Podcast
Questions and Answers
At what age does the peak incidence of GER occur?
At what age does the peak incidence of GER occur?
- 4 months (correct)
- 2 months
- 6 months
- 8 months
When does GER generally resolve spontaneously in most infants?
When does GER generally resolve spontaneously in most infants?
- Before 18 months of age
- After 12 months of age (correct)
- Before 6 months of age
- Before 9 months of age
What is the medication of choice for pinworm treatment?
What is the medication of choice for pinworm treatment?
- Metronidazole
- Mebendazole (correct)
- Tinidazole
- Pyrantel pamoate
What percentage of children in temperate climates can be infected with Enterobius vermicularis?
What percentage of children in temperate climates can be infected with Enterobius vermicularis?
What is a common method for diagnosing pinworms?
What is a common method for diagnosing pinworms?
What is a key preventive measure for pinworm transmission?
What is a key preventive measure for pinworm transmission?
What is a notable adverse effect of pyrantel pamoate?
What is a notable adverse effect of pyrantel pamoate?
What should be emphasized in nursing care for pinworms?
What should be emphasized in nursing care for pinworms?
What is a key aspect of preventing giardiasis?
What is a key aspect of preventing giardiasis?
What is a distinctive feature of nitazoxanide in comparison to metronidazole and tinidazole?
What is a distinctive feature of nitazoxanide in comparison to metronidazole and tinidazole?
What is a common mode of pinworm transmission?
What is a common mode of pinworm transmission?
What is a recommended practice to prevent pinworm reinfection?
What is a recommended practice to prevent pinworm reinfection?
What should families be informed about regarding pinworm recurrence?
What should families be informed about regarding pinworm recurrence?
What is a notable adverse effect of metronidazole and tinidazole?
What is a notable adverse effect of metronidazole and tinidazole?
Which diagnostic evaluation method is NOT mentioned for gastroesophageal reflux?
Which diagnostic evaluation method is NOT mentioned for gastroesophageal reflux?
What is the most common surgical procedure for children with severe complications of gastroesophageal reflux?
What is the most common surgical procedure for children with severe complications of gastroesophageal reflux?
Which feeding maneuver is mentioned as potentially improving mild gastroesophageal reflux symptoms in infants?
Which feeding maneuver is mentioned as potentially improving mild gastroesophageal reflux symptoms in infants?
What is the primary cause of inflammation and reactive airway disease in gastroesophageal reflux?
What is the primary cause of inflammation and reactive airway disease in gastroesophageal reflux?
What is a potential complication of gastroesophageal reflux in children?
What is a potential complication of gastroesophageal reflux in children?
What is the recommended sleeping position for infants to minimize reflux, considering the risk of sudden infant death syndrome?
What is the recommended sleeping position for infants to minimize reflux, considering the risk of sudden infant death syndrome?
What is a potential pharmacological therapy for treating infants and children with gastroesophageal reflux disease (GERD)?
What is a potential pharmacological therapy for treating infants and children with gastroesophageal reflux disease (GERD)?
What is the primary pathophysiology of gastroesophageal reflux?
What is the primary pathophysiology of gastroesophageal reflux?
What is a potential lifestyle modification for managing gastroesophageal reflux?
What is a potential lifestyle modification for managing gastroesophageal reflux?
What is a potential complication of the Nissen fundoplication surgical procedure?
What is a potential complication of the Nissen fundoplication surgical procedure?
What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?
What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?
What is a potential therapeutic option for managing gastroesophageal reflux depending on its severity?
What is a potential therapeutic option for managing gastroesophageal reflux depending on its severity?
What are some simple measures to help parents cope with frequent spitting up in infants with GERD?
What are some simple measures to help parents cope with frequent spitting up in infants with GERD?
What is the most frequent infection in the world in terms of intestinal parasitic diseases?
What is the most frequent infection in the world in terms of intestinal parasitic diseases?
What is the potential transmission route for giardiasis?
What is the potential transmission route for giardiasis?
How can the diagnosis of giardiasis be made?
How can the diagnosis of giardiasis be made?
Which medication for treatment of giardiasis is said to have an 80 to 100% cure rate after a single dose?
Which medication for treatment of giardiasis is said to have an 80 to 100% cure rate after a single dose?
What is a possible intervention for severe cases of regurgitation and growth restriction in infants with GERD?
What is a possible intervention for severe cases of regurgitation and growth restriction in infants with GERD?
What is the cause of giardiasis?
What is the cause of giardiasis?
What is the incidence trend of intestinal parasitic diseases, especially giardiasis, among young children in day care centers in Canada?
What is the incidence trend of intestinal parasitic diseases, especially giardiasis, among young children in day care centers in Canada?
What is the role of parents in pediatric nursing care for GERD?
What is the role of parents in pediatric nursing care for GERD?
What are the symptoms of giardiasis?
What are the symptoms of giardiasis?
What are the possible interventions for parents to cope with GERD in infants?
What are the possible interventions for parents to cope with GERD in infants?
What are the possible medications for treatment of giardiasis?
What are the possible medications for treatment of giardiasis?
What is the peak age range for children with appendicitis?
What is the peak age range for children with appendicitis?
What is the most common cause of obstruction in appendicitis?
What is the most common cause of obstruction in appendicitis?
What is a potential complication of appendiceal perforation?
What is a potential complication of appendiceal perforation?
What is the classic first symptom of appendicitis?
What is the classic first symptom of appendicitis?
Which medication is indicated for induction therapy in children with moderate to severe UC and CD?
Which medication is indicated for induction therapy in children with moderate to severe UC and CD?
What is the primary goal of any treatment regimen for UC and CD?
What is the primary goal of any treatment regimen for UC and CD?
Which medication is designed for controlled release in the ileum and is indicated for ileal and right-sided colitis?
Which medication is designed for controlled release in the ileum and is indicated for ileal and right-sided colitis?
Which immunomodulator is used to induce and maintain remission in children with IBD who are steroid resistant or steroid dependent?
Which immunomodulator is used to induce and maintain remission in children with IBD who are steroid resistant or steroid dependent?
Which medication is used to treat left-sided colitis with suppository and enema preparations?
Which medication is used to treat left-sided colitis with suppository and enema preparations?
Which medication has been shown to be effective in inducing remission in severe steroid-dependent UC?
Which medication has been shown to be effective in inducing remission in severe steroid-dependent UC?
Which medication is indicated for induction and maintenance therapy in left-sided colitis?
Which medication is indicated for induction and maintenance therapy in left-sided colitis?
Which medication blocks the synthesis of purine, thus inhibiting the ability of DNA and RNA to hinder lymphocyte function?
Which medication blocks the synthesis of purine, thus inhibiting the ability of DNA and RNA to hinder lymphocyte function?
What is the preferred imaging tool for diagnosing pediatric appendicitis?
What is the preferred imaging tool for diagnosing pediatric appendicitis?
Which diagnostic evaluation method is NOT mentioned for pediatric appendicitis?
Which diagnostic evaluation method is NOT mentioned for pediatric appendicitis?
What is the most common surgical procedure for treating pediatric appendicitis?
What is the most common surgical procedure for treating pediatric appendicitis?
What is a key sign of peritonitis in pediatric patients with appendicitis?
What is a key sign of peritonitis in pediatric patients with appendicitis?
What is the primary treatment for pediatric appendicitis before perforation?
What is the primary treatment for pediatric appendicitis before perforation?
What is a common nonoperative treatment for ruptured pediatric appendicitis?
What is a common nonoperative treatment for ruptured pediatric appendicitis?
What is the role of antibiotics in the management of pediatric appendicitis?
What is the role of antibiotics in the management of pediatric appendicitis?
What is a key aspect of postoperative care for pediatric appendicitis?
What is a key aspect of postoperative care for pediatric appendicitis?
What is crucial in the assessment of abdominal pain in nonverbal children with suspected appendicitis?
What is crucial in the assessment of abdominal pain in nonverbal children with suspected appendicitis?
What can the loss of extracellular fluid (ECF) to the peritoneal cavity lead to in pediatric patients with appendicitis?
What can the loss of extracellular fluid (ECF) to the peritoneal cavity lead to in pediatric patients with appendicitis?
What is the gold standard imaging tool for diagnosing pediatric appendicitis?
What is the gold standard imaging tool for diagnosing pediatric appendicitis?
What is a notable complication of pediatric appendicitis?
What is a notable complication of pediatric appendicitis?
What is the standard treatment for Meckel diverticulum?
What is the standard treatment for Meckel diverticulum?
What is an essential part of routine assessment for postoperative care of nonperforated appendix?
What is an essential part of routine assessment for postoperative care of nonperforated appendix?
What is the primary cause of excoriation around the surgical site?
What is the primary cause of excoriation around the surgical site?
What is the recommended approach to prevent complications associated with prolonged bed rest postoperatively?
What is the recommended approach to prevent complications associated with prolonged bed rest postoperatively?
What is the standard diagnosis approach for Meckel diverticulum?
What is the standard diagnosis approach for Meckel diverticulum?
What is the primary cause of Meckel diverticulum?
What is the primary cause of Meckel diverticulum?
What is the standard care for a ruptured appendix and peritonitis?
What is the standard care for a ruptured appendix and peritonitis?
What is a potential consequence of inadequate skin care postoperatively?
What is a potential consequence of inadequate skin care postoperatively?
What is the primary preventive measure for complications associated with prolonged bed rest postoperatively?
What is the primary preventive measure for complications associated with prolonged bed rest postoperatively?
What percentage of the Canadian population is affected by Inflammatory Bowel Disease (IBD)?
What percentage of the Canadian population is affected by Inflammatory Bowel Disease (IBD)?
Which type of IBD primarily affects the colon and rectum?
Which type of IBD primarily affects the colon and rectum?
What is the primary characteristic of Crohn disease (CD) in terms of inflammation?
What is the primary characteristic of Crohn disease (CD) in terms of inflammation?
What is the aim of therapeutic management for IBD?
What is the aim of therapeutic management for IBD?
What is a significant challenge in pediatric CD?
What is a significant challenge in pediatric CD?
What has been observed in relation to breastfeeding and the risk of developing CD?
What has been observed in relation to breastfeeding and the risk of developing CD?
What type of immune process characterizes Crohn disease (CD)?
What type of immune process characterizes Crohn disease (CD)?
What is a key characteristic of ulcerative colitis (UC) in terms of immune response?
What is a key characteristic of ulcerative colitis (UC) in terms of immune response?
What is the course of IBD characterized by?
What is the course of IBD characterized by?
What age group is at the highest risk of IBD diagnosis?
What age group is at the highest risk of IBD diagnosis?
What is the etiology of IBD considered to be?
What is the etiology of IBD considered to be?
What is the primary difference between ulcerative colitis (UC) and Crohn disease (CD)?
What is the primary difference between ulcerative colitis (UC) and Crohn disease (CD)?
What is a common cause of growth failure in children with Crohn's Disease (CD)?
What is a common cause of growth failure in children with Crohn's Disease (CD)?
What is a potential consequence of inadequate dietary intake in children with IBD?
What is a potential consequence of inadequate dietary intake in children with IBD?
What is a factor contributing to malnutrition in children with IBD?
What is a factor contributing to malnutrition in children with IBD?
What is a potential consequence of excessive GI losses in children with IBD?
What is a potential consequence of excessive GI losses in children with IBD?
Which medication is not effective in infants for peptic ulcer disease (PUD)?
Which medication is not effective in infants for peptic ulcer disease (PUD)?
What is the standard first-line treatment for H. pylori in peptic ulcer disease (PUD)?
What is the standard first-line treatment for H. pylori in peptic ulcer disease (PUD)?
What is a common adverse effect of medications for peptic ulcer disease (PUD)?
What is a common adverse effect of medications for peptic ulcer disease (PUD)?
What is the most common form of acute viral hepatitis?
What is the most common form of acute viral hepatitis?
How is Hepatitis A primarily spread?
How is Hepatitis A primarily spread?
What is the likelihood of infants developing jaundice due to HAV infection?
What is the likelihood of infants developing jaundice due to HAV infection?
Does HAV infection result in chronic infection or chronic liver disease?
Does HAV infection result in chronic infection or chronic liver disease?
What is the standard first-line treatment for HAV infection?
What is the standard first-line treatment for HAV infection?
What is the long-term prognosis for peptic ulcer disease (PUD)?
What is the long-term prognosis for peptic ulcer disease (PUD)?
What is the role of nursing care for peptic ulcer disease (PUD)?
What is the role of nursing care for peptic ulcer disease (PUD)?
What can cause hepatitis?
What can cause hepatitis?
Is proton pump inhibitor (PPI) therapy effective in infants for peptic ulcer disease (PUD)?
Is proton pump inhibitor (PPI) therapy effective in infants for peptic ulcer disease (PUD)?
Which of the following is a significant cause of ulcers, weakening the gastric mucosal barrier and allowing acid to damage the mucosa?
Which of the following is a significant cause of ulcers, weakening the gastric mucosal barrier and allowing acid to damage the mucosa?
What is the primary cause of gastric ulcers induced by exogenous factors like Aspirin and NSAIDs?
What is the primary cause of gastric ulcers induced by exogenous factors like Aspirin and NSAIDs?
Which syndrome may occur in children with multiple, large, or recurrent ulcers?
Which syndrome may occur in children with multiple, large, or recurrent ulcers?
What is the primary diagnostic method for detecting Helicobacter pylori infection in pediatric peptic ulcer disease?
What is the primary diagnostic method for detecting Helicobacter pylori infection in pediatric peptic ulcer disease?
What is the primary focus of therapeutic management for pediatric peptic ulcer disease?
What is the primary focus of therapeutic management for pediatric peptic ulcer disease?
What is the primary medical management for reducing or neutralizing gastric acid secretion in pediatric peptic ulcer disease?
What is the primary medical management for reducing or neutralizing gastric acid secretion in pediatric peptic ulcer disease?
Which age group is primary ulcers more common in?
Which age group is primary ulcers more common in?
What is the primary pathophysiological imbalance involved in the development of peptic ulcers?
What is the primary pathophysiological imbalance involved in the development of peptic ulcers?
What is the primary cause of secondary ulcers in infants and children with underlying diseases or taking certain medications?
What is the primary cause of secondary ulcers in infants and children with underlying diseases or taking certain medications?
What percentage of children in North America are diagnosed with peptic ulcer disease (PUD)?
What percentage of children in North America are diagnosed with peptic ulcer disease (PUD)?
What are the factors contributing to ulcer formation in pediatric peptic ulcer disease?
What are the factors contributing to ulcer formation in pediatric peptic ulcer disease?
What is a notable characteristic of primary ulcers in children with pediatric peptic ulcer disease?
What is a notable characteristic of primary ulcers in children with pediatric peptic ulcer disease?
Which nutritional support is recommended for children with adequate oral intake in Inflammatory Bowel Disease (IBD)?
Which nutritional support is recommended for children with adequate oral intake in Inflammatory Bowel Disease (IBD)?
What has been shown to improve nutritional status and induce disease remission in Inflammatory Bowel Disease (IBD) patients?
What has been shown to improve nutritional status and induce disease remission in Inflammatory Bowel Disease (IBD) patients?
What is the long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is the long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is a questionable dietary choice for active Inflammatory Bowel Disease (IBD)?
What is a questionable dietary choice for active Inflammatory Bowel Disease (IBD)?
What is the less likely outcome of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?
What is the less likely outcome of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?
What is a surgical option for Ulcerative Colitis (UC)?
What is a surgical option for Ulcerative Colitis (UC)?
What is a surgical option for Crohn's Disease (CD)?
What is a surgical option for Crohn's Disease (CD)?
What is a crucial nursing consideration in managing Inflammatory Bowel Disease (IBD)?
What is a crucial nursing consideration in managing Inflammatory Bowel Disease (IBD)?
What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is a crucial nursing role in managing Inflammatory Bowel Disease (IBD)?
What is a crucial nursing role in managing Inflammatory Bowel Disease (IBD)?
How is Peptic Ulcer Disease (PUD) described in terms of location?
How is Peptic Ulcer Disease (PUD) described in terms of location?
What is a recommended nursing consideration for Peptic Ulcer Disease (PUD)?
What is a recommended nursing consideration for Peptic Ulcer Disease (PUD)?
What is the incubation period for hepatitis E?
What is the incubation period for hepatitis E?
Which hepatitis infection has an incubation period of 45 to 160 days?
Which hepatitis infection has an incubation period of 45 to 160 days?
What is the primary route of transmission for hepatitis D?
What is the primary route of transmission for hepatitis D?
What is the recommended vaccination strategy for hepatitis A for infants less than 6 months?
What is the recommended vaccination strategy for hepatitis A for infants less than 6 months?
Which region has high prevalence of hepatitis B?
Which region has high prevalence of hepatitis B?
What is the average incubation period for hepatitis C?
What is the average incubation period for hepatitis C?
Which hepatitis infection is absent in Canada, the United States, and Western Europe?
Which hepatitis infection is absent in Canada, the United States, and Western Europe?
What is the primary risk factor for acquiring HCV?
What is the primary risk factor for acquiring HCV?
What is the primary route of transmission for HBV infection?
What is the primary route of transmission for HBV infection?
Which type of hepatitis infection is more severe than HBV infection?
Which type of hepatitis infection is more severe than HBV infection?
What is the primary preventive measure for HBV infection in newborns at risk?
What is the primary preventive measure for HBV infection in newborns at risk?
Which population is hepatitis D primarily endemic in?
Which population is hepatitis D primarily endemic in?
What percentage of affected children with cleft lip and palate (CL/P) are male?
What percentage of affected children with cleft lip and palate (CL/P) are male?
At what gestational age does fetal ultrasonography become reliable for prenatal diagnosis of cleft lip and palate (CL/P)?
At what gestational age does fetal ultrasonography become reliable for prenatal diagnosis of cleft lip and palate (CL/P)?
When is surgical repair of cleft lip (CL) typically performed?
When is surgical repair of cleft lip (CL) typically performed?
What maternal factors are linked to cleft lip and palate (CL/P)?
What maternal factors are linked to cleft lip and palate (CL/P)?
What is the primary cause of cleft deformities?
What is the primary cause of cleft deformities?
When is surgical repair of cleft palate (CP) typically performed?
When is surgical repair of cleft palate (CP) typically performed?
How many newborns in Canada are affected by cleft lip and palate (CL/P) annually?
How many newborns in Canada are affected by cleft lip and palate (CL/P) annually?
What percentage of cleft deformities occur with a recognized syndrome?
What percentage of cleft deformities occur with a recognized syndrome?
When are unilateral clefts more common than bilateral clefts?
When are unilateral clefts more common than bilateral clefts?
At what age does cleft lip (CL) become apparent?
At what age does cleft lip (CL) become apparent?
What portion of the palate consists of the remaining hard and soft palate?
What portion of the palate consists of the remaining hard and soft palate?
What is the primary management approach for cleft palate (CP)?
What is the primary management approach for cleft palate (CP)?
What is the primary cause of liver failure and liver transplant for Canadian children?
What is the primary cause of liver failure and liver transplant for Canadian children?
How is acute hemorrhage of varices managed in children with liver cirrhosis?
How is acute hemorrhage of varices managed in children with liver cirrhosis?
What is the primary treatment for ascites in children with liver cirrhosis?
What is the primary treatment for ascites in children with liver cirrhosis?
What is the suggested cause of the progressive inflammation leading to complete obliteration of the bile ducts in biliary atresia?
What is the suggested cause of the progressive inflammation leading to complete obliteration of the bile ducts in biliary atresia?
What has revolutionized the approach to liver cirrhosis in Canadian children?
What has revolutionized the approach to liver cirrhosis in Canadian children?
Which type of liver transplantation has been associated with better survival outcomes in children?
Which type of liver transplantation has been associated with better survival outcomes in children?
What is the primary treatment for hepatic encephalopathy in children with liver cirrhosis?
What is the primary treatment for hepatic encephalopathy in children with liver cirrhosis?
What is the primary consequence of portal hypertension in children with liver cirrhosis?
What is the primary consequence of portal hypertension in children with liver cirrhosis?
What is crucial for the nutritional support of children with liver cirrhosis and malnutrition?
What is crucial for the nutritional support of children with liver cirrhosis and malnutrition?
What has decreased the wait time for liver transplantation in children?
What has decreased the wait time for liver transplantation in children?
What is the primary nursing emphasis for children with liver cirrhosis?
What is the primary nursing emphasis for children with liver cirrhosis?
What is the primary goal of liver cirrhosis treatment in children?
What is the primary goal of liver cirrhosis treatment in children?
Which factor is NOT mentioned as a cause of articulation errors in children with cleft lip and palate (CL/P)?
Which factor is NOT mentioned as a cause of articulation errors in children with cleft lip and palate (CL/P)?
What is commonly used to drain the middle ear and prevent hearing impairment in children with CL/P?
What is commonly used to drain the middle ear and prevent hearing impairment in children with CL/P?
What is a primary focus of nursing care for newborns with CL/P?
What is a primary focus of nursing care for newborns with CL/P?
What is linked to growth failure in infants with CL/P?
What is linked to growth failure in infants with CL/P?
Which feeding method is protective against otitis media in infants with CL/P?
Which feeding method is protective against otitis media in infants with CL/P?
What is available to assist with feeding infants with CL/P?
What is available to assist with feeding infants with CL/P?
What may infants with CL/P tend to swallow excessive of during feedings?
What may infants with CL/P tend to swallow excessive of during feedings?
What may not improve feeding efficiency or growth in infants with CL/P within the first year of life?
What may not improve feeding efficiency or growth in infants with CL/P within the first year of life?
What can help infants with CP feed efficiently?
What can help infants with CP feed efficiently?
What is a potential consequence of feeding obturators in infants with CL/P?
What is a potential consequence of feeding obturators in infants with CL/P?
What is a potential challenge for children with CL/P?
What is a potential challenge for children with CL/P?
What can lead to recurrent ear infections and scarring of the tympanic membrane in children with CL/P?
What can lead to recurrent ear infections and scarring of the tympanic membrane in children with CL/P?
What is the primary treatment for Biliary Atresia (BA)?
What is the primary treatment for Biliary Atresia (BA)?
What is the aim of the Kasai procedure for Biliary Atresia (BA)?
What is the aim of the Kasai procedure for Biliary Atresia (BA)?
What is the survival rate with native liver at 10 years of age if the Kasai procedure is done before 30 days of age for Biliary Atresia (BA)?
What is the survival rate with native liver at 10 years of age if the Kasai procedure is done before 30 days of age for Biliary Atresia (BA)?
What is the primary cause of cleft lip (CL) and cleft palate (CP)?
What is the primary cause of cleft lip (CL) and cleft palate (CP)?
What is the association of cleft palate (CP) with deformed dental structures?
What is the association of cleft palate (CP) with deformed dental structures?
What is the potential long-term outcome of Biliary Atresia (BA) despite the Kasai procedure?
What is the potential long-term outcome of Biliary Atresia (BA) despite the Kasai procedure?
What is the role of ursodeoxycholic acid in the medical management of Biliary Atresia (BA)?
What is the role of ursodeoxycholic acid in the medical management of Biliary Atresia (BA)?
What is the potential consequence of untreated Biliary Atresia (BA) in children?
What is the potential consequence of untreated Biliary Atresia (BA) in children?
What is a common presentation of Biliary Atresia (BA) in infants?
What is a common presentation of Biliary Atresia (BA) in infants?
What is a common challenge in children with Biliary Atresia (BA) that requires close nursing attention?
What is a common challenge in children with Biliary Atresia (BA) that requires close nursing attention?
What is a key aspect of nursing care for children with Biliary Atresia (BA) postoperatively?
What is a key aspect of nursing care for children with Biliary Atresia (BA) postoperatively?
What is a potential consequence of Kasai failure in Biliary Atresia (BA)?
What is a potential consequence of Kasai failure in Biliary Atresia (BA)?
Which of the following is a potential consequence of cirrhosis in children?
Which of the following is a potential consequence of cirrhosis in children?
What is a key goal of managing cirrhosis in children?
What is a key goal of managing cirrhosis in children?
What is a common clinical manifestation of cirrhosis in children?
What is a common clinical manifestation of cirrhosis in children?
What is an important consideration for therapeutic management of cirrhosis in children?
What is an important consideration for therapeutic management of cirrhosis in children?
What is a potential cause of cirrhosis in children?
What is a potential cause of cirrhosis in children?
Which manifestation may be present in children with impaired intrahepatic blood flow due to cirrhosis?
Which manifestation may be present in children with impaired intrahepatic blood flow due to cirrhosis?
What is a potential consequence of impaired pulmonary function in children with cirrhosis?
What is a potential consequence of impaired pulmonary function in children with cirrhosis?
What is a primary goal of managing cirrhosis in children?
What is a primary goal of managing cirrhosis in children?
What is the most common esophageal malformation?
What is the most common esophageal malformation?
Which syndrome is often associated with EA/TEF?
Which syndrome is often associated with EA/TEF?
What is the acronym for syndromes involving a combination of Vertebral, Anorectal, Cardiovascular, TracheoEsophageal, Renal, and Limb abnormalities?
What is the acronym for syndromes involving a combination of Vertebral, Anorectal, Cardiovascular, TracheoEsophageal, Renal, and Limb abnormalities?
What is the most frequently occurring anomaly with EA/TEF?
What is the most frequently occurring anomaly with EA/TEF?
What is the most common form of Esophageal Atresia (EA) and Tracheoesophageal Fistula (TEF)?
What is the most common form of Esophageal Atresia (EA) and Tracheoesophageal Fistula (TEF)?
What is the diagnostic evaluation for EA and TEF based on?
What is the diagnostic evaluation for EA and TEF based on?
What percentage of infants with EA have tracheomalacia?
What percentage of infants with EA have tracheomalacia?
What are signs of significant tracheomalacia in infants with EA?
What are signs of significant tracheomalacia in infants with EA?
What is the primary therapeutic management for EA and TEF?
What is the primary therapeutic management for EA and TEF?
In what percentage of infants with EA is significant tracheomalacia present?
In what percentage of infants with EA is significant tracheomalacia present?
What is the aim of surgical correction for EA and TEF?
What is the aim of surgical correction for EA and TEF?
What is the preferred procedure for infants who are preterm, have multiple anomalies, or are in poor condition?
What is the preferred procedure for infants who are preterm, have multiple anomalies, or are in poor condition?
What is the primary factor determining the prognosis for EA and TEF?
What is the primary factor determining the prognosis for EA and TEF?
What is a possible complication in infants with EA and TEF?
What is a possible complication in infants with EA and TEF?
What is the primary aim of therapeutic management for EA and TEF?
What is the primary aim of therapeutic management for EA and TEF?
What is the preferred surgical approach for correcting EA and TEF?
What is the preferred surgical approach for correcting EA and TEF?
Which condition is associated with the covered herniation of abdominal organs, often with other defects?
Which condition is associated with the covered herniation of abdominal organs, often with other defects?
What is the primary nursing emphasis for children with esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary nursing emphasis for children with esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary cause of growth failure in children with gastroschisis?
What is the primary cause of growth failure in children with gastroschisis?
What is the most common type of hernia in boys?
What is the most common type of hernia in boys?
What is the primary goal of preoperative nursing care for infants with abdominal wall defects?
What is the primary goal of preoperative nursing care for infants with abdominal wall defects?
What is the primary cause of reactive airway disease in children with EA/TEF?
What is the primary cause of reactive airway disease in children with EA/TEF?
What is the primary focus of therapeutic management for infants with gastroschisis?
What is the primary focus of therapeutic management for infants with gastroschisis?
Which condition involves the uncovered herniation of bowel with a lower likelihood of associated anomalies?
Which condition involves the uncovered herniation of bowel with a lower likelihood of associated anomalies?
What is the primary consequence of prolonged NPO status or lack of oral stimulation in infants with esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary consequence of prolonged NPO status or lack of oral stimulation in infants with esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary focus of nursing care for infants requiring esophageal replacement?
What is the primary focus of nursing care for infants requiring esophageal replacement?
What is the primary consequence of feeding obturators in infants with cleft lip/palate (CL/P)?
What is the primary consequence of feeding obturators in infants with cleft lip/palate (CL/P)?
What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is a common complication of primary repair for esophageal atresia and tracheoesophageal fistula?
What is a common complication of primary repair for esophageal atresia and tracheoesophageal fistula?
What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?
What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?
What is the primary purpose of routine esophageal dilation in the management of esophageal strictures?
What is the primary purpose of routine esophageal dilation in the management of esophageal strictures?
What is a key consideration in the discharge education for infants with repaired esophagus?
What is a key consideration in the discharge education for infants with repaired esophagus?
What is the most desirable position for a newborn with typical esophageal atresia and tracheoesophageal fistula?
What is the most desirable position for a newborn with typical esophageal atresia and tracheoesophageal fistula?
What is a potential indication for fundoplication in infants with esophageal atresia and tracheoesophageal fistula?
What is a potential indication for fundoplication in infants with esophageal atresia and tracheoesophageal fistula?
What is a crucial factor in the prognosis of esophageal atresia and tracheoesophageal fistula?
What is a crucial factor in the prognosis of esophageal atresia and tracheoesophageal fistula?
What is a common consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula?
What is a common consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula?
What is crucial for early detection of esophageal atresia and tracheoesophageal fistula?
What is crucial for early detection of esophageal atresia and tracheoesophageal fistula?
What is a common complication in preterm low-birth-weight infants with associated anomalies?
What is a common complication in preterm low-birth-weight infants with associated anomalies?
What is a primary consideration in the postoperative care of infants with esophageal atresia and tracheoesophageal fistula?
What is a primary consideration in the postoperative care of infants with esophageal atresia and tracheoesophageal fistula?
What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula?
What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula?
Which condition is characterized by projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure in the first 2 to 5 weeks of life?
Which condition is characterized by projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure in the first 2 to 5 weeks of life?
Which congenital obstruction usually appears in the newborn period?
Which congenital obstruction usually appears in the newborn period?
What is the primary cause of obstruction in hypertrophic pyloric stenosis?
What is the primary cause of obstruction in hypertrophic pyloric stenosis?
Which group is more commonly affected by hypertrophic pyloric stenosis?
Which group is more commonly affected by hypertrophic pyloric stenosis?
What is the primary method for diagnosis of hypertrophic pyloric stenosis?
What is the primary method for diagnosis of hypertrophic pyloric stenosis?
What is the standard treatment for hypertrophic pyloric stenosis?
What is the standard treatment for hypertrophic pyloric stenosis?
What is a common symptom of hypertrophic pyloric stenosis?
What is a common symptom of hypertrophic pyloric stenosis?
What is a key focus of preoperative care for hypertrophic pyloric stenosis?
What is a key focus of preoperative care for hypertrophic pyloric stenosis?
What is a crucial aspect of postoperative care for hypertrophic pyloric stenosis?
What is a crucial aspect of postoperative care for hypertrophic pyloric stenosis?
What is the primary role of nursing care in hypertrophic pyloric stenosis?
What is the primary role of nursing care in hypertrophic pyloric stenosis?
What is a notable risk factor for hypertrophic pyloric stenosis?
What is a notable risk factor for hypertrophic pyloric stenosis?
What is a common outcome for infants with hypertrophic pyloric stenosis if diagnosed early?
What is a common outcome for infants with hypertrophic pyloric stenosis if diagnosed early?
What is a primary consideration in the surgical management of hypertrophic pyloric stenosis?
What is a primary consideration in the surgical management of hypertrophic pyloric stenosis?
What is a crucial aspect of parental involvement in the care process for hypertrophic pyloric stenosis?
What is a crucial aspect of parental involvement in the care process for hypertrophic pyloric stenosis?
What is a key focus of postoperative care for hypertrophic pyloric stenosis?
What is a key focus of postoperative care for hypertrophic pyloric stenosis?
What is a common method for managing dehydration in infants with hypertrophic pyloric stenosis?
What is a common method for managing dehydration in infants with hypertrophic pyloric stenosis?
What is the most common cause of intestinal obstruction in children between the ages of 5 months and 3 years?
What is the most common cause of intestinal obstruction in children between the ages of 5 months and 3 years?
What is the success rate of nonoperative reduction in cases of intussusception?
What is the success rate of nonoperative reduction in cases of intussusception?
What is the primary diagnostic method for confirming intussusception?
What is the primary diagnostic method for confirming intussusception?
What is the standard treatment for intussusception if nonoperative reduction is unsuccessful?
What is the standard treatment for intussusception if nonoperative reduction is unsuccessful?
What is the primary aim of postoperative care for infants after surgery?
What is the primary aim of postoperative care for infants after surgery?
What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?
What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?
What is the primary cause of cleft lip and cleft palate?
What is the primary cause of cleft lip and cleft palate?
What is the primary focus of nursing care for infants requiring esophageal replacement?
What is the primary focus of nursing care for infants requiring esophageal replacement?
What is the primary characteristic of Crohn's disease in terms of inflammation?
What is the primary characteristic of Crohn's disease in terms of inflammation?
What is the primary aim of therapeutic management for esophageal atresia and tracheoesophageal fistula?
What is the primary aim of therapeutic management for esophageal atresia and tracheoesophageal fistula?
What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?
What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?
What is the primary cause of reactive airway disease in children with esophageal atresia and tracheoesophageal fistula?
What is the primary cause of reactive airway disease in children with esophageal atresia and tracheoesophageal fistula?
What is the definitive diagnostic procedure for malrotation and volvulus?
What is the definitive diagnostic procedure for malrotation and volvulus?
What is the primary treatment for malrotation?
What is the primary treatment for malrotation?
What are the symptoms that may be present in infants with malrotation?
What are the symptoms that may be present in infants with malrotation?
What is the classification basis for anorectal malformations?
What is the classification basis for anorectal malformations?
What is the diagnostic evaluation for anorectal malformations primarily focused on?
What is the diagnostic evaluation for anorectal malformations primarily focused on?
What is a potential complication associated with surgery for malrotation?
What is a potential complication associated with surgery for malrotation?
What is the primary nursing intervention for infants with malrotation preoperatively?
What is the primary nursing intervention for infants with malrotation preoperatively?
What is a potential consequence of anorectal malformations?
What is a potential consequence of anorectal malformations?
What is a common presentation of imperforate anus?
What is a common presentation of imperforate anus?
What is the ratio of occurrence of anorectal malformations between male and female infants?
What is the ratio of occurrence of anorectal malformations between male and female infants?
What is the potential life-threatening complication of malrotation if not promptly diagnosed and treated?
What is the potential life-threatening complication of malrotation if not promptly diagnosed and treated?
What is the potential consequence of malrotation and volvulus if not promptly diagnosed and surgically treated?
What is the potential consequence of malrotation and volvulus if not promptly diagnosed and surgically treated?
What is the primary surgical treatment for perineal fistulas in newborns with anorectal malformations?
What is the primary surgical treatment for perineal fistulas in newborns with anorectal malformations?
What may indicate the presence of rectourinary fistulas in newborns with anorectal malformations?
What may indicate the presence of rectourinary fistulas in newborns with anorectal malformations?
What is the primary method to identify anal stenosis in older children with anorectal malformations?
What is the primary method to identify anal stenosis in older children with anorectal malformations?
Which procedure may be required if the rectum is unidentifiable by the posterior approach in anorectal malformations surgery?
Which procedure may be required if the rectum is unidentifiable by the posterior approach in anorectal malformations surgery?
What is the primary factor influencing the long-term prognosis of anorectal malformations?
What is the primary factor influencing the long-term prognosis of anorectal malformations?
What is the primary method for successful treatment of anal stenosis?
What is the primary method for successful treatment of anal stenosis?
Which imaging technique is performed to determine the existence of other malformations in newborns with anorectal malformations?
Which imaging technique is performed to determine the existence of other malformations in newborns with anorectal malformations?
What is the primary nursing role in managing anorectal malformations in newborns?
What is the primary nursing role in managing anorectal malformations in newborns?
What is the primary surgical procedure for correcting anorectal malformations in newborns with perineal fistulas?
What is the primary surgical procedure for correcting anorectal malformations in newborns with perineal fistulas?
What is the primary preoperative care for newborns with anorectal malformations undergoing posterior sagittal anorectoplasty (PSARP)?
What is the primary preoperative care for newborns with anorectal malformations undergoing posterior sagittal anorectoplasty (PSARP)?
What is the primary method to manage perineal fistulas in newborns with anorectal malformations?
What is the primary method to manage perineal fistulas in newborns with anorectal malformations?
What is the primary surgical treatment for anorectal malformations that cannot be corrected by the posterior approach?
What is the primary surgical treatment for anorectal malformations that cannot be corrected by the posterior approach?
Which of the following is a condition classified as an absorptive defect in malabsorption syndromes?
Which of the following is a condition classified as an absorptive defect in malabsorption syndromes?
What is the primary cause of malabsorption in Hirschsprung's disease?
What is the primary cause of malabsorption in Hirschsprung's disease?
Which anatomical defect affects digestion by decreasing the transit time of substances and compromises the absorptive surface?
Which anatomical defect affects digestion by decreasing the transit time of substances and compromises the absorptive surface?
What is the primary defect in lactase deficiency?
What is the primary defect in lactase deficiency?
Which medication is often prescribed to improve diarrhea associated with bile salt malabsorption?
Which medication is often prescribed to improve diarrhea associated with bile salt malabsorption?
What is a potential consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?
What is a potential consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?
What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?
What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?
What is the primary preventive measure for catheter sepsis related to central venous access devices (CVAD)?
What is the primary preventive measure for catheter sepsis related to central venous access devices (CVAD)?
What is the most important component of nursing care during parenteral nutrition therapy?
What is the most important component of nursing care during parenteral nutrition therapy?
What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?
What is the primary cause of mortality in infants and children with Short Bowel Syndrome (SBS)?
What is the primary cause of mortality in infants and children with Short Bowel Syndrome (SBS)?
What is the aim of surgical interventions such as constructing intestinal valves or tapering enteroplasty in SBS?
What is the aim of surgical interventions such as constructing intestinal valves or tapering enteroplasty in SBS?
What is a potential consequence of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?
What is a potential consequence of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?
What is a potential life-threatening complication of malrotation if not promptly diagnosed and treated?
What is a potential life-threatening complication of malrotation if not promptly diagnosed and treated?
What is a key aspect of postoperative care for pediatric appendicitis?
What is a key aspect of postoperative care for pediatric appendicitis?
What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?
What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?
Which type of deficiency may lead to lactose intolerance?
Which type of deficiency may lead to lactose intolerance?
What can untreated celiac disease in children lead to?
What can untreated celiac disease in children lead to?
What is a common source of gluten that requires label reading to avoid?
What is a common source of gluten that requires label reading to avoid?
What is a potential consequence of untreated celiac disease?
What is a potential consequence of untreated celiac disease?
What is the primary cause of lactose intolerance?
What is the primary cause of lactose intolerance?
What is a potential consequence of financial burdens due to celiac disease?
What is a potential consequence of financial burdens due to celiac disease?
What is the primary cause of gluten intolerance?
What is the primary cause of gluten intolerance?
What is a common symptom of lactose intolerance?
What is a common symptom of lactose intolerance?
What is a potential cause of secondary lactase deficiency?
What is a potential cause of secondary lactase deficiency?
What is the primary treatment for celiac disease-related nutritional deficiencies?
What is the primary treatment for celiac disease-related nutritional deficiencies?
What is a potential consequence of severe mucosal damage in celiac disease?
What is a potential consequence of severe mucosal damage in celiac disease?
What is a common symptom of lactose intolerance?
What is a common symptom of lactose intolerance?
What is the reported incidence of celiac disease?
What is the reported incidence of celiac disease?
What is the primary cause of celiac disease?
What is the primary cause of celiac disease?
Where are the genes located that are found in almost 90% of those affected with celiac disease?
Where are the genes located that are found in almost 90% of those affected with celiac disease?
What is the primary diagnostic method for celiac disease?
What is the primary diagnostic method for celiac disease?
What is the primary treatment for chronic celiac disease?
What is the primary treatment for chronic celiac disease?
What is the role of gradual introduction of gluten in the infant’s diet between 4 and 12 months?
What is the role of gradual introduction of gluten in the infant’s diet between 4 and 12 months?
What are the classic symptoms of celiac disease?
What are the classic symptoms of celiac disease?
What are the commercially available serological tests for celiac disease?
What are the commercially available serological tests for celiac disease?
What is the primary response of most children with celiac disease after instituting the gluten-free diet?
What is the primary response of most children with celiac disease after instituting the gluten-free diet?
What is the gender distribution of celiac disease?
What is the gender distribution of celiac disease?
What is the characteristic feature of celiac disease in the small bowel?
What is the characteristic feature of celiac disease in the small bowel?
What is the primary cause of impaired growth in children with celiac disease?
What is the primary cause of impaired growth in children with celiac disease?
What is the primary method used for positive diagnosis of lactose intolerance?
What is the primary method used for positive diagnosis of lactose intolerance?
What may lead to reduced bone mineral density and osteoporosis in children with lactose intolerance?
What may lead to reduced bone mineral density and osteoporosis in children with lactose intolerance?
What is a viable option for individuals with lactose intolerance?
What is a viable option for individuals with lactose intolerance?
What is a potential consequence of avoiding dairy products in individuals with lactose intolerance?
What is a potential consequence of avoiding dairy products in individuals with lactose intolerance?
What is a key difference between lactose intolerance and dairy allergy?
What is a key difference between lactose intolerance and dairy allergy?
What is a potential treatment for lactose intolerance?
What is a potential treatment for lactose intolerance?
What is a possible consequence of inadequate dairy intake in individuals with lactose intolerance?
What is a possible consequence of inadequate dairy intake in individuals with lactose intolerance?
What is a potential method to improve lactose intolerance?
What is a potential method to improve lactose intolerance?
What is a necessary supplementation due to reduced dairy intake in individuals with lactose intolerance?
What is a necessary supplementation due to reduced dairy intake in individuals with lactose intolerance?
What is a characteristic of lactose intolerance?
What is a characteristic of lactose intolerance?
What is a potential consequence of inadequate dairy intake in individuals with lactose intolerance?
What is a potential consequence of inadequate dairy intake in individuals with lactose intolerance?
What is a viable option for lactose intolerance?
What is a viable option for lactose intolerance?
What is the primary diagnostic method for lactose intolerance?
What is the primary diagnostic method for lactose intolerance?
What may happen if children with lactose intolerance avoid dairy products?
What may happen if children with lactose intolerance avoid dairy products?
What is a viable option for managing lactose intolerance?
What is a viable option for managing lactose intolerance?
What is a potential consequence of inadequate skin care postoperatively in short-bowel syndrome?
What is a potential consequence of inadequate skin care postoperatively in short-bowel syndrome?
What is a potential life-threatening complication of short-bowel syndrome if not promptly diagnosed and treated?
What is a potential life-threatening complication of short-bowel syndrome if not promptly diagnosed and treated?
What is necessary due to reduced dairy intake in individuals with lactose intolerance?
What is necessary due to reduced dairy intake in individuals with lactose intolerance?
What is the aim of treatment for lactose intolerance?
What is the aim of treatment for lactose intolerance?
What is a potential effect of probiotics in lactose intolerance?
What is a potential effect of probiotics in lactose intolerance?
What is often mistaken for lactose intolerance but is triggered by various factors in addition to lactose?
What is often mistaken for lactose intolerance but is triggered by various factors in addition to lactose?
What is the most common symptom of lactose intolerance?
What is the most common symptom of lactose intolerance?
What is a potential consequence of lactose intolerance?
What is a potential consequence of lactose intolerance?
What is a malabsorptive disorder resulting from decreased mucosal surface area?
What is a malabsorptive disorder resulting from decreased mucosal surface area?
Study Notes
Pediatric Nursing Care for Gastroesophageal Reflux Disease (GERD) and Intestinal Parasitic Diseases
- Pediatric nursing care for GERD involves identification of symptoms, parent education on home care, and possible surgical care
- Parents should be reassured that most infants and children outgrow GERD and lifestyle changes are often sufficient
- Simple measures such as using bibs and prone positioning can help parents cope with frequent spitting up in infants
- Parents should be educated about positioning, avoiding feeding spicy foods, and scheduling more frequent feeding times
- Severe cases of regurgitation and growth restriction may require NG tube or gastrostomy feedings, which necessitate special caregiver preparation
- Parents need specific information about the administration and efficacy of medications for GERD, such as PPIs
- Intestinal parasitic diseases, including giardiasis, are the most frequent infections in the world
- In Canada, the incidence of intestinal parasitic diseases, especially giardiasis, has increased among young children in day care centers
- Giardiasis is caused by the protozoan Giardia lamblia, with potential transmission through contaminated water, food, and person-to-person contact
- Symptoms of giardiasis include abdominal cramps and diarrhea, and diagnosis can be made through microscopic examination of stool specimens or duodenal fluid
- Medications for treatment of giardiasis include metronidazole, tinidazole, paromomycin, and nitazoxanide
- Tinidazole is said to have an 80 to 100% cure rate after a single dose and has fewer adverse effects than metronidazole
Inflammatory Bowel Disease: Key Points
- Inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC) and Crohn disease (CD), distinct chronic intestinal inflammations.
- Both UC and CD have similar epidemiological, immunological, and clinical features, but CD is more disabling with less effective treatment than UC.
- IBD affects approximately 0.7% of the Canadian population, with adolescents and young adults at highest risk of diagnosis.
- The etiology of IBD is multifactorial, involving genetic predisposition, defective immunoregulation, and environmental factors.
- Ulcerative colitis primarily affects the colon and rectum, with varying degrees of mucosal inflammation and systemic symptoms.
- Crohn disease involves any part of the GI tract, with transmural inflammation, skip lesions, and extraintestinal manifestations.
- Diagnostic evaluation for UC and CD includes laboratory tests, serological panels, upper GI series, endoscopy, and imaging.
- Therapeutic management aims to control the inflammatory process, achieve long-term remission, promote healthy growth, and maintain a balanced lifestyle.
- Growth failure is a significant challenge in pediatric CD, affecting healthy development.
- Breastfeeding decreases the risk of developing CD, while infantile diarrhea increases the risk.
- CD is characterized by a chronic immune process with a T-helper-1 cytokine profile, while UC's response is more humoral and mediated by T-helper-2 cells.
- The course of IBD is unpredictable, with flare-ups severely impairing physical and social functioning, requiring individualized and managed treatment.
Hepatitis Infections in Children
- Hepatitis A vaccine is recommended over immunoglobulin for people over 6 months of age, while immunoglobulin is recommended for infants less than 6 months and those with contraindications for vaccination.
- Incidence of hepatitis B is declining with universal immunization programs, but varies globally, with high-prevalence areas in Africa and Asia and lower prevalence in Canada.
- HBV infection can be acute or chronic, transmitted parenterally through blood, bodily fluids, and other sources like organ transplantation and mother-to-infant transmission.
- Universal vaccination for all children is recommended in Canada, with newborns at risk if the mother is infected, as infants are more than 90% likely to become chronic carriers.
- Incubation period of HBV infection varies from 45 to 160 days, with high-risk groups including individuals with hemophilia, IV drug users, and those in congregate settings.
- Highest risk factor for acquiring HCV is a history of injection drug use, with transmission through contaminated blood, especially from IV drug use and from pregnant parent to child.
- HCV incubation averages 7 to 9 weeks, with about 85% of individuals infected developing chronic disease.
- Hepatitis D is rare in North America but endemic in other regions, occurring primarily in hemophiliac patients, immigrants from endemic regions, and IV drug users.
- Hepatitis D infection is more severe than HBV infection, requiring testing in children who are hepatitis B carriers with evidence of serum hepatitis B surface antigen positivity and elevated liver enzymes despite an undetectable HBV viral load.
- Hepatitis E is absent in Canada, the United States, and Western Europe but endemic in other regions, enterally transmitted, with an incubation period of 2 to 9 weeks.
- Hepatitis E is uncommon in children, does not cause chronic liver disease, but can be devastating among pregnant persons with an unusually high case-fatality rate.
- Hepatitis infections in children have varying transmission routes, incubation periods, and severity, with different vaccination and testing recommendations based on the specific type of hepatitis.
Biliary Atresia and Cleft Lip/Palate: Diagnosis, Treatment, and Nursing Care
- Biliary atresia (BA) is a liver disease in infants, often presenting with jaundice, pale stool, and dark urine.
- Early diagnosis of BA is crucial for the child's survival, as it may initially present with mild jaundice.
- Diagnostic evaluation for BA involves blood tests, additional laboratory analyses, abdominal ultrasonography, hepatobiliary scintigraphy, and liver biopsy.
- The primary treatment for BA is the hepatic portoenterostomy (Kasai procedure), aiming to establish bile drainage, with a success rate of 80 to 90% in newborns.
- Kasai failure and progressive cirrhosis may still occur, leading to the need for eventual liver transplantation.
- Medical management for BA includes nutritional support, supplementation of vitamins and minerals, and the use of ursodeoxycholic acid to decrease cholestasis and treat hypercholesterolemia.
- Untreated BA leads to progressive cirrhosis and death in most children by 2 years of age, while the Kasai procedure improves long-term survival, with 49% of children surviving with their native liver at 10 years of age if the procedure is done before 30 days of age.
- Nursing care for children with BA involves supporting the family, educating them about the treatment plan, and providing postoperative care similar to major abdominal surgery.
- Growth failure, pruritus, and nutritional challenges are common in children with BA, requiring close nursing attention and support for the family.
- Families of children with BA need education about proper administration of medications and nutritional therapy, while also receiving psychosocial support.
- Cleft lip (CL) and cleft palate (CP) are common congenital malformations of the head and neck, resulting from the failure of fusion of facial structures during embryonic development.
- CL and CP may occur separately or together, with CP involving the soft and hard palates and being associated with deformed dental structures.
Pediatric Surgical Conditions: Tracheomalacia, Esophageal Atresia/Tracheoesophageal Fistula, and Hernias
- Tracheomalacia can be a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF) and parents should be educated on its signs and symptoms.
- Gastroesophageal reflux (GER) may occur after feedings resume in children with EA/TEF, leading to reactive airway disease with wheezing and labored respirations.
- Children with EA/TEF may face difficulties with thriving and gaining weight, especially if born preterm, requiring early intervention and interprofessional referral for developmental milestones.
- For infants requiring esophageal replacement, non-nutritive sucking with a pacifier and oral stimulation are provided to develop mature sucking patterns.
- Prolonged NPO status or lack of oral stimulation can lead to feeding difficulties and oral hypersensitivity, requiring guidance and potential referral to a feeding behavior program.
- Parents of children with EA/TEF need support in adjusting to the condition, particularly during the immediate transfer to critical care and hospitalization, and should be prepared for discharge with necessary home care skills.
- Hernias, including umbilical and inguinal, pose risks when circulation is impaired or when organs encroach on other structures, with inguinal hernias being more common in boys.
- Omphalocele and gastroschisis are rare abdominal wall defects, with omphalocele occurring in 1 in 3,000 to 10,000 live births and gastroschisis in 1 in 6,000 live births, with a gradual increase in prevalence noted in Canada.
- Omphalocele involves the covered herniation of abdominal organs, often with other defects, while gastroschisis is the uncovered herniation of bowel with a lower likelihood of associated anomalies.
- Preoperative nursing care for both defects involves managing thermoregulation, fluid and electrolyte balance, and physiological support, with surgical closure and postoperative management improving prognosis.
- The prognosis for infants born with abdominal wall defects has improved, with over 80% survival for omphalocele and over 90% for gastroschisis, although residual feeding difficulties such as GER are not uncommon.
- Therapeutic management and nursing care for infants with abdominal wall defects include covering exposed viscera, fluid and electrolyte replacement, gastric decompression, and surgical closure after reduction of contents.
Esophageal Atresia and Tracheoesophageal Fistula Nursing Care
- Prognosis is linked to birth weight, associated congenital anomalies, and time of diagnosis.
- Nearly 100% survival rate in full-term newborns without severe respiratory distress or other anomalies.
- Most deaths result from extreme prematurity or other lethal anomalies.
- Preterm low–birth-weight infants with associated anomalies have a high incidence of complications.
- Complications of primary repair include anastomotic leak, strictures, dysphagia, and GER.
- Routine esophageal dilation is often used to treat strictures resulting from tension or ischemia.
- Feeding difficulties are common and growth must be monitored; fundoplication may be required.
- Early detection of the malformation is crucial.
- Newborns with signs of EA must have a patent airway established to prevent respiratory compromise.
- The most desirable position for a newborn with typical EA and TEF is supine with the head elevated on an inclined plane of at least 30 degrees.
- Postoperative care includes respiratory assessment, airway management, thermoregulation, fluid and electrolyte management, and often parenteral nutrition.
- Discharge education should include instructions about feeding techniques in the infant with a repaired esophagus, including a semi-upright feeding position, small feedings, and observation for adequacy of swallowing.
Management of Anorectal Malformations in Newborns
- Meconium on the perineum in newborns may not always indicate anal patency, as a fistula may allow meconium evacuation through the vagina.
- Rectourinary fistulas should be suspected if there is meconium in the urine.
- Anal stenosis may not be identified until the child is older and presents with a history of difficult defecation, abdominal distension, and ribbonlike stools.
- Abdominal ultrasonography is performed to determine the existence of other malformations.
- Successful treatment for anal stenosis is generally accomplished by manual dilations, initiated by a healthcare provider and continued at home by parents.
- Perineal fistulas are treated by anoplasty during the newborn period, with more extensive defects managed with a colostomy and corrective surgical repair later in the first year.
- The type of defect, sacral anatomy, and muscle quality influence the long-term prognosis.
- Surgical treatment of anorectal malformations involves anoplasty, colostomy, posterior sagittal anorectoplasty (PSARP), or other pull-through procedures.
- A laparotomy may be required if the rectum is unidentifiable by the posterior approach.
- Nursing care includes identifying undetected anorectal malformations, preoperative care, postoperative care, and support for families in providing optimum care for the child.
- Preoperative PSARP care often involves irrigation of the distal stoma to prevent fecal contamination of the operative site.
- Nurses play a vital role in helping families of a child with anorectal malformations provide optimum care for successful bowel management and enhanced quality of life.
Lactose Intolerance and Short-Bowel Syndrome: Key Points
- Lactose intolerance symptoms include abdominal pain, bloating, flatulence, and diarrhea after lactose consumption
- Symptoms of lactose intolerance onset within 30 minutes to several hours after lactose ingestion
- Lactose intolerance is often mistaken for a dairy allergy or IBS, but dairy allergies are immediate and may cause skin rash or hives, while IBS is triggered by various factors in addition to lactose
- Diagnosis of lactose intolerance may be based on history and improvement with a lactose-reduced diet
- Breath hydrogen test is used for positive diagnosis, with lactose-deficient individuals showing higher hydrogen levels in breath samples after ingesting lactose
- Treatment involves eliminating or reducing dairy products, with most individuals tolerating a single serving of lactose per day, especially when consumed with food
- Avoiding dairy products in children with lactose intolerance may lead to reduced bone mineral density and osteoporosis
- Probiotics may improve lactose intolerance, but their widespread use in infants requires further study
- Supplementation of calcium and vitamin D is necessary due to reduced dairy intake
- Yogurt, hard cheeses, lactase-treated dairy products, and lactase tablets are viable options for lactose intolerance
- Lactose intolerance does not manifest as an anaphylactic-type reaction
- Short-bowel syndrome is a malabsorptive disorder resulting from decreased mucosal surface area, often due to extensive resection of the small intestine
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Test your knowledge of pediatric nursing care for Gastroesophageal Reflux Disease (GERD) and Intestinal Parasitic Diseases with this quiz. Explore symptoms, treatments, and caregiver education for GERD, as well as the causes, symptoms, diagnosis, and medications for intestinal parasitic diseases such as giardiasis.
