COMMON PEDIATRIC DISORDERS (GI) o Basophils

- Cephalocaudal approach (CLAN; Chronic Lymphocytes, Acute

Neutrophils)
CLEFT LIP AND CLEFT PALATE
o Chronic conditions usually have ↑
CLEFT LIP SIMILARITIES CLEFT PALATE
Lymphocytes
- Caused by: - Speech
o Acute conditions usually have ↑
- Heredity problem
- Maternal neutrophils
smoking Agranulocytes (Ben10)
- Common in Problems: - Common in o Basophils
males - Difficulty in females o Eosinophils
feeding o Neutrophils
- Risk for
aspiration GASTROESOPHAGEAL REFLUX DISEASE/ CHALASIA
Risk for
Problem:
infection
(URTI) - Incompetent lower esophageal sphincter
Nursing Responsibilities (cardiac sphincter)
- Use of large nipples for - Training cap and
easier suctioning medicine dropper (for Signs and Symptoms:
well regulated drops;
- Forceful vomiting
prevents aspiration)
- Heartburn (chest pain due to HCL acid is
Surgical management
backflowing and causes damage to esophageal
Cheiloplasty Palatoplasty
Rule of 10: - Surgical repair of lining)
- 10 weeks cleft palate - Bitter taste in the mouth
- 10 pounds Rule: - Dysphagia Difficulty of swallowing
- 10K WBC - Not too early - Odynophagia Painful swallowing
- 10g/dL Hgb (risk for - Hoarseness of voice regurgitation can cause
reopening of the laryngeal damage.
palate)
- Not too late (will Diagnostics:
↑ risk for speech - Barium swallow (2days)
problem)
o Eliminate it before 2 days (to prevent
- Usually done 18-
obstruction) by increasing OFI and use
24 months
of laxatives as ordered

- Maternal smoking Management:

o cigarettes have Carbon monoxide which - ↓ fat diet – hard to digest
may attach to hemoglobin and form - ↑ fiber diet – fiber enhances digestion; ↑
carboxyhemoglobin; prevents oxygen peristalsis movement
(O2=nutrients) from binding to - SFF (small frequent feeding) – ↑ in stretch = ↑
hemoglobin which leads to ↓ oxygen to in contractions (lobo sample)
fetus resulting to developmental - Avoid: spicy foods, tobacco, caffeine, alcohol
problem - Medications:
- WBC (Never Let Monkeys Eat Banana) o Antacids:
o Neutrophils  Magnesium – side effect is
o Lymphocytes Diarrhea (Mg Tae)
o Monocytes  Aluminum - side effect is
o Eosinophils constipation (Al ang Tae)
 o H2 Blockers: “tidine” - Retarded growth
o PPI (proton pump inhibitors): “prazole” - Failure to thrive (delayed milestone)
o Head of bed Elevated: 6-8 inches during
Management:
inches to prevent regurgitation
- Avoid BROW (Barley, Rye, Oat, Wheat) because
Pyloric Stenosis
this contains ↑ concentration of gluten
- Narrowing of pyloric sphincter - Foods to allow: meat, eggs, milk products (milk,
- Pyloric sphincter regulates gastric emptying cheese, cream), all fruits and veggies, rice and
time corn
- Abdominal distention will lead to olive shape
***birthday party: BRING OWN CAKE
mass.
- Children who attend birthday party is looking
Signs and symptoms:
forward on eating cake. Commercially
- Projectile vomiting – without bile prepared cakes have gluten so you must bring
- Prone to metabolic alkalosis you gluten free cake for your child with celiac
disease.
*Vomiting with bile suggests intestinal obstruction
Consent
*Vomiting leads to alkalosis
Sequence for signing consent:
*Diarrhea leads to acidosis
- Patient
Management: - Spouse
- Monitor feeding patterns - Children
- Assess the vomitus (to check for presence of - Parents
bile) - Grand parents
- ↑ oral fluid intake to ease digestion, prevent - Siblings
abdominal distention - Nearest kin
- Prevent aspiration by feeding slowly - Hospital Director
- Burp frequently to prevent gas
formation/abdominal distention
- ↑ Fowler’s position to prevent regurgitation
- Surgery: Pyloromyotomy
o Incision that splits the obstruction

Celiac Disease/ Celiac Sprue/ Gluten Sensitive

enteropathy

- disease condition of the GI that is caused by

extreme sensitivity to gluten or malabsorption
of gluten
- irreversible
- needs gluten free diet for life

Signs and symptoms:

- Acute diarrhea
- Steatorrhea – FFF (Foul Fatty Feces)
- Anorexia
- Vomiting
- Severe abdominal distention
- Body wasting (Cachexia)