GI

Published on Mar 02, 2016

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PRESENTATION OUTLINE

GI

continued....
Photo by Double--M

Diarrhea

different types....
Acute
Acute infectious/infectious gastroenteritis
Chronic
Intractable diarrhea of infancy
Chronic nonspecific diarrhea (CNSD)

causes:
Rotavirus
Salmonella, Shigella, Campylobacter organisms
Giardia organisms
Cryptosporidium organisms
Clostridium difficile
Plesiomonas, Yersinia organisms
Antibiotic effects



Photo by find eric

C Diff

what's the Diff? 
http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/definition...

Treatment for Diarrhea:
Assessment of fluid and electrolyte imbalance
Rehydration
Oral rehydration therapy (ORT)
Intravenous rehydration
Maintenance of fluid therapy
Reintroduction of an adequate diet
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Newborn

Constipation
First meconium should be passed within 24-36 hours of birth; if not, assess for
Intestinal atresia, stenosis
Hirschsprung disease, hypothyroidism
Meconium plug, meconium ileus (CF)


in infancy:
Often related to diet
Almost unknown in exclusively breastfed infants
Stool may become infrequent because of minimal residue from digested breast milk
May develop in formula-fed infants
Interventions

Hirschsprung Disease

MEGACOLON
Hirschsprung Disease: Pathophysiology

Aganglionic segment usually includes the rectum and proximal colon
Accumulation of stool with distention
Failure of internal anal sphincter to relax
Potential for enterocolitis

Hirschsprung Disease: Diagnostic Evaluation
Most cases diagnosed in the first few months of life
Complete and careful history
X-ray, barium enema studies
Anorectal manometric examination
Rectal biopsy to confirm diagnosis

*Treatment:
Surgery
Two stages
Temporary ostomy
Second stage: “pull-through” procedure
Nursing care
Preoperative
Postoperative
Discharge
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Vomiting

nausea or no nausea
Forceful ejection of gastric contents through the mouth
Often accompanied by nausea
Nonbilious and bilious
Therapeutic management
Nursing care management


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GERD

GER:
Transfer of gastric contents into the esophagus
Occurs in everyone
Frequency and persistency: abnormal
May occur without GER disease
GER disease may occur without regurgitation
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Intestinal Parasite

mvp: Giardiasis and Pinworms
Giardia is a genus of anaerobic flagellated protozoan parasites of the phylum Sarcomastigophora that colonise and reproduce in the small intestines of several vertebrates,

The pinworm, also known as threadworm or seatworm, is a parasitic worm. It is a nematode and a common intestinal parasite or helminth, especially in humans.
Photo by frankieleon

Acute Appendicitis

vermiform appendix
Inflammation of the vermiform appendix
Causes and pathophysiology
Diagnostic evaluation
McBurney point
Therapeutic management
Treatment of ruptured appendix
Prognosis
Postoperative care

Diverticulum

Remnant of the fetal mesenteric duct
Remnant of the fetal mesenteric duct
The most common congenital malformation of the GI tract
Occurs in 2%-4% of the population
Pathophysiology
Ulceration, bleeding, intestinal obstruction
Photo by eflon

Inflammatory

Bowel Disease
Includes ulcerative colitis and Crohn’s disease

http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/definit...

Causes and pathophysiology
Diagnostic evaluation
Medical treatment or surgical treatment
Nutritional support
Prognosis
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Peptic Ulcer Disease

acute or chronic
Acute or chronic condition
Causes and pathophysiology
Diagnostic evaluation
Therapeutic management
Medical
Surgical
Prognosis

Hepatitis

sex and unwashed spinach
Hepatitis A
is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.
Hepatitis B
is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.
Hepatitis C
is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.
Hepatitis D
infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.
Hepatitis E
is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.
Hepatitis G
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Cleft Lip

Cleft Palate
http://www.mayoclinic.org/diseases-conditions/cleft-palate/basics/causes/co...

Closure of lip defect precedes correction of the palate
Performed when patients are 2-3 months of age
“Rule of tens”
Z-plasty to minimize retraction of scar
Millard rotational advancement technique
Protect suture line with Logan bow or other methods


Typically performed when patients are 6-12 months of age
Effect on speech development
Prognosis
Nursing care
Photo by Wen-Yan King

Esophageal

Atresia and TE Fistula
atresia: is a condition in which an orifice or passage in the body is abnormally closed or absent. Examples of atresia include: Imperforate anus, malformation of the opening between the rectum and anus.

Esophageal atresia: failure of esophagus to develop as a continuous passage
TEF: failure of the trachea to separate into a distinct structure
May occur separately or in combination
Cause unknown
Diagnostic evaluation
Clinical manifestations
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Hernia

DANGER- incarceration/strangulation

Pyloric

Stenoisis
Constriction of pyloric sphincter with obstruction of gastric outlet
Pathophysiology
Therapeutic management
Prognosis
Nursing care management
Preoperative and postoperative care

Intussusception

3months-3 years
Telescoping or invagination of one portion of intestine into another
Most common cause of intestinal obstruction in children aged 3 months to 3 years
Occasionally due to intestinal lesions (10%)
Cause is often unknown

Diagnostic evaluation
Subjective findings
Ultrasonography
Therapeutic management
Spontaneous resolution in 10% of patients
Prognosis
Nursing care

Malrotation: abnormal rotation of intestine around the superior mesenteric artery during embryologic development
Volvulus: twisting of intestine around itself, thereby compromising blood supply to intestines
May cause necrosis, peritonitis, perforation, and death
Photo by gnuckx

Celiac

Hannah Cilli

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