Gastrointestinal Diseases proportion to

the low-
Dehydration:
depressed
grade fever. fontanelle,
Urine output sunken eyes,
Vomiting is usually and poor skin
normal. turgor.
- suffering from a mild gastroenteritis (infection)
Therapeutic MNG - Stool: liquid
caused by a viral or bacterial organism
- Diarrhea is green (might be
not yet mixed with
Nursing - Risk for deficient fluid
serious at mucus and
Diagnosis volume related to
this stage blood)
vomiting
and children - Urine: scanty
Outcome - Skin turgor remains
can be cared and
Evaluation good; specific gravity of
for at home. concentrated
urine is 1.003 to 1.030;
- If with - Laboratory
urine output is more
vomiting, tx: findings:
than 1mL/kg/hr;
must involve elevated
episodes of vomiting
resting of GI hematocrit,
decreased in frequency
tract but only hemoglobin and
Therapeutic - Withhold food from the
for a short serum protein
Management stomach for a time as if
time. levels and the
there is nothing in the
- After 1 hour, cause would be
stomach, vomiting
parents are dehydration
cannot occur. now able to - Electrolyte
- To decrease vomiting: offer
withhold food and fluid
determinations
Pedialyte will indicate a
for a time (nothing by (an oral re- metabolic
mouth[NPO]) hydration acidosis.
depending on the age solution) but
of the child Therapeutic MNG
only in small - Focuses on
amounts regulating
electrolyte and
Diarrhea fluid balance by
oral or IV
– caused by a virus is the major cause of infant rehydration
gastroenteritis in developing countries that therapy.
invade the GI tract include rotaviruses and - ALL children
adenoviruses. with severe
Mild Diarrhea Severe Diarrhea diarrhea that
Assessment Assessment took longer than
- The Mucous - Rectal Temp: 24 hours should
membrane 103* - 104*F have a stool
of the mouth (39.5* - 40*C) culture taken.
appears dry - Pulse and These can be
and the skin Respirations: taken from the
fells warm weak & rapid rectum or from
although - Skin: pale and the stool in a
skin turgor cool diaper or a
will - Appearance: bedpan.
not yet be Apprehensive, NSG DX
decreased. Listless, and - Deficient fluid
The pulse lethargic volume related
will be rapid - Obvious signs of to loss of fluid
and through diarrhea
out of
 - Risk for impaired o Poor skin turgor
skin integrity o Weight loss
related to
presence of Therapeutic - Treatment is surgical
diarrheal stool Management or laparoscopic
on skin correction(a
- Anxiety related pyloromyotomy)
to traumatic - Before surgery, if
experience electrolyte imbalance,
Outcome Eval dehydration, and
- Skin turgor starvation have
remains good; already occurred, this
specific gravity should be corrected
of urine is 1.003 through the
- Skin diaper area administration of IV
is not Fluid (usually isotonic
erythematous or saline or 5% glucose
ulcerated in saline)
- Child interacts - Oral feedings are
with parents in withheld to prevent
age-appropriate further electrolyte
way; can be depletion.
comforted after - An infant who is
painful receiving only IV Fluid
procedures. generally needs a
pacifier to meet
nonnutritive sucking
needs and be
comfortable.
Hypertonic Pyloric Stenosis Nursing - Risk for deficient fluid
– if hypertrophy or hyperplasia of the muscle Diagnosis volume related to
surrounding the sphincter occurs, it is difficult for inability to retain food
the stomach to empty. Outcome - Skin Turgor remains
- Duration: begins at 6 Evaluation good; Specific gravity
Assessment
weeks of age of urine is 1.0to 1.030;
- Intensity: Projectile Vomiting episodes
vomiting have ceased; Weight
- Frequency: is within acceptable
Immediately after age- appropriate
eating parameters
- Description of the - Infant’s temp is below
Vomitus: Sour but 98.6* (37*C) axillary;
contains no bile incision is clean, dry,
- Is the Infant ill? No. and intact without
- Signs of dehydration: erythema or drainage.
o Lack of tears - The surgical incision
o Dry mucous for pyloric stenosis
membrane of the may be covered with
mouth collodion, a solution
o Sunken fontanelles similar to clear nail
o Fever polish, or a similar
o Decreased urine commercial compound
output to help keep
urine and feces from
 should be kept folded Constipation
low to prevent the - Lethargy
incision from being - Tachycardia
contaminated, and - Rapid, shallow
change diapers
frequently. breathing
- Anorexia
- Possible vomiting
Nursing Care - Prepare the child and
Intussusception family for surgery
using
- Proximal segment of the bowel developmentally
telescopes into a more distal segment, appropriate
resulting in lymphatic and venous techniques
obstruction causing edema in the area. - Avoid applying heat to
- Common in infants and children ages
the abdomen.
Assessment - Stools mixed with blood - Avoid enemas or
and mucus that laxatives.
resemble the
Therapeutic PREOPERATIVE NSG ACTIONS
consistency of red - Administer IV fluid
Procedures
currant jelly. replacement as
- Vomiting
prescribed.
- Fever - Administer IV Fluid
- Tender, distended antibiotic.
abdomen
POSTOPERATIVE NSG
Nursing - Stabilize the child prior
ACTIONS
Care to the procedure
o IV Fluids to correct - Assess respiratory
and prevent status and maintain
dehydration airway.
o NG tube for - Provide supplemental
decompression oxygen as prescribed.
- Teach the family and - Obtain vital signs.
child about the
nonsurgical procedure. - Assess surgical site for
S Therapeutic Air enema bleeding or any other
- w/ or w/o contrast abnormalities.
Procedures
- performed by a - Assess bowel sounds
radiologist and bowel function.

Appendicitis
- Inflammation of the vermiform
appendix caused from an obstruction of
the lumen of the appendix.
- Average client age is 10 years.
Assessment - Abdominal pain in the
right lower quadrant
- Rigid abdomen
- Decreased or absent
bowel sounds
- Fever
- Diarrhea or