Professional Documents
Culture Documents
Week 14 Gastrointestinal Disorders
Week 14 Gastrointestinal Disorders
CLINICAL MANIFESTATION
Alternating Diarrhea and Constipation Kapag tumaas ang intraluminal pressure magiistop ang blood
Flatulence flow sa appendix then magkakaroon ng inflammatory
Bloating response. Ang problema kapag di agad na manage ang
Abdominal distention appendicitis may chance na magrupture yun and yung
Lower abdominal pain intraluminal content spread in the abdomen and since
maraming bacteria sa intraluminal magcacause siya ng
THERAPEUTIC MANAGEMENT peritonitis and sepsis.
Environmental modifications Kapag nawala ang pain- rupture
Stress management CLINICAL MANIFESTATION
Psychosocial intervention First symptom: colicky, cramping, abdominal pain
Antispasmodics (HMDD-buscupan ) in the periumbilical area
Antidiarrheal (diatabs) – wag lagi kasi baka Nausea, vomiting, anorexia
magkaroon ng drug tolerance Blumberg sign: rebound tenderness – ipipress ang
Simethicone (anti-flatulence) RLQ then saka siya sassakit kapag inaangat yung
Diet kamay
o High fiber (soluble) – naabsorb ng katawan Rovsing sign: RLQ tenderness upon palpation of
o Psyllium supplements other quadrants
*kapag nagtatae – kumain ng apple na walang balat Psoas sign – Ififilex ang(R) hip for testing, then hindi
*kapag constipated – kumain ng apple na may balat siya mafiflex
NURSING MANAGEMENT Obturator sign – papatayuin or higa then papaikutin
Family support and education ang legs kapag sumakit ang RLQ (+)
Collaborate with the family with dietary DIAGNOSTIC EVALUATION
modifications: Basing on history and physical examination
o Eating slowly CBC: high WBC - walang infection pero may
o Avoiding carbonated beverages (nakakapautot inflammation
ang carbonated beverages) Ultrasonography
o Adding fiber to diet CT scan
o Relieving environmental stress THERAPEUTIC MANAGEMENT
Surgery- APPENDECTOMY (open or
INFLAMMATORY CONDITIONS laparoscopic)
Kapag nagrupture(X-laparascopic) winawash ang
ACUTE APPENDICITIS intestine para walang maiwan na fecal debris
→ Inflammation of the vermiform appendix pagkatapos massive antibiotics (metronidazole)
→ Appendix – produces mucus and house of good
bacteria (RLQ- mcBurnysi Point)
NURSING MANAGEMENT
Assist in establishing diagnosis (physical exam)
Instruct the child to point a finger on the painful
region
PATHOPHYSIOLOGY Light palpation will satisfactorily elicit pain
Wag laging ipalpate
Pre-op care
o Avoid hot compress
o Avoid extensive palpation
o Avoid analgesic (cover symptom of
ruptured)
o Avoid enema (increase intraluminal
pressure that might cause rupture)
Post-op care
o Flat on bed In position
MECKEL DIVERTICULUM
→ Remnant of the fetal omphalomesentric duct that
connects the yolk sac with the primitive midgut
during fetal life
→ Normally the structure obliterates by 7th – 8th of
gestation
→ Mechanisms that causes obstruction: intussusception,
incarceration by hernia, volvulus
CLINICAL MANIFESTATION
Sudden onset of crampy abdominal pain
Inconsolable crying
Drawing up of knees on the chest
Bilous vomiting
Palpable sausage-shaped mass in abdomen
Currant jelly-like stool (Blood and mucus) (painful)
DIAGNOSTIC EVALUATION
Based on subjective finding
Barium enema (highlight the intestine)
Abdominal radiograph
Rectal exam (mucus and blood)
THERAPEUTIC MANAGEMENT
Non-surgical hydrostatic reduction - using enema CLINICAL MANIFESTATION
or air pressure Failure to thrive
o Not recommended if there are signs of Chronic diarrhea => prone to dehydration
perforation (pagkabutas ng intestine) Abdominal distention
Necrosis Muscle wasting
Peritonitis (rigid or board like abdomen) Anorexia
Bloating Irritability
Surgery – resection of non-viable portion DIAGNOSTIC EVALUATION
o NG decompression
Presence of antigliadin and antiendomysial
o IVF
immunoglobulin and their disappearance when
o Antibiotic therapy
gluten is removed in the diet
NURSING MANAGEMENT Villous atrophy and hyperplasia in children who eat a
Assist in establishing diagnosis diet with gluten - intestine biopsy
Explain the basic defect to the parents and how its (esophagogastroduodenoscopy)
corrected Remission of symptoms upon gluten withdrawal
DIAGNOSTIC EVALUATION
Apparent at birth
CL diagnosed in utero through ultrasound 14-16th
week
Palpation of the palate
THERAPEUTIC MANAGEMENT DIAGNOSTIC EVALUATION
Surgery
o Cleft lip (cheiloplasty) Radiographic studies (radiopaque insertion in
o Cleft palate (palatoplasty) abdomen)
Polyhydramnios (2000ml of amniotic fluid) – clue to
a possibility of EA
THERAPEUTIC MANAGEMENT