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Pediatric GI DisordersMaternity & Pediatric Nursing

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________ is caused by transient relaxation of the LES during swallowing, crying or any other Valsalva maneuver that increases intraabdominal pressure.
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Gastroesophageal Reflux
What impact does inflammation have on the lab values for CRP (C-Reactive Protein) and Sed Rate?
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They are both elevated in the presence of inflammation (ie. inflammatory bowel disease)
Sulfasalazine is a medication used primarily to treat which inflammatory bowel disease, Chron's or Ulcerative Colitis?
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Chron's
Asacol/mesalamine is a medication used primarily to treat which inflammatory bowel disease, Chron's or Ulcerative Colitis?
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Ulcerative Colitis
What are some common nonpharmacologic interventions to treat a child with GERD?
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Elevating the head of the bed, keeping the child upright for 30 minutes after eating, smaller, more frequent meals.
What classes of medications are prescribed for children with GERD?
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H2 antagonists like Ranitidine (Zantac) or Famotidine (pepcid). Most effective in treatment of esophagitis. Or...Proton pump inhibitors like Nexium (esomepraxole),Prevacid (lansoprazole),Prilosec (omeprazole)or Protonix (pantoprazole). Prokinetic medications like Reglan or Urecholine may also be prescribed.
Class of medications that promote esophageal peristalsis and accelerate gastric emptying, often used in treating pediatric cases of GERD...
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Prokinetics: Bethanecol (Urecholine) and Metoclopramide (Reglan)
What respiratory conditions can develop secondary to GER?
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Coughing, wheezing, stridor, apnea, frequent respiratory infections, pneumonia, reflux-induced asthma
When surgical intervention is required for the treatment of GER, what surgery is performed?
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A Nissen fundoplication where the gastric fundus is wrapped around the lower 2-3 cm of the esophagus.
What impact does GERD have on the cardiac system?
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It often causes episodes of bradycardia
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What is the most common cause of emergent abdominal surgery in children?
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Appendicitis (median ages 4-15)
_________ is caused by a closed-loop obstruction of the appendix, typically comprised of fecal material. Intraluminal pressure increases and causes edema, bacterial overgrowth and perforation.
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Appendicitis
What are the signs and symptoms of appendicitis?
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Pain with gradual onset that is persistent and intensifies over time (RLQ), n/v, small-volume, frequent soft stools, low-grade fever, Tachycardia, Pallor, Lethargy, Irritability, and/or Stooped posture
_________ is the area midway between the anterior superior iliac crest and the umbilicus where maximal tenderness typically occurs due to appendicitis.
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McBurney's Point
Peritonitis is a serious complication of appendicitis. What are the signs and symptoms?
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Diffuse abdominal tenderness, distention
When should you suspect an appendix has perforated?
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If a child's abdominal pain is suddenly relieved without intervention
When treating a child for fluid volume deficit, why is it important to avoid high carbohydrate liquids and what are some examples?
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They are low in electrolytes and decrease stool transit time. Examples: Kool-Aid, fruit juice
What is the best indicator of fluid volume status in children?
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Daily weights
What type of fluids are discouraged during the acute phases of diarrhea and why?
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Milk products because they may worsen diarrhea
How long should a child be on a clear liquid diet when treating diarrhea?
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No more than 24 hours because it can result in liquid stools (called starvation stools)
Which inflammatory bowel disease (Chron's or Colitis)? Rectal bleeding
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Ulcerative colitis
  
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