,
avoid causative foods
infant feeding precautions for GERD - thicken formula with rice cereal, upright for an hour after feeds,
small frequent feedings, burp often
meds for GERD - metoclopramide, lansoprazole, omeprazole
nissen fundoplication - repair of the diaphragm and fundus wrapping, so that the gastric juices can't get
back up
, GERD causative agents - milk, citrus juices, red sauce, carbonation, cigarette smoke
pyloric stenosis clinical manifestations - - non-bilious vomiting after feed
-can become projectile
-dehydration
-poor weight gain
-failure to thrive
timeline for pyloric stenosis - a week after birth - 5 months after birth
treatment for pyloric stenosis - pylorotomy
what did Ivey compare pyloric stenosis to - water hose being cut off then released!
diagnosis for pyloric stenosis - olive sign in stomach area, ultrasound
post-op care for pyloric stenosis - fold diaper below incision site, small feedings with frequent burping
volvulus intestinal obstruction - twisting of the intestine
volvulus intestinal obstruction: symptoms - crying, legs pulled up, distended abdomen, bilious vomiting
volvulus intestinal obstruction: treatment - surgery to untwist intestine
intussusception intestinal obstruction - invaginated intestine, collapses in on itself like a telescope
Physical assessment steps review - inspection, auscultation, percussion, palpation
high pitched loud tinkling sounds in bowel - obstruction
when can we claim absent bowel sounds? - 5 mins no sound
tympanic sound - gas
dull sound - organ
celiac disease: clinical manifestations - abdominal bloating, diarrhea, vomiting, thin extremities with
normal-appearing face, flatulence, foul-smelling stools and steatorrhea, dermatitis herpetiformis
celiac disease: treatment - gluten-free diet
gluten-free diet - no: wheat, rye, barley
yes: rice, corn, oats
dermatitis herpetiformis location - on elbows, knees, shoulders, neck area
definitive diagnosis for celiac disease - blood test to see if gluten antibodies
appendicitis clinical manifestations - initial pain in the periumbilical area, moves to right lower quadrant
(McBurney's point), low-grade fever, n/v, positioning, rebound tenderness, pain
,Pre-op care for appendicitis - NPO, IV access, consent!
treatment for appendicitis - surgery
Post-op care for appendicitis - monitor for infection, bowel sounds, bleeding
if emergency ruptured appendectomy - JP drain post-op
Gastroesophageal reflux disease (GERD): clinical manifestations - -recurrent vom, coughing, choking
-slow or no weight gain
-excessive irritability or crying
-arching
-throat clearing
older children: heart burn, sore throat
GERD treatments - feeding precautions, Nissen fundoplication, gradual increase in feeding after surgery,
avoid causative foods
infant feeding precautions for GERD - thicken formula with rice cereal, upright for an hour after feeds,
small frequent feedings, burp often
meds for GERD - metoclopramide, lansoprazole, omeprazole
nissen fundoplication - repair of the diaphragm and fundus wrapping, so that the gastric juices can't get
back up
, GERD causative agents - milk, citrus juices, red sauce, carbonation, cigarette smoke
pyloric stenosis clinical manifestations - - non-bilious vomiting after feed
-can become projectile
-dehydration
-poor weight gain
-failure to thrive
timeline for pyloric stenosis - a week after birth - 5 months after birth
treatment for pyloric stenosis - pylorotomy
what did Ivey compare pyloric stenosis to - water hose being cut off then released!
diagnosis for pyloric stenosis - olive sign in stomach area, ultrasound
post-op care for pyloric stenosis - fold diaper below incision site, small feedings with frequent burping
volvulus intestinal obstruction - twisting of the intestine
volvulus intestinal obstruction: symptoms - crying, legs pulled up, distended abdomen, bilious vomiting
volvulus intestinal obstruction: treatment - surgery to untwist intestine
intussusception intestinal obstruction - invaginated intestine, collapses in on itself like a telescope
