Medical Conditions: Dehydration and Appendicitis
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Questions and Answers

What is dehydration?

Dehydration is a body fluid disturbance when the output exceeds intake and results from causes such as fluid loss through the skin, respiratory, urinary, or GI tract.

What are the signs of mild dehydration in children?

  • 3-5% fluid loss (correct)
  • 6-9% fluid loss
  • Greater than 10% fluid loss
  • None of the above

What are the signs of moderate dehydration in children?

  • 3-5% fluid loss
  • 6-9% fluid loss (correct)
  • Greater than 10% fluid loss
  • None of the above

What is appendicitis?

<p>Appendicitis is inflammation of the vermiform appendix caused from an obstruction of the lumen of the appendix.</p> Signup and view all the answers

The average client with appendicitis is 10 years old.

<p>True (A)</p> Signup and view all the answers

What is an indicator of a burst appendix?

<p>Abdominal pain in the right lower quadrant that is relieved by pain (D)</p> Signup and view all the answers

When preparing a child for surgery for appendicitis, you should avoid enemas or laxatives.

<p>True (A)</p> Signup and view all the answers

What is intussusception?

<p>Intussusception is when the proximal segment of the bowel telescopes into a more distal segment, resulting in lymphatic and venous obstruction causing edema in the area.</p> Signup and view all the answers

Intussusception is more common in children between the ages of 3 months and 6 years.

<p>True (A)</p> Signup and view all the answers

What are expected findings of intussusception?

<p>Screaming with knees to chest (A), Sudden abdominal pain (B), Distended abdomen (C), Vomiting &amp; fever (D), Stool mixed with blood and mucus that resembles jelly (E), Abdominal sausage-shaped mass (F)</p> Signup and view all the answers

Intussusception can be treated with an air enema or surgery.

<p>True (A)</p> Signup and view all the answers

What is pyloric stenosis?

<p>Pyloric stenosis is a thickening of the pyloric sphincter, which creates an obstruction in the first few weeks of life.</p> Signup and view all the answers

What are some symptoms of pyloric stenosis?

<p>Olive shaped mass in the upper right quadrant (A), Constant hunger (B), Non-bilious emesis that may be blood tinged (C), Failure to gain weight (D), Possible peristaltic wave that moves from left to right when the baby is lying supine (E), Vomiting following feeding (F)</p> Signup and view all the answers

Pyloric stenosis can be treated with surgery.

<p>True (A)</p> Signup and view all the answers

What is Hirschsprung’s disease?

<p>Hirschsprung’s disease is a structural anomaly in the GI tract caused by a lack of ganglionic cells in segments of the colon, resulting in decreased motility and mechanical obstruction.</p> Signup and view all the answers

A baby with Hirschsprung’s disease may fail to pass meconium within 24-48 hours after birth.

<p>True (A)</p> Signup and view all the answers

What is GERD?

<p>GERD is a condition where gastric contents back up into the esophagus and cause tissue damage.</p> Signup and view all the answers

What are some symptoms of GERD in infants?

<p>Spitting up or forceful vomiting (A), Apnea (B), Respiratory problems (C), Non-cardiac chest pain (D), Difficulty swallowing (E), Irritability (F), Stiffening (G), Excessive crying (H), Chronic cough (I), Arching of back (J), Heartburn (K), Abdominal pain (L), Blood in vomitus (M), Failure to thrive (N)</p> Signup and view all the answers

What are some nursing care and education tips for children with GERD?

<p>Offer small frequent meals (A), Give proton pump inhibitors and H2 receptor antagonists (B), Position the child with their head elevated after meals (C), Thicken infant formula with rice cereal (D)</p> Signup and view all the answers

What is Meckel’s Diverticulum?

<p>Meckel’s Diverticulum is a complication resulting from the failure of the omphalomesenteric duct to fuse during embryonic development.</p> Signup and view all the answers

What are some expected findings of Meckel’s Diverticulum?

<p>Painless rectal bleeding (A), Bloody stool with mucus (B), Abdominal pain (C)</p> Signup and view all the answers

Meckel’s Diverticulum can be treated with surgical removal.

<p>True (A)</p> Signup and view all the answers

Flashcards

Dehydration

Fluid loss exceeding intake, leading to disturbances in body fluids. This can happen due to fluid loss through sweat, breathing, urine, or digestive system.

Mild Dehydration

Fluid loss of 3-5% in infants and 3-4% in children.

Moderate Dehydration

Fluid loss of 6-9% in infants and 6-8% in children.

Severe Dehydration

Fluid loss over 10% in infants and children.

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Oral Hydration

Replacing fluids lost through drinking liquids, like water or electrolyte drinks.

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IV Bolus

Rapidly giving fluids through a vein, like a quick burst of water into a sponge.

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Maintenance IV Fluids

Giving fluids slowly through a vein to maintain fluid levels, like a steady stream of water into a sponge.

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Appendicitis

Inflammation of the appendix, a small pouch attached to the large intestine. It usually happens due to a blockage in the appendix.

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Appendicitis Symptoms

Pain in the lower right side of the abdomen, relieved when the appendix bursts. Other symptoms include a stiff abdomen, decreased bowel sounds, fever, lethargy, diarrhea or constipation, rapid heartbeat, rapid shallow breathing, loss of appetite, and vomiting.

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Appendicitis Management

Avoid enemas, laxatives, and applying heat to the abdomen. Prepare for surgery.

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Ruptured Appendicitis Pre-Operative

Replace electrolytes and fluids, give antibiotics through a vein, and drain the stomach with a tube.

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Ruptured Appendicitis Post-Operative

Monitor vital signs, manage pain, check bowel sounds, look for infection in the abdomen, keep the patient fasting with a tube in their stomach.

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Intussusception

A condition where a part of the intestine folds inwards, like a telescope, blocking the flow of digested food and fluids.

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Intussusception Symptoms

Sudden abdominal pain, screaming with knees pulled to chest, a sausage-shaped mass in the abdomen, bloody and mucus-filled stool resembling jelly, vomiting, fever, and a swollen belly.

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Intussusception Treatment

Air enema or surgery.

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Pyloric Stenosis

Thickening of the muscle that controls the opening from the stomach to the small intestine, causing a blockage.

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Pyloric Stenosis Symptoms

Vomiting after feeding, non-bile vomit (may be blood tinged), constant hunger, a hard mass in the upper right abdomen, a wave-like motion in the stomach, failure to gain weight, and dehydration symptoms like pale skin, dry lips, decreased urine output, rapid heartbeat, and sunken eyes.

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Pyloric Stenosis Treatment

Surgery, fasting, and monitoring fluid intake and output.

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Hirschsprung's Disease

Birth defect where some nerve cells in the colon are missing, leading to poor muscle function and blockage of waste.

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Hirschsprung's Disease Symptoms in Newborn/Infant

Failure to pass meconium after birth, bile-colored vomit, refusal to eat, swollen belly, poor growth, constipation, and episodes of diarrhea and vomiting.

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Hirschsprung's Disease Symptoms in Child

Poor nutrition, anemia, swollen belly, visible muscle movement in the gut, a hard mass of waste felt in the abdomen, constipation, and foul-smelling, thin stool.

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Hirschsprung's Disease Treatment

Surgical removal of the affected part of the colon. Sometimes a temporary opening in the colon (ostomy) may be needed.

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GERD (Gastroesophageal Reflux Disease)

Acid from the stomach flows back up into the esophagus, causing irritation and damage.

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GERD Symptoms in Infants

Spitting up, forceful vomiting, irritability, excessive crying, blood in vomit, arching back, stiffening, breathing problems, poor growth, and pauses in breathing.

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GERD Symptoms in Children

Heartburn, stomach pain, difficulty swallowing, chronic cough, and pain in the chest not related to the heart.

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GERD Nursing Care

Offer small, frequent meals, keep the child upright after eating, thicken infant formula with rice cereal, and use medications to reduce stomach acid.

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Meckel's Diverticulum

A small pouch in the small intestine that develops during pregnancy when a tube from the belly button to the intestines doesn't fully disappear.

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Meckel's Diverticulum Symptoms

Painless bleeding from the rectum, stomach pain, and bloody stool with mucus.

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Meckel's Diverticulum Treatment

Surgical removal of the pouch.

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Study Notes

Dehydration

  • Body fluid imbalance when output exceeds intake.
  • Caused by fluid loss through skin, respiratory, urinary, or GI tract.
  • Mild: 3-5% (infants) / 3-4% (children)
  • Moderate: 6-9% (infants) / 6-8% (children)
  • Severe: >10% (infants) / >8% (children)
  • Treatment: 20 ml/kg IV bolus, maintenance IV fluids, push/pull method.

Diarrhea and Dehydration

  • Diagnosed when accompanied by dehydration.

Appendicitis

  • Inflammation of the appendix, often caused by blockage.
  • Average patient age: 10 years old.
  • Symptoms: Right lower quadrant (RLQ) pain, pain relief could indicate rupture.
  • Other signs: rigid abdomen, rebound tenderness, decreased/absent bowel sounds, fever, lethargy, diarrhea/constipation, tachycardia, rapid shallow breathing, anorexia, vomiting

Preparing for Appendicitis Surgery

  • Avoid enemas and laxatives.
  • Avoid applying heat to abdomen.
  • Preoperative procedures: Electrolyte and fluid replacement, IV antibiotics, NG tube for decompression.
  • Postoperative care: Obtain vitals, pain medication, monitor bowel sounds, assess for peritonitis.

Intussusception

  • Proximal segment of bowel telescopes into a distal segment.
  • Leads to lymphatic/venous obstruction and subsequent edema.
  • Associated with ischemia, increased mucus in the intestines.
  • Common age range: 3 months to 6 years
  • Symptoms: Sudden abdominal pain, screaming, knees to chest.

Pyloric Stenosis

  • Thickening of the pyloric sphincter, causing obstruction.
  • Occurs in infants during first few weeks of life.
  • Symptoms: Vomiting (non-bilious, may be blood tinged), constant hunger, olive-shaped mass in upper right quadrant (RUQ).

Hirschsprung's Disease

  • Structural GI tract anomaly, lack of ganglionic cells in certain sections of colon.
  • Decreased intestinal motility, mechanical intestinal obstruction.
  • Newborn/infant signs: Failure to pass meconium within 24-48 hours after birth, vomiting (often bile), refusal to eat, abdominal distention.
  • Older child/kid signs: Failure to thrive, episodes of diarrhea and vomiting, abdominal distention, visible peristalsis, palpable fecal mass, constipation.
  • Foul, ribbon-like stool.

Meckel's Diverticulum

  • Complication of incomplete fusion of the omphalomesenteric duct during development.
  • Symptoms: Painless rectal bleeding, abdominal pain, bloody stools with mucus.
  • Treatment: Surgical removal of diverticulum.

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Description

Test your knowledge on dehydration and appendicitis with this quiz. Explore the causes, symptoms, and treatment protocols for both conditions. Ideal for medical students and healthcare professionals seeking to reinforce their understanding of these critical medical issues.

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