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Pediatric Nursing Reviewer – Caused by fecalith(feces) and

Gastrointestinal Dysfunction microorganism

CONSTIPATION - more than 3 days without passage of Assessment:
stool  Colicky abdominal pain
Causes:  Referred pain – McBurney’s point (right lower
 Other complications quadrant of the abdomen)
 Drug related  Rovsing Pain – pain on one side is felt on the
 Idiopathic other side
 Other systemic disorder  Rebound tenderness- pain upon palpitation
Management: (pag diniinan mu ung hawak, hindi masakit pero
 Increase fluid intake pag tinangal mo na, sobrang sakit)
 Increase fiber intake  Patient cannot walk kasi masakit
 Water soluble enema  Sudden relief of pain with tachycardia followed
 Stool softeners ex. Lactulose by diffuse pain– rupture na ung appendix that
HIRSCHSPRUNG DISEASE may lead to peritonitis (inflammation of
 congenital disease peritoneum)
 Absence of ganglion cell
 DON’T apply HOT or COLD compress because it
 No peristalsis
may rupture the appendix
 Mega colon
 Emergency appendectomy
 Position – supine
 Distended abdomen
 If ruptured – laparoscopic appendectomy
 Chronic constipation
VOMITING – expulsion of gastric content
 Ribbon like stool
 Metabolic Alkalosis (linalabas nya kasi ung
acid sa katawan)
 Rectal Exam:
 Rectum is empty
 Oral rehydration
 Internal sphincter is contracted
 Assess for vomiting
 Passage of liquid stool
 Intake and output monitoring
 Accumulation of gas
 Position – side lying to prevent aspiration
 Barium Enema
DIARRHEA – frequent watery stool
 Rectal biopsy
 Acute diarrhea
 Anorectal mamometry – catheter with balloon
o Common in less than 5 years old kasi ala
pang bacteria that aids in absorption
 Surgery – 2 stages o Caused by opportunistic bacteria and
o 1st stage – gagawa ng ostomy for viruses
temporaty passage of stool
 Chronic diarrhea
o 2nd stage – corrective surgery but the
o Caused by parasites
patient must be 9kls/20lbs
o Can by because of malabsorption and
 Swenson anatomic defects
 Boley Types of diarrhea
 Duhanel  Mild – loose stool
 Soave – endorectal pull  Moderate – severe loose stool
 Health teachings:  Severe – numerous loose stool
o Stool Management:
o Bowel movement  Continue breast feeding to rehydrate the child
o Abdominal girth and to increase its immunity
o How to manage constipation
 Rehydrate the child
o Operation
 Intake and Output monitoring
 Hand washing to prevent infection (bacteria,
– inflammation of veniform appendix
virus, parasites)
– MOST common surgical emergency
 If severe diarrhea – IV is recommended
PYLORIC STENOSIS – circumferential muscle of pyloric  Example of gluten rich food
sphincter becomes thickened B – Barley
R- Rye
O – oatmeal
W – wheat
 The body is not able to convert gluten to
gliaedin. Gliaedin is toxic to intestinal
mucosa that leads to MALABSORPTION
Assessment:  Steatorrhea – (fats)
 Vomiting (projectile)  Malnutrition – (carbohydrates at proteins)
 Vomits NON-BILE  Osteomalacia – (vitamin D)
 Dehydration kasi nag vomit sya  Hemorrhage – (vitamin K)
 Failure to thrive  Anemia – (folic acid and iron)
 Weight loss Management:
 Metabolic Alkalosis (vomit)  DON’T GIVE gluten rich food
 Olive shape mass (right umbilicus) – palpated in  YES to rice
an empty stomach  Increase protein intake
Management:  Increase vitamins and minerals
 Pyloromyotomy (FREDET RAMSTET procedure) MECKEL’S DIVERTICULUM – remnants of omphale
 Correct fluid and electrolytes before surgery  Mesenteric duct
 Post op care:  It fails to obliterate – formation of fistula
o Give water with glucose for 4 – 6 hours that connects umbilicus and intestine
o Give formula food after 24 hours
INTUSSUSEPTION – invagination of bowel leading to
telescoping of the intestine

 Bleeding
 Blood in the stool (melena)
Assessment:  Currant jelly stool (painless)
 Inflammation Management:
 Compression of veins  Surgery
 Vomits WITH BILE o Closure of the duct
 Leakage of blood that leads to edema o Correct bleeding
 Currant jelly stool (Painful) o Prevent shock
 Sausage mass (epigastrium)  Correct fluid and electrolyte balance
Management: CLEFT LIP AND CLEFT PALATE – congenital disorder
 Barium Enema can be diagnostic exam Causes:
 Air pressure  Radiation
 Surgery to decrease invagination  Rubella virus
o Determinant that the procedure is  Drug related
successful is passage of BROWN STOOL Cleft lip – common in male
 Intolerant to gluten Cleft lip and Cleft palate – common in male

CLEFT LIP – small notch in the upper lip

 Can be slight or complete
 It is the separation of the nose to the nasal  Triple Drug Therapy
to the septum o Bismuth
CLEFT PALATE – opening at the palate o Amoxicillin
 Can be in middle or bilateral o Metronidazole
 Not to breast feed because it destroy Or
tissues o Ranitidine
o Use breck feeder/haberman feeder o Amoxicillin
– it is a device use in feeding a child o Claritromycin
with cleft lip
o Position – upright position to aids in
 Surgery : Cleft lip first before cleft palate
because the lip use for feeding, unlikely to
the palate that are use in speech
 Cleft Lip – cheiloplasty/Z plasty
 Cleft Palate – Palatoplasty
 Post op care:
o No to hard foods
o No to suctioning
o Restrain – to protect the suture (Logan
Bar) but position every 2 hours
o Position:
 Cleft Lip – Supine/side lying for
draining secretions
 Cleft Palate – prone position
o Refer to:
 Psychologist (trauma)
 Speech therapist
 Orthodontist (teeth formation)
 Organization
PEPTIC ULCER DISEASE – loss of submucosal and
muscular layer of the gastrointertinal tract
 Bacteria (Helicobacter Pylori)
 Not eating on time
 Idiopathic
 Acidic foods (spicy foods, acidic foods)
Types: - Duodenal Ulcer – pain after eating
 Gastric Ulcer – pain while eating
 Pain in the abdomen, usually morning and
Diagnostic: Urea Breath test
 Endoscopy with biopsy
 Antacids
 Bismuth and sucralfate for GIT protection