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Pediatric GI DisordersMaternity & Pediatric Nursing

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Question Answer
T/F Using a fleet enema to treat constipation won't get immediate response. A SMOG enema does get immediate results.
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True
When does functional constipation usually develop?
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During the toilet training years
What are some structural abnormalities that can result in secondary causes of constipation? (3)
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Strictures Ectopic anus Hirschsprung disease
What are two systemic conditions that can cause secondary constipation?
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Lead poisoning or hypothyroidism
What classes of medications used in the pediatric population are known to cause constipation?
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Antacids Diuretics antiepileptics Antihistamines Opioids Iron supplementatio
It has been 36 hours and a newborn baby on your floor hasn't passed meconium. What conditions can this be a sign/symptom of? (6)
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Cystic Fibrosis Intestinal atresia or stenosis Hirschsprung disease Hypothyroidism Meconium plugs Meconium ileus
How is constipation typically managed initially?
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With increased fiber and fluids. If this doesn't work, behavior modification is used.
What are the four most common risk factors for developing constipation?
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Family hx of GI disorders, recent hx of anal fissures or rectal bleeding, hx of sexual abuse, or hx of passing meconium beyond 24 hours after birth
When assessing a child brought in by their parent for constipation, you note the presence of a deep pilonidal dimple with a hair tuft on the child's lower back. Based on this finding, you suspect _______ is the underlying cause of the constipation.
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Spina Bifida Occulta
When assessing a child brought in by their parent for constipation, you note the presence flat buttocks. Based on this finding, you suspect ________ is the underlying cause of the constipation.
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Sacral agenesis.
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When assessing a child brought in by their parent for constipation, the mother reports seeing bright red blood on the child's stool a couple of weeks ago. Based on this, you suspect the cause of constipation is...
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A painful experience during defecation resulting in a fear of it, causing the child to hold stool. (Most common cause)
When assessing a child brought in by their parent for constipation, you percuss the abdomen and note dullness. Based on this finding, you suspect the presence of a _________.
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Fecal mass
How should an infant/toddler be positioned in preparation for an enema administration?
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On their abdomen with their knees bent
How should a child or adolescent be positioned in preparation for the administration of an enema?
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On their left side with the right leg flexed towards their chest
How far should the enema tube be inserted into an infant's rectum and how much volume is usually recommended?
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2.5-4 cm/1-1.5 inches, and usually 250 mL or less is infused
How far should the enema tube be inserted into an infant's rectum and how much volume is usually recommended?
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2.5-4 cm/1-1.5 inches, and usually 250 mL or less is infused
How far should the enema tube be inserted into a toddler/preschooler's rectum and how much volume is usually recommended?
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5-7.5 cm/2-3 inches, 250-500 mL infusion
How far should the enema tube be inserted into an adolescent's rectum and how much volume is usually recommended?
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5-7.5 cm/2-3 inches, with 500-1000 mL infusion
T/F After an enema, you should hold a child's buttocks together for 5-10 minutes to promote retention of the enema.
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True
A mechanical obstruction caused by inadequate motility of part of the intestine from the lack of ganglionic cells in the bowel...
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Hirschsprung's Disease
What is the most common cause of neonatal intestinal obstructions?
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Hirschsrpung's disease
  
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