Nursing Science: Maternal and Child Health - Gastrointestinal Disorders
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Questions and Answers

What is the primary location of thrush stomatitis in children?

  • Stomach and small intestine
  • Esophagus
  • Large intestine and anus
  • Tongue and inner cheeks (correct)

    • What is the primary cause of thrush stomatitis in children?

  • Fungal infection by Candida (correct)
  • Bacterial infection
  • Poor sterilization of feeding equipment
  • Viral infection

    • What is the primary symptom of thrush stomatitis in children?

  • Vomiting
  • Diarrhea
  • White patches on the tongue and inner cheeks (correct)
  • Abdominal pain

    • What is the primary treatment for thrush stomatitis in children?

    <p>Oral antifungal medication</p> Signup and view all the answers

    What is an important part of nursing management for thrush stomatitis?

    <p>Cleanliness of feeding equipment</p> Signup and view all the answers

    How is thrush stomatitis typically spread?

    <p>Through contaminated feeding equipment</p> Signup and view all the answers

    What is a common complication of thrush stomatitis in children?

    <p>Anorexia</p> Signup and view all the answers

    What is the primary goal of nursing management in thrush stomatitis?

    <p>Preventing the spread of infection</p> Signup and view all the answers

    What is the primary cause of acute infectious diarrhea in children?

    <p>Rotavirus</p> Signup and view all the answers

    What is the definition of acute diarrhea?

    <p>A sudden increase in stool frequency and a change in consistency</p> Signup and view all the answers

    What is the primary goal of the clinical evaluation of a child with acute gastroenteritis?

    <p>To ask questions about recent travel and dietary habits</p> Signup and view all the answers

    What is the treatment of choice for infants and children with acute diarrhea and dehydration?

    <p>Oral rehydration therapy (ORT)</p> Signup and view all the answers

    What is a common cause of chronic diarrhea?

    <p>All of the above</p> Signup and view all the answers

    What is the definition of chronic diarrhea?

    <p>An increase in stool frequency and water content with a duration of more than 14 days</p> Signup and view all the answers

    What is the advantage of oral rehydration therapy (ORT) over IV rehydration?

    <p>It is more effective, safer, less painful, and less costly</p> Signup and view all the answers

    What is the importance of asking about dietary habits in the clinical evaluation of a child with acute gastroenteritis?

    <p>To explore the presence or absence of other symptoms</p> Signup and view all the answers

    What is the primary cause of colic in infants?

    <p>Excessive swallowing of air</p> Signup and view all the answers

    What is a common symptom of colic?

    <p>Sudden attack of abdominal pain</p> Signup and view all the answers

    What is the purpose of giving infants sterile water after each feeding?

    <p>To wash the mouth</p> Signup and view all the answers

    What is the definition of diarrhea?

    <p>A symptom that results from disorders involving digestive, absorptive, and secretory functions</p> Signup and view all the answers

    What is the estimated number of episodes of diarrhea worldwide each year?

    <p>1.3 billion</p> Signup and view all the answers

    What is the purpose of giving hot fluids such as anise or caraway to infants with colic?

    <p>To help in expulsion of gases</p> Signup and view all the answers

    What is the classification of diarrhea?

    <p>Acute or chronic</p> Signup and view all the answers

    What is the purpose of teaching mothers good feeding techniques in the management of colic?

    <p>To prevent over or rapid feeding</p> Signup and view all the answers

    How much ORS should be given to a child with each diarrheal stool if the stool volume is unknown?

    <p>10 ml/kg</p> Signup and view all the answers

    What is the recommended frequency of giving ORS to a vomiting child?

    <p>At frequent intervals and in small amounts</p> Signup and view all the answers

    How can a caregiver assess the frequency and amount of stool losses?

    <p>By monitoring the number of wet diapers or voidings</p> Signup and view all the answers

    What is an important aspect of education on ORT?

    <p>Administration and replacement of ongoing losses</p> Signup and view all the answers

    How often should a mother give ORS to her child?

    <p>One teaspoonful every 1-2 minutes</p> Signup and view all the answers

    What is a limitation of ORS therapy?

    <p>It is ineffective in severe dehydration</p> Signup and view all the answers

    How can diarrhea be prevented?

    <p>By feeding only breast milk for the first 6 months of life</p> Signup and view all the answers

    What is an advantage of ORS therapy?

    <p>It prevents and treats dehydration</p> Signup and view all the answers

    What is a key practice to minimize microbial contamination and growth in weaning foods?

    <p>Improving preparation and storage practices</p> Signup and view all the answers

    What is a recommended practice to prevent diarrhea?

    <p>Washing hands with soap and water</p> Signup and view all the answers

    What is a complication of diarrhea?

    <p>Dehydration</p> Signup and view all the answers

    What is the primary goal of Plan A in managing dehydration?

    <p>To give more fluid than usual at home</p> Signup and view all the answers

    What is a sign that a patient should be shifted to a health facility?

    <p>Frequent stools and repeated vomiting</p> Signup and view all the answers

    What is the recommended fluid for rehydration in Plan B?

    <p>ORS</p> Signup and view all the answers

    What is the recommended fluid for severe dehydration in Plan C?

    <p>Ringer's lactate</p> Signup and view all the answers

    What is the recommended initial fluid dose for an infant < 1 year in Plan C?

    <p>30 ml/kg body weight</p> Signup and view all the answers

    Study Notes

    Management of Children with Gastrointestinal Disorders

    • The digestive tract consists of a long continuous tube that extends from the mouth to the anus, including the mouth, pharynx, esophagus, stomach, small intestine, and large intestine.
    • The tongue and teeth are accessory structures located in the mouth, and the salivary glands, liver, gallbladder, and pancreas are major accessory organs that have a role in digestion.

    Thrush Stomatitis

    • Definition: An infection of the mouth caused by Candida fungus that presents as adherent white plaques, usually on the tongue and inner cheeks.
    • Etiology: Infection may occur from the vaginal canal of the mother, poorly sterilized bottles or nipples, mother's breast, or the attendant's hands.
    • Clinical manifestations: White patches in the mouth, discomfort during feeding, anorexia, and bleeding if the patches are removed.
    • Treatment: Medications, including prescription topical or oral antifungal medications, such as Nystatin.
    • Nursing Management: Ensure cleanliness of all articles that enter the infant's mouth, provide the infant with their own feeding equipment, use a medicine dropper if the nipple irritates, and give the infant sterile water after each feeding to wash the mouth.

    Colic

    • Definition: Paroxysmal intestinal cramp due to accumulation of excessive gas, causing discomfort and pain.
    • Etiology: Excessive swallowing of air, over or rapid feeding, excessive intake of carbohydrates, disease of the GIT, hernias, intestinal obstruction, and hunger.
    • Clinical manifestations: Sudden attack of abdominal pain, crying, distended and tensed abdomen, congestion of the face, and cyanosis in severe cases.
    • Nursing Management: Bubble the infant frequently and gently, use an upright position to help with eructation, give hot fluids such as anise or caraway to help expel gases, provide loving care to relieve tension, and teach the mother good feeding techniques.

    Diarrhea

    • Definition: A symptom that results from disorders involving digestive, absorptive, and secretory functions, caused by abnormal intestinal water and electrolyte transport.
    • Incidence: Approximately 1.3 billion episodes of diarrhea occur worldwide each year, with 24% of all deaths in children living in developing countries related to diarrhea and dehydration.
    • Types of Diarrhea: Diarrheal disturbances involve the stomach and intestines (gastroenteritis), the small intestine (enteritis), the colon (colitis), or the colon and intestines (enterocolitis).
    • Acute Diarrhea: A leading cause of illness in children younger than 5 years of age, defined as a sudden increase in frequency and a change in consistency of stools, often caused by an infectious agent in the GI tract.
    • Chronic Diarrhea: Defined as an increase in stool frequency and increased water content with a duration of more than 14 days, often caused by chronic conditions such as malabsorption syndromes, inflammatory bowel disease, immunodeficiency, food allergy, lactose intolerance, or chronic nonspecific diarrhea.

    Therapeutic Management of Diarrhea

    • Infants and children with acute diarrhea and dehydration should be treated with oral rehydration therapy (ORT).
    • ORT is more effective, safer, less painful, and less costly than IV rehydration.
    • The management of most cases of acute diarrhea takes place in the home with education of the caregiver.
    • Caregivers should be taught to monitor for signs of dehydration, assess the frequency and amount of stool losses, and educate on ORT administration and replacement of ongoing losses.

    Prevention of Diarrhea

    • Feed only breast milk for the first 6 months of life and continue breastfeeding for at least the first 2 years of life.
    • Avoid the use of infant feeding bottles.
    • Improve practices related to the preparation and storage of weaning foods to minimize microbial contamination and growth.
    • Use clean water for drinking.
    • Wash hands after defecation or disposing of feces, and before preparing food or eating.
    • Safely dispose of feces, including those of infants, and use sanitary latrines.
    • Immunization, especially measles, can help prevent diarrhea.

    Complications of Diarrhea

    • Dehydration
    • Electrolyte disturbance (Hypernatremia, Hyponatremia, Hypokalemia, Hypoglycemia)
    • Convulsion-Febrile, Shigella encephalopathy
    • Abdominal distention
    • Paralytic ileus
    • Intussusception (Dysentery)
    • Vit A deficiency

    Dehydration

    • Definition: A consequence of watery diarrhea caused by the loss of water and electrolytes in liquid or loose stools and vomitus.
    • How to assess a patient for dehydration: Monitor for signs of dehydration, especially the number of wet diapers or voidings, and the amount of fluids taken by mouth.

    Plan A for Dehydration Management

    • At home, give more fluid than usual, using homemade fluids (rice, water, tea without sugar, soup, yogurt).
    • Give 100-200 ml of fluid after each loose stool for children under 2 years.

    Plan B for Dehydration Management

    • In a rehydration center, give ORS (75ml/kg) slowly, reassess the patient's condition, and if no signs of dehydration, shift to Plan A.
    • If some dehydration, repeat Plan B.
    • If severe dehydration, shift to Plan C.

    Plan C for Dehydration Management

    • In a hospital, give IV fluids: Ringer's lactate or normal saline.
    • Do not use 5% glucose (dextrose) solution, as it increases the risk for hyponatremia, which can cause cerebral edema.
    • Give 100 ml/kg of body weight.
    • For infants under 1 year, give 1st 30 ml/kg body weight in 1 hour and the next 70 ml/kg body weight in 5 hours.

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    Description

    This quiz covers the management of common gastrointestinal disorders in children, including thrush stomatitis, vomiting, colic, diarrhea, and dehydration.

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