Gastrointestinal Disorders

Gastrointestinal Disorders
By:Jan Bazner-Chandler
CPNP, CNS, MSN, RN

Embryonic Development
* Failure to fuse = cleft lip and palate
* Failure to differentiate = duodenal stenosis
* Atresia or abnormal closing of structure:
o Esophogeal atresia
o Anal-rectal malformation
o Biliary atresia

Fetal Development
* Fistula is an abnormal connection
* Incomplete or abnormal placement
Prenatal History
* Birth weight
* Prematurity
* History of maternal infection
* Polyhydramnios
* Down Syndrome
Health History
* Congenital anomalies
* Growth or feeding problems
* Travel
* Economic status
* Food preparation
* General hygiene
* Family history of allergies

Present Illness
* Onset and duration of symptoms
* Weight loss or gain
* Recent changes in diet
Vomiting
Nursing Assessment
* Abdominal distention
* Abdominal pain
* Abdominal assessment
Measuring Abdominal Girth
Bowden Text
Diagnostic Tests
* Flat plate of abdomen
* Barium swallow or UGI
Diagnostic Tests
* Ultrasound
* CT scan = tumors, abscess, obstruction
* 24 hour probe = Gastro esophogeal reflux
* Biopsy of liver, esophagus, stomach, intestine
Stool and Blood
* White blood cells
* Ova and Parasite
* Bacterial cultures
* Blood

FTT
Cleft Lip and Palate
Incomplete fusion of the primitive oral cavity
Feeding
Post Surgery Care
Cleft Lip Repair
Cleft Palate
Palate Repair
ESSR
Devices For Feeding
Whaley & Wong
Post Surgery Repair
Long Term Referrals
Esophageal Atresia
Failure of the esophagus
Clinical Manifestations
X-ray Findings
Pre-surgery Care
Post Surgery Care
Ball & Bindler
Post Operative Care
Long Term Complications
Pyloric Stenosis
Clinical Manifestations
Management Pre-surgery
Feeding Post-operatively
Hernias
Inguinal Hernia
Hydrocele
Umbilical Hernia
Diaphragmatic Hernia
Clinical Manifestations
X-ray Diaphragmatic Hernia
Treatment
* ECMO
* Ventilator support
* Chest tube
* Umbilical artery catheter
* NG tube
* Surgical correction when stable
Long Term Problems
Abdominal Defects
Omphalocele
Gastroschisis
Immediate Nursing Intervention
Gastroschisis Repair
Silastic Silo
Treatment
Prune Belly
Intussusception
Clinical Manifestation
Diagnostic X-ray
Management
Surgical Intervention
Hirschsprung Disease
Definition
Clinical Manifestations
Diagnosis and Treatment
Typical X-ray
Colostomy at Birth
Pull-through Surgery
Long Term Complications
Appendicitis
Pathophysiology
Clinical Manifestations
Appendectomy
Ruptured Appendix
Perforation
Interventions for Perforation
Post Operative Care
Nursing Interventions
Inflammatory Bowel Disease
Ulcerative Colitis
Crohn’s Disease
Diagnostic Tests
Drug Therapy
Gastro-esophageal Reflux
Clinical Manifestations GEF
Conservative Management GER
GERD: Gastro-esophageal Reflux Disease
Diagnostic Work-up for GERD
Pharmacologic Therapy
Surgical Management: GERD
Necrotizing Enterocolitis
NEC
Complications
Celiac Disease
Dietary Restrictions
Lactose Intolerance

Gastrointestinal Disorders.ppt