Pediatric Nursing Care Quiz
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Questions and Answers

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?

  • 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?

  • Metronidazole
  • Mebendazole (correct)
  • Tinidazole
  • Pyrantel pamoate

    • What percentage of children in temperate climates can be infected with Enterobius vermicularis?

    <p>30%</p> Signup and view all the answers

    What is a common method for diagnosing pinworms?

    <p>Tape test</p> Signup and view all the answers

    What is a key preventive measure for pinworm transmission?

    <p>Hand hygiene</p> Signup and view all the answers

    What is a notable adverse effect of pyrantel pamoate?

    <p>Stains stool and vomitus bright red</p> Signup and view all the answers

    What should be emphasized in nursing care for pinworms?

    <p>Clear instructions for the tape test</p> Signup and view all the answers

    What is a key aspect of preventing giardiasis?

    <p>Education on sanitation practices</p> Signup and view all the answers

    What is a distinctive feature of nitazoxanide in comparison to metronidazole and tinidazole?

    <p>Has no bitter taste</p> Signup and view all the answers

    What is a common mode of pinworm transmission?

    <p>Hand-to-mouth</p> Signup and view all the answers

    What is a recommended practice to prevent pinworm reinfection?

    <p>Washing clothes and bed linens in hot water</p> Signup and view all the answers

    What should families be informed about regarding pinworm recurrence?

    <p>It is common and should be treated in the same manner as the initial infection</p> Signup and view all the answers

    What is a notable adverse effect of metronidazole and tinidazole?

    <p>Cause metallic taste and GI adverse effects</p> Signup and view all the answers

    Which diagnostic evaluation method is NOT mentioned for gastroesophageal reflux?

    <p>Esophageal manometry</p> Signup and view all the answers

    What is the most common surgical procedure for children with severe complications of gastroesophageal reflux?

    <p>Nissen fundoplication</p> Signup and view all the answers

    Which feeding maneuver is mentioned as potentially improving mild gastroesophageal reflux symptoms in infants?

    <p>Thickened feedings</p> Signup and view all the answers

    What is the primary cause of inflammation and reactive airway disease in gastroesophageal reflux?

    <p>Inappropriate transient relaxation of the lower esophageal sphincter (LES)</p> Signup and view all the answers

    What is a potential complication of gastroesophageal reflux in children?

    <p>Esophageal stricture</p> Signup and view all the answers

    What is the recommended sleeping position for infants to minimize reflux, considering the risk of sudden infant death syndrome?

    <p>Supine position</p> Signup and view all the answers

    What is a potential pharmacological therapy for treating infants and children with gastroesophageal reflux disease (GERD)?

    <p>H2-receptor antagonists</p> Signup and view all the answers

    What is the primary pathophysiology of gastroesophageal reflux?

    <p>Inappropriate transient relaxation of the lower esophageal sphincter (LES)</p> Signup and view all the answers

    What is a potential lifestyle modification for managing gastroesophageal reflux?

    <p>Smoking cessation</p> Signup and view all the answers

    What is a potential complication of the Nissen fundoplication surgical procedure?

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

    What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?

    <p>Excessive crying</p> Signup and view all the answers

    What is a potential therapeutic option for managing gastroesophageal reflux depending on its severity?

    <p>Lifestyle modifications</p> Signup and view all the answers

    What are some simple measures to help parents cope with frequent spitting up in infants with GERD?

    <p>Using bibs and prone positioning</p> Signup and view all the answers

    What is the most frequent infection in the world in terms of intestinal parasitic diseases?

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

    What is the potential transmission route for giardiasis?

    <p>Contaminated water, food, and person-to-person contact</p> Signup and view all the answers

    How can the diagnosis of giardiasis be made?

    <p>Microscopic examination of stool specimens or duodenal fluid</p> Signup and view all the answers

    Which medication for treatment of giardiasis is said to have an 80 to 100% cure rate after a single dose?

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

    What is a possible intervention for severe cases of regurgitation and growth restriction in infants with GERD?

    <p>NG tube or gastrostomy feedings</p> Signup and view all the answers

    What is the cause of giardiasis?

    <p>Protozoan Giardia lamblia</p> Signup and view all the answers

    What is the incidence trend of intestinal parasitic diseases, especially giardiasis, among young children in day care centers in Canada?

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

    What is the role of parents in pediatric nursing care for GERD?

    <p>Identification of symptoms and parent education on home care</p> Signup and view all the answers

    What are the symptoms of giardiasis?

    <p>Abdominal cramps and diarrhea</p> Signup and view all the answers

    What are the possible interventions for parents to cope with GERD in infants?

    <p>Positioning, avoiding feeding spicy foods, and scheduling more frequent feeding times</p> Signup and view all the answers

    What are the possible medications for treatment of giardiasis?

    <p>Metronidazole, tinidazole, paromomycin, and nitazoxanide</p> Signup and view all the answers

    What is the peak age range for children with appendicitis?

    <p>10-18 years</p> Signup and view all the answers

    What is the most common cause of obstruction in appendicitis?

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

    What is a potential complication of appendiceal perforation?

    <p>Partial bowel obstruction</p> Signup and view all the answers

    What is the classic first symptom of appendicitis?

    <p>Periumbilical pain</p> Signup and view all the answers

    Which medication is indicated for induction therapy in children with moderate to severe UC and CD?

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

    What is the primary goal of any treatment regimen for UC and CD?

    <p>Maintain remission over time</p> Signup and view all the answers

    Which medication is designed for controlled release in the ileum and is indicated for ileal and right-sided colitis?

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

    Which immunomodulator is used to induce and maintain remission in children with IBD who are steroid resistant or steroid dependent?

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

    Which medication is used to treat left-sided colitis with suppository and enema preparations?

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

    Which medication has been shown to be effective in inducing remission in severe steroid-dependent UC?

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

    Which medication is indicated for induction and maintenance therapy in left-sided colitis?

    <p>Rectal steroid therapy</p> Signup and view all the answers

    Which medication blocks the synthesis of purine, thus inhibiting the ability of DNA and RNA to hinder lymphocyte function?

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

    What is the preferred imaging tool for diagnosing pediatric appendicitis?

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

    Which diagnostic evaluation method is NOT mentioned for pediatric appendicitis?

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

    What is the most common surgical procedure for treating pediatric appendicitis?

    <p>Laparoscopic surgery</p> Signup and view all the answers

    What is a key sign of peritonitis in pediatric patients with appendicitis?

    <p>Sudden pain relief after perforation</p> Signup and view all the answers

    What is the primary treatment for pediatric appendicitis before perforation?

    <p>Rehydration, antibiotics, and appendectomy</p> Signup and view all the answers

    What is a common nonoperative treatment for ruptured pediatric appendicitis?

    <p>IV antibiotics and oral antibiotics post-discharge</p> Signup and view all the answers

    What is the role of antibiotics in the management of pediatric appendicitis?

    <p>To lower postoperative complications</p> Signup and view all the answers

    What is a key aspect of postoperative care for pediatric appendicitis?

    <p>IV fluids and continued antibiotics</p> Signup and view all the answers

    What is crucial in the assessment of abdominal pain in nonverbal children with suspected appendicitis?

    <p>Abdominal pain assessment</p> Signup and view all the answers

    What can the loss of extracellular fluid (ECF) to the peritoneal cavity lead to in pediatric patients with appendicitis?

    <p>Electrolyte imbalance and hypovolemic shock</p> Signup and view all the answers

    What is the gold standard imaging tool for diagnosing pediatric appendicitis?

    <p>CT scanning</p> Signup and view all the answers

    What is a notable complication of pediatric appendicitis?

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

    What is the standard treatment for Meckel diverticulum?

    <p>Surgical removal</p> Signup and view all the answers

    What is an essential part of routine assessment for postoperative care of nonperforated appendix?

    <p>Regular bowel sound checks</p> Signup and view all the answers

    What is the primary cause of excoriation around the surgical site?

    <p>Frequent dressing changes</p> Signup and view all the answers

    What is the recommended approach to prevent complications associated with prolonged bed rest postoperatively?

    <p>Early ambulation with adequate pain management</p> Signup and view all the answers

    What is the standard diagnosis approach for Meckel diverticulum?

    <p>Specialized radiographic study</p> Signup and view all the answers

    What is the primary cause of Meckel diverticulum?

    <p>Fetal omphalomesenteric duct remnant</p> Signup and view all the answers

    What is the standard care for a ruptured appendix and peritonitis?

    <p>IV fluids, NPO, and NG tube with low continuous gastric decompression</p> Signup and view all the answers

    What is a potential consequence of inadequate skin care postoperatively?

    <p>Delayed wound healing</p> Signup and view all the answers

    What is the primary preventive measure for complications associated with prolonged bed rest postoperatively?

    <p>Early ambulation with adequate pain management</p> Signup and view all the answers

    What percentage of the Canadian population is affected by Inflammatory Bowel Disease (IBD)?

    <p>0.7%</p> Signup and view all the answers

    Which type of IBD primarily affects the colon and rectum?

    <p>Ulcerative colitis (UC)</p> Signup and view all the answers

    What is the primary characteristic of Crohn disease (CD) in terms of inflammation?

    <p>Transmural inflammation</p> Signup and view all the answers

    What is the aim of therapeutic management for IBD?

    <p>Control the inflammatory process, achieve long-term remission, promote healthy growth, and maintain a balanced lifestyle</p> Signup and view all the answers

    What is a significant challenge in pediatric CD?

    <p>Growth failure</p> Signup and view all the answers

    What has been observed in relation to breastfeeding and the risk of developing CD?

    <p>Breastfeeding decreases the risk of developing CD</p> Signup and view all the answers

    What type of immune process characterizes Crohn disease (CD)?

    <p>Chronic immune process with a T-helper-1 cytokine profile</p> Signup and view all the answers

    What is a key characteristic of ulcerative colitis (UC) in terms of immune response?

    <p>Response is more humoral and mediated by T-helper-2 cells</p> Signup and view all the answers

    What is the course of IBD characterized by?

    <p>Unpredictable, with flare-ups severely impairing physical and social functioning</p> Signup and view all the answers

    What age group is at the highest risk of IBD diagnosis?

    <p>Adolescents and young adults</p> Signup and view all the answers

    What is the etiology of IBD considered to be?

    <p>Multifactorial, involving genetic predisposition, defective immunoregulation, and environmental factors</p> Signup and view all the answers

    What is the primary difference between ulcerative colitis (UC) and Crohn disease (CD)?

    <p>Location and nature of inflammation</p> Signup and view all the answers

    What is a common cause of growth failure in children with Crohn's Disease (CD)?

    <p>Inadequate dietary intake due to anorexia and increased disease activity</p> Signup and view all the answers

    What is a potential consequence of inadequate dietary intake in children with IBD?

    <p>Delayed sexual maturation and restricted height</p> Signup and view all the answers

    What is a factor contributing to malnutrition in children with IBD?

    <p>Medication–nutrient interaction leading to excessive nutrient absorption</p> Signup and view all the answers

    What is a potential consequence of excessive GI losses in children with IBD?

    <p>Excessive nutrient loss leading to malnutrition</p> Signup and view all the answers

    Which medication is not effective in infants for peptic ulcer disease (PUD)?

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

    What is the standard first-line treatment for H. pylori in peptic ulcer disease (PUD)?

    <p>Triple-medication therapy</p> Signup and view all the answers

    What is a common adverse effect of medications for peptic ulcer disease (PUD)?

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

    What is the most common form of acute viral hepatitis?

    <p>Hepatitis A</p> Signup and view all the answers

    How is Hepatitis A primarily spread?

    <p>Through the fecal-oral route</p> Signup and view all the answers

    What is the likelihood of infants developing jaundice due to HAV infection?

    <p>1 in 12</p> Signup and view all the answers

    Does HAV infection result in chronic infection or chronic liver disease?

    <p>No</p> Signup and view all the answers

    What is the standard first-line treatment for HAV infection?

    <p>HAV vaccine</p> Signup and view all the answers

    What is the long-term prognosis for peptic ulcer disease (PUD)?

    <p>Variable, with many ulcers treated successfully but some recurring</p> Signup and view all the answers

    What is the role of nursing care for peptic ulcer disease (PUD)?

    <p>Promoting healing through medication adherence and considering stress as a factor in ulcer formation</p> Signup and view all the answers

    What can cause hepatitis?

    <p>Viral infections, metabolic conditions, and immune-mediated diseases</p> Signup and view all the answers

    Is proton pump inhibitor (PPI) therapy effective in infants for peptic ulcer disease (PUD)?

    <p>No</p> Signup and view all the answers

    Which of the following is a significant cause of ulcers, weakening the gastric mucosal barrier and allowing acid to damage the mucosa?

    <p>Helicobacter pylori infection</p> Signup and view all the answers

    What is the primary cause of gastric ulcers induced by exogenous factors like Aspirin and NSAIDs?

    <p>Inhibition of prostaglandin synthesis</p> Signup and view all the answers

    Which syndrome may occur in children with multiple, large, or recurrent ulcers?

    <p>Zollinger-Ellison syndrome</p> Signup and view all the answers

    What is the primary diagnostic method for detecting Helicobacter pylori infection in pediatric peptic ulcer disease?

    <p>Upper endoscopy and biopsy</p> Signup and view all the answers

    What is the primary focus of therapeutic management for pediatric peptic ulcer disease?

    <p>Preventing recurrence</p> Signup and view all the answers

    What is the primary medical management for reducing or neutralizing gastric acid secretion in pediatric peptic ulcer disease?

    <p>Histamine (H2) receptor antagonists</p> Signup and view all the answers

    Which age group is primary ulcers more common in?

    <p>Children older than 10 years</p> Signup and view all the answers

    What is the primary pathophysiological imbalance involved in the development of peptic ulcers?

    <p>Imbalance between destructive and defensive factors in the GI tract</p> Signup and view all the answers

    What is the primary cause of secondary ulcers in infants and children with underlying diseases or taking certain medications?

    <p>Underlying diseases</p> Signup and view all the answers

    What percentage of children in North America are diagnosed with peptic ulcer disease (PUD)?

    <p>1.8 to 5%</p> Signup and view all the answers

    What are the factors contributing to ulcer formation in pediatric peptic ulcer disease?

    <p>Ulcerogenic medications</p> Signup and view all the answers

    What is a notable characteristic of primary ulcers in children with pediatric peptic ulcer disease?

    <p>More common in children older than 10 years</p> Signup and view all the answers

    Which nutritional support is recommended for children with adequate oral intake in Inflammatory Bowel Disease (IBD)?

    <p>Parenteral nutrition with high-protein, high-calorie diet</p> Signup and view all the answers

    What has been shown to improve nutritional status and induce disease remission in Inflammatory Bowel Disease (IBD) patients?

    <p>Oral elemental formulas</p> Signup and view all the answers

    What is the long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?

    <p>Colorectal cancer</p> Signup and view all the answers

    What is a questionable dietary choice for active Inflammatory Bowel Disease (IBD)?

    <p>Bran or high-fiber diets</p> Signup and view all the answers

    What is the less likely outcome of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?

    <p>Inducing remission</p> Signup and view all the answers

    What is a surgical option for Ulcerative Colitis (UC)?

    <p>Subtotal colectomy with ileostomy</p> Signup and view all the answers

    What is a surgical option for Crohn's Disease (CD)?

    <p>Segmental intestinal resections</p> Signup and view all the answers

    What is a crucial nursing consideration in managing Inflammatory Bowel Disease (IBD)?

    <p>Guidance on diet and coping with stress</p> Signup and view all the answers

    What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?

    <p>Colorectal cancer</p> Signup and view all the answers

    What is a crucial nursing role in managing Inflammatory Bowel Disease (IBD)?

    <p>Explaining the purpose and expected outcomes of nutritional therapies</p> Signup and view all the answers

    How is Peptic Ulcer Disease (PUD) described in terms of location?

    <p>Duodenal and primary</p> Signup and view all the answers

    What is a recommended nursing consideration for Peptic Ulcer Disease (PUD)?

    <p>Guidance on smoking cessation</p> Signup and view all the answers

    What is the incubation period for hepatitis E?

    <p>2 to 9 weeks</p> Signup and view all the answers

    Which hepatitis infection has an incubation period of 45 to 160 days?

    <p>Hepatitis B</p> Signup and view all the answers

    What is the primary route of transmission for hepatitis D?

    <p>Parenteral transmission</p> Signup and view all the answers

    What is the recommended vaccination strategy for hepatitis A for infants less than 6 months?

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

    Which region has high prevalence of hepatitis B?

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

    What is the average incubation period for hepatitis C?

    <p>7 to 9 weeks</p> Signup and view all the answers

    Which hepatitis infection is absent in Canada, the United States, and Western Europe?

    <p>Hepatitis E</p> Signup and view all the answers

    What is the primary risk factor for acquiring HCV?

    <p>Injection drug use</p> Signup and view all the answers

    What is the primary route of transmission for HBV infection?

    <p>Parenteral transmission</p> Signup and view all the answers

    Which type of hepatitis infection is more severe than HBV infection?

    <p>Hepatitis D</p> Signup and view all the answers

    What is the primary preventive measure for HBV infection in newborns at risk?

    <p>Universal vaccination</p> Signup and view all the answers

    Which population is hepatitis D primarily endemic in?

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

    What percentage of affected children with cleft lip and palate (CL/P) are male?

    <p>70-90%</p> Signup and view all the answers

    At what gestational age does fetal ultrasonography become reliable for prenatal diagnosis of cleft lip and palate (CL/P)?

    <p>13-14 weeks</p> Signup and view all the answers

    When is surgical repair of cleft lip (CL) typically performed?

    <p>2-3 months</p> Signup and view all the answers

    What maternal factors are linked to cleft lip and palate (CL/P)?

    <p>Alcohol, smoking, and obesity</p> Signup and view all the answers

    What is the primary cause of cleft deformities?

    <p>Genetic defect in cell migration</p> Signup and view all the answers

    When is surgical repair of cleft palate (CP) typically performed?

    <p>6-9 months</p> Signup and view all the answers

    How many newborns in Canada are affected by cleft lip and palate (CL/P) annually?

    <p>600</p> Signup and view all the answers

    What percentage of cleft deformities occur with a recognized syndrome?

    <p>70-80%</p> Signup and view all the answers

    When are unilateral clefts more common than bilateral clefts?

    <p>In all ethnic groups</p> Signup and view all the answers

    At what age does cleft lip (CL) become apparent?

    <p>At birth</p> Signup and view all the answers

    What portion of the palate consists of the remaining hard and soft palate?

    <p>Secondary portion</p> Signup and view all the answers

    What is the primary management approach for cleft palate (CP)?

    <p>Surgical repair</p> Signup and view all the answers

    What is the primary cause of liver failure and liver transplant for Canadian children?

    <p>Biliary atresia</p> Signup and view all the answers

    How is acute hemorrhage of varices managed in children with liver cirrhosis?

    <p>IV fluids, blood products, vasopressin, and gastric lavage</p> Signup and view all the answers

    What is the primary treatment for ascites in children with liver cirrhosis?

    <p>Sodium restriction and diuretics</p> Signup and view all the answers

    What is the suggested cause of the progressive inflammation leading to complete obliteration of the bile ducts in biliary atresia?

    <p>Immune mechanisms or viral injury</p> Signup and view all the answers

    What has revolutionized the approach to liver cirrhosis in Canadian children?

    <p>Liver transplantation</p> Signup and view all the answers

    Which type of liver transplantation has been associated with better survival outcomes in children?

    <p>Living donor transplantation</p> Signup and view all the answers

    What is the primary treatment for hepatic encephalopathy in children with liver cirrhosis?

    <p>Limiting ammonia formation and absorption with medications like neomycin and lactulose</p> Signup and view all the answers

    What is the primary consequence of portal hypertension in children with liver cirrhosis?

    <p>Esophageal and gastric varices</p> Signup and view all the answers

    What is crucial for the nutritional support of children with liver cirrhosis and malnutrition?

    <p>Fat-soluble vitamins and minerals supplements</p> Signup and view all the answers

    What has decreased the wait time for liver transplantation in children?

    <p>Reduced-sized grafts</p> Signup and view all the answers

    What is the primary nursing emphasis for children with liver cirrhosis?

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

    What is the primary goal of liver cirrhosis treatment in children?

    <p>Prolonging survival</p> Signup and view all the answers

    Which factor is NOT mentioned as a cause of articulation errors in children with cleft lip and palate (CL/P)?

    <p>Nasal congestion</p> Signup and view all the answers

    What is commonly used to drain the middle ear and prevent hearing impairment in children with CL/P?

    <p>Myringotomy tubes</p> Signup and view all the answers

    What is a primary focus of nursing care for newborns with CL/P?

    <p>Feeding difficulties and emotional support for parents</p> Signup and view all the answers

    What is linked to growth failure in infants with CL/P?

    <p>Preoperative feeding difficulties</p> Signup and view all the answers

    Which feeding method is protective against otitis media in infants with CL/P?

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

    What is available to assist with feeding infants with CL/P?

    <p>Cleft Lip/Cleft Palate Nurser and Special Needs Feeder</p> Signup and view all the answers

    What may infants with CL/P tend to swallow excessive of during feedings?

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

    What may not improve feeding efficiency or growth in infants with CL/P within the first year of life?

    <p>Feeding obturators</p> Signup and view all the answers

    What can help infants with CP feed efficiently?

    <p>Positioning, bottle selection, and supportive techniques</p> Signup and view all the answers

    What is a potential consequence of feeding obturators in infants with CL/P?

    <p>No improvement in feeding efficiency</p> Signup and view all the answers

    What is a potential challenge for children with CL/P?

    <p>Social adjustment and self-image</p> Signup and view all the answers

    What can lead to recurrent ear infections and scarring of the tympanic membrane in children with CL/P?

    <p>Inefficient eustachian tube function</p> Signup and view all the answers

    What is the primary treatment for Biliary Atresia (BA)?

    <p>Hepatic portoenterostomy (Kasai procedure)</p> Signup and view all the answers

    What is the aim of the Kasai procedure for Biliary Atresia (BA)?

    <p>To establish bile drainage</p> Signup and view all the answers

    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)?

    <p>Around 49%</p> Signup and view all the answers

    What is the primary cause of cleft lip (CL) and cleft palate (CP)?

    <p>Failure of fusion of facial structures during embryonic development</p> Signup and view all the answers

    What is the association of cleft palate (CP) with deformed dental structures?

    <p>CP involves the soft and hard palates</p> Signup and view all the answers

    What is the potential long-term outcome of Biliary Atresia (BA) despite the Kasai procedure?

    <p>Progressive cirrhosis</p> Signup and view all the answers

    What is the role of ursodeoxycholic acid in the medical management of Biliary Atresia (BA)?

    <p>To decrease cholestasis and treat hypercholesterolemia</p> Signup and view all the answers

    What is the potential consequence of untreated Biliary Atresia (BA) in children?

    <p>Progressive cirrhosis and death</p> Signup and view all the answers

    What is a common presentation of Biliary Atresia (BA) in infants?

    <p>Dark urine</p> Signup and view all the answers

    What is a common challenge in children with Biliary Atresia (BA) that requires close nursing attention?

    <p>Growth failure</p> Signup and view all the answers

    What is a key aspect of nursing care for children with Biliary Atresia (BA) postoperatively?

    <p>Supporting the family and educating them about the treatment plan</p> Signup and view all the answers

    What is a potential consequence of Kasai failure in Biliary Atresia (BA)?

    <p>Progressive cirrhosis</p> Signup and view all the answers

    Which of the following is a potential consequence of cirrhosis in children?

    <p>Impaired pulmonary function due to pressure against the diaphragm</p> Signup and view all the answers

    What is a key goal of managing cirrhosis in children?

    <p>Monitoring liver function and managing specific complications</p> Signup and view all the answers

    What is a common clinical manifestation of cirrhosis in children?

    <p>Jaundice and poor growth</p> Signup and view all the answers

    What is an important consideration for therapeutic management of cirrhosis in children?

    <p>Assessment of the child’s degree of liver dysfunction for transplantation evaluation</p> Signup and view all the answers

    What is a potential cause of cirrhosis in children?

    <p>Viral infection</p> Signup and view all the answers

    Which manifestation may be present in children with impaired intrahepatic blood flow due to cirrhosis?

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

    What is a potential consequence of impaired pulmonary function in children with cirrhosis?

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

    What is a primary goal of managing cirrhosis in children?

    <p>Monitoring liver function</p> Signup and view all the answers

    What is the most common esophageal malformation?

    <p>Esophageal atresia</p> Signup and view all the answers

    Which syndrome is often associated with EA/TEF?

    <p>Down syndrome</p> Signup and view all the answers

    What is the acronym for syndromes involving a combination of Vertebral, Anorectal, Cardiovascular, TracheoEsophageal, Renal, and Limb abnormalities?

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

    What is the most frequently occurring anomaly with EA/TEF?

    <p>Cardiac anomalies</p> Signup and view all the answers

    What is the most common form of Esophageal Atresia (EA) and Tracheoesophageal Fistula (TEF)?

    <p>Proximal esophageal segment terminating in a blind pouch, and the distal segment connected to the trachea by a short fistula</p> Signup and view all the answers

    What is the diagnostic evaluation for EA and TEF based on?

    <p>Radiographic studies and clinical manifestations</p> Signup and view all the answers

    What percentage of infants with EA have tracheomalacia?

    <p>Up to 75%</p> Signup and view all the answers

    What are signs of significant tracheomalacia in infants with EA?

    <p>Barking cough and cyanosis</p> Signup and view all the answers

    What is the primary therapeutic management for EA and TEF?

    <p>Surgical repair of the anomaly</p> Signup and view all the answers

    In what percentage of infants with EA is significant tracheomalacia present?

    <p>Up to 20%</p> Signup and view all the answers

    What is the aim of surgical correction for EA and TEF?

    <p>To restore normal tracheoesophageal anatomy and function</p> Signup and view all the answers

    What is the preferred procedure for infants who are preterm, have multiple anomalies, or are in poor condition?

    <p>Staged procedure involving palliative measures</p> Signup and view all the answers

    What is the primary factor determining the prognosis for EA and TEF?

    <p>Presence and severity of associated anomalies</p> Signup and view all the answers

    What is a possible complication in infants with EA and TEF?

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

    What is the primary aim of therapeutic management for EA and TEF?

    <p>To restore normal tracheoesophageal function</p> Signup and view all the answers

    What is the preferred surgical approach for correcting EA and TEF?

    <p>Open surgical repair</p> Signup and view all the answers

    Which condition is associated with the covered herniation of abdominal organs, often with other defects?

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

    What is the primary nursing emphasis for children with esophageal atresia/tracheoesophageal fistula (EA/TEF)?

    <p>Feeding assistance</p> Signup and view all the answers

    What is the primary cause of growth failure in children with gastroschisis?

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

    What is the most common type of hernia in boys?

    <p>Inguinal hernia</p> Signup and view all the answers

    What is the primary goal of preoperative nursing care for infants with abdominal wall defects?

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

    What is the primary cause of reactive airway disease in children with EA/TEF?

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

    What is the primary focus of therapeutic management for infants with gastroschisis?

    <p>Surgical closure</p> Signup and view all the answers

    Which condition involves the uncovered herniation of bowel with a lower likelihood of associated anomalies?

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

    What is the primary consequence of prolonged NPO status or lack of oral stimulation in infants with esophageal atresia/tracheoesophageal fistula (EA/TEF)?

    <p>Feeding difficulties</p> Signup and view all the answers

    What is the primary focus of nursing care for infants requiring esophageal replacement?

    <p>Feeding assistance</p> Signup and view all the answers

    What is the primary consequence of feeding obturators in infants with cleft lip/palate (CL/P)?

    <p>Feeding difficulties</p> Signup and view all the answers

    What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?

    <p>Reactive airway disease</p> Signup and view all the answers

    What is a common complication of primary repair for esophageal atresia and tracheoesophageal fistula?

    <p>Anastomotic leak</p> Signup and view all the answers

    What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?

    <p>Extreme prematurity</p> Signup and view all the answers

    What is the primary purpose of routine esophageal dilation in the management of esophageal strictures?

    <p>Treating strictures resulting from tension or ischemia</p> Signup and view all the answers

    What is a key consideration in the discharge education for infants with repaired esophagus?

    <p>Feeding techniques in a semi-upright position</p> Signup and view all the answers

    What is the most desirable position for a newborn with typical esophageal atresia and tracheoesophageal fistula?

    <p>Supine with the head elevated on an inclined plane of at least 30 degrees</p> Signup and view all the answers

    What is a potential indication for fundoplication in infants with esophageal atresia and tracheoesophageal fistula?

    <p>Feeding difficulties and GER</p> Signup and view all the answers

    What is a crucial factor in the prognosis of esophageal atresia and tracheoesophageal fistula?

    <p>Birth weight</p> Signup and view all the answers

    What is a common consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula?

    <p>Feeding difficulties</p> Signup and view all the answers

    What is crucial for early detection of esophageal atresia and tracheoesophageal fistula?

    <p>Clinical suspicion</p> Signup and view all the answers

    What is a common complication in preterm low-birth-weight infants with associated anomalies?

    <p>High incidence of complications</p> Signup and view all the answers

    What is a primary consideration in the postoperative care of infants with esophageal atresia and tracheoesophageal fistula?

    <p>Respiratory assessment and airway management</p> Signup and view all the answers

    What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula?

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

    Which condition is characterized by projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure in the first 2 to 5 weeks of life?

    <p>Pyloric stenosis</p> Signup and view all the answers

    Which congenital obstruction usually appears in the newborn period?

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

    What is the primary cause of obstruction in hypertrophic pyloric stenosis?

    <p>Thickening of pyloric sphincter muscle</p> Signup and view all the answers

    Which group is more commonly affected by hypertrophic pyloric stenosis?

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

    What is the primary method for diagnosis of hypertrophic pyloric stenosis?

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

    What is the standard treatment for hypertrophic pyloric stenosis?

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

    What is a common symptom of hypertrophic pyloric stenosis?

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

    What is a key focus of preoperative care for hypertrophic pyloric stenosis?

    <p>Hydration and electrolyte balance</p> Signup and view all the answers

    What is a crucial aspect of postoperative care for hypertrophic pyloric stenosis?

    <p>Hygienic care and protection from infections</p> Signup and view all the answers

    What is the primary role of nursing care in hypertrophic pyloric stenosis?

    <p>Observation of vital signs and hydration status</p> Signup and view all the answers

    What is a notable risk factor for hypertrophic pyloric stenosis?

    <p>Maternal smoking</p> Signup and view all the answers

    What is a common outcome for infants with hypertrophic pyloric stenosis if diagnosed early?

    <p>Rapid recovery</p> Signup and view all the answers

    What is a primary consideration in the surgical management of hypertrophic pyloric stenosis?

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

    What is a crucial aspect of parental involvement in the care process for hypertrophic pyloric stenosis?

    <p>Providing emotional support</p> Signup and view all the answers

    What is a key focus of postoperative care for hypertrophic pyloric stenosis?

    <p>Hygienic care and protection from infections</p> Signup and view all the answers

    What is a common method for managing dehydration in infants with hypertrophic pyloric stenosis?

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

    What is the most common cause of intestinal obstruction in children between the ages of 5 months and 3 years?

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

    What is the success rate of nonoperative reduction in cases of intussusception?

    <p>80 to 95%</p> Signup and view all the answers

    What is the primary diagnostic method for confirming intussusception?

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

    What is the standard treatment for intussusception if nonoperative reduction is unsuccessful?

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

    What is the primary aim of postoperative care for infants after surgery?

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

    What is the most common cause of death in newborns with esophageal atresia and tracheoesophageal fistula?

    <p>Aspiration pneumonia</p> Signup and view all the answers

    What is the primary cause of cleft lip and cleft palate?

    <p>Maternal smoking</p> Signup and view all the answers

    What is the primary focus of nursing care for infants requiring esophageal replacement?

    <p>Nutritional support</p> Signup and view all the answers

    What is the primary characteristic of Crohn's disease in terms of inflammation?

    <p>Continuous inflammation</p> Signup and view all the answers

    What is the primary aim of therapeutic management for esophageal atresia and tracheoesophageal fistula?

    <p>Preventing aspiration</p> Signup and view all the answers

    What is a potential clinical manifestation of gastroesophageal reflux symptoms in infants?

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

    What is the primary cause of reactive airway disease in children with esophageal atresia and tracheoesophageal fistula?

    <p>Gastroesophageal reflux</p> Signup and view all the answers

    What is the definitive diagnostic procedure for malrotation and volvulus?

    <p>Upper GI series</p> Signup and view all the answers

    What is the primary treatment for malrotation?

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

    What are the symptoms that may be present in infants with malrotation?

    <p>Bilious vomiting, recurrent abdominal pain, lower GI bleeding</p> Signup and view all the answers

    What is the classification basis for anorectal malformations?

    <p>Gender and anatomical features</p> Signup and view all the answers

    What is the diagnostic evaluation for anorectal malformations primarily focused on?

    <p>Inspecting the perineal area for anomalies</p> Signup and view all the answers

    What is a potential complication associated with surgery for malrotation?

    <p>Short-bowel syndrome</p> Signup and view all the answers

    What is the primary nursing intervention for infants with malrotation preoperatively?

    <p>NG tube insertion</p> Signup and view all the answers

    What is a potential consequence of anorectal malformations?

    <p>Urinary incontinence</p> Signup and view all the answers

    What is a common presentation of imperforate anus?

    <p>Abnormal communications from the rectum</p> Signup and view all the answers

    What is the ratio of occurrence of anorectal malformations between male and female infants?

    <p>2:1</p> Signup and view all the answers

    What is the potential life-threatening complication of malrotation if not promptly diagnosed and treated?

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

    What is the potential consequence of malrotation and volvulus if not promptly diagnosed and surgically treated?

    <p>Short-bowel syndrome</p> Signup and view all the answers

    What is the primary surgical treatment for perineal fistulas in newborns with anorectal malformations?

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

    What may indicate the presence of rectourinary fistulas in newborns with anorectal malformations?

    <p>Meconium in the urine</p> Signup and view all the answers

    What is the primary method to identify anal stenosis in older children with anorectal malformations?

    <p>History of difficult defecation and ribbonlike stools</p> Signup and view all the answers

    Which procedure may be required if the rectum is unidentifiable by the posterior approach in anorectal malformations surgery?

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

    What is the primary factor influencing the long-term prognosis of anorectal malformations?

    <p>Type of defect, sacral anatomy, and muscle quality</p> Signup and view all the answers

    What is the primary method for successful treatment of anal stenosis?

    <p>Manual dilations</p> Signup and view all the answers

    Which imaging technique is performed to determine the existence of other malformations in newborns with anorectal malformations?

    <p>Abdominal ultrasonography</p> Signup and view all the answers

    What is the primary nursing role in managing anorectal malformations in newborns?

    <p>Providing postoperative care and support for families</p> Signup and view all the answers

    What is the primary surgical procedure for correcting anorectal malformations in newborns with perineal fistulas?

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

    What is the primary preoperative care for newborns with anorectal malformations undergoing posterior sagittal anorectoplasty (PSARP)?

    <p>Irrigation of the distal stoma</p> Signup and view all the answers

    What is the primary method to manage perineal fistulas in newborns with anorectal malformations?

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

    What is the primary surgical treatment for anorectal malformations that cannot be corrected by the posterior approach?

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

    Which of the following is a condition classified as an absorptive defect in malabsorption syndromes?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What is the primary cause of malabsorption in Hirschsprung's disease?

    <p>Accelerated bowel motility</p> Signup and view all the answers

    Which anatomical defect affects digestion by decreasing the transit time of substances and compromises the absorptive surface?

    <p>Short-bowel syndrome</p> Signup and view all the answers

    What is the primary defect in lactase deficiency?

    <p>Congenital lactose intolerance</p> Signup and view all the answers

    Which medication is often prescribed to improve diarrhea associated with bile salt malabsorption?

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

    What is a potential consequence of inadequate growth in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?

    <p>Bowel atrophy</p> Signup and view all the answers

    What is a potential cause of feeding difficulties in infants with esophageal atresia and tracheoesophageal fistula (EA/TEF)?

    <p>Bacterial overgrowth</p> Signup and view all the answers

    What is the primary preventive measure for catheter sepsis related to central venous access devices (CVAD)?

    <p>Proper catheter care</p> Signup and view all the answers

    What is the most important component of nursing care during parenteral nutrition therapy?

    <p>Administering nutritional therapy</p> Signup and view all the answers

    What is a potential long-term complication of Inflammatory Bowel Disease (IBD) that requires surveillance colonoscopies?

    <p>Colon cancer</p> Signup and view all the answers

    What is the primary cause of mortality in infants and children with Short Bowel Syndrome (SBS)?

    <p>Parenteral nutrition cholestasis</p> Signup and view all the answers

    What is the aim of surgical interventions such as constructing intestinal valves or tapering enteroplasty in SBS?

    <p>To slow intestinal transit</p> Signup and view all the answers

    What is a potential consequence of Total Parenteral Nutrition (TPN) in ulcerative colitis (UC) compared to Crohn's disease (CD)?

    <p>Less likely outcome of TPN</p> Signup and view all the answers

    What is a potential life-threatening complication of malrotation if not promptly diagnosed and treated?

    <p>Midgut volvulus</p> Signup and view all the answers

    What is a key aspect of postoperative care for pediatric appendicitis?

    <p>Antibiotic prophylaxis</p> Signup and view all the answers

    What is the primary manifestation of tracheomalacia as a complication of esophageal atresia/tracheoesophageal fistula (EA/TEF)?

    <p>Respiratory distress</p> Signup and view all the answers

    Which type of deficiency may lead to lactose intolerance?

    <p>Lactase deficiency</p> Signup and view all the answers

    What can untreated celiac disease in children lead to?

    <p>Lactose intolerance</p> Signup and view all the answers

    What is a common source of gluten that requires label reading to avoid?

    <p>Hydrolyzed vegetable protein</p> Signup and view all the answers

    What is a potential consequence of untreated celiac disease?

    <p>Severe symptoms</p> Signup and view all the answers

    What is the primary cause of lactose intolerance?

    <p>Deficiency of lactase enzyme</p> Signup and view all the answers

    What is a potential consequence of financial burdens due to celiac disease?

    <p>Increased risk of nutritional deficiencies</p> Signup and view all the answers

    What is the primary cause of gluten intolerance?

    <p>Genetic mutation</p> Signup and view all the answers

    What is a common symptom of lactose intolerance?

    <p>Bloating and gas</p> Signup and view all the answers

    What is a potential cause of secondary lactase deficiency?

    <p>Damage to the intestinal lumen</p> Signup and view all the answers

    What is the primary treatment for celiac disease-related nutritional deficiencies?

    <p>Appropriate supplements</p> Signup and view all the answers

    What is a potential consequence of severe mucosal damage in celiac disease?

    <p>Temporary lactose intolerance</p> Signup and view all the answers

    What is a common symptom of lactose intolerance?

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

    What is the reported incidence of celiac disease?

    <p>1 in 266</p> Signup and view all the answers

    What is the primary cause of celiac disease?

    <p>Intestinal intolerance to dietary gluten</p> Signup and view all the answers

    Where are the genes located that are found in almost 90% of those affected with celiac disease?

    <p>Chromosome 6</p> Signup and view all the answers

    What is the primary diagnostic method for celiac disease?

    <p>Biopsy of the small intestine</p> Signup and view all the answers

    What is the primary treatment for chronic celiac disease?

    <p>Dietary changes</p> Signup and view all the answers

    What is the role of gradual introduction of gluten in the infant’s diet between 4 and 12 months?

    <p>It prevents celiac disease</p> Signup and view all the answers

    What are the classic symptoms of celiac disease?

    <p>Impaired growth, chronic diarrhea, abdominal distension, and malabsorption</p> Signup and view all the answers

    What are the commercially available serological tests for celiac disease?

    <p>Antigliadin antibodies, antiendomysium IgA, and antitissue transglutaminase IgA and IgG antibodies</p> Signup and view all the answers

    What is the primary response of most children with celiac disease after instituting the gluten-free diet?

    <p>Favorable response, including weight gain and improved appetite</p> Signup and view all the answers

    What is the gender distribution of celiac disease?

    <p>Higher occurrence in women than men</p> Signup and view all the answers

    What is the characteristic feature of celiac disease in the small bowel?

    <p>Villous atrophy</p> Signup and view all the answers

    What is the primary cause of impaired growth in children with celiac disease?

    <p>Malabsorption of nutrients</p> Signup and view all the answers

    What is the primary method used for positive diagnosis of lactose intolerance?

    <p>Breath hydrogen test</p> Signup and view all the answers

    What may lead to reduced bone mineral density and osteoporosis in children with lactose intolerance?

    <p>Avoiding dairy products</p> Signup and view all the answers

    What is a viable option for individuals with lactose intolerance?

    <p>Lactase-treated dairy products</p> Signup and view all the answers

    What is a potential consequence of avoiding dairy products in individuals with lactose intolerance?

    <p>Increased risk of osteoporosis</p> Signup and view all the answers

    What is a key difference between lactose intolerance and dairy allergy?

    <p>Lactose intolerance causes skin rash or hives</p> Signup and view all the answers

    What is a potential treatment for lactose intolerance?

    <p>Reducing dairy products</p> Signup and view all the answers

    What is a possible consequence of inadequate dairy intake in individuals with lactose intolerance?

    <p>Increased risk of osteoporosis</p> Signup and view all the answers

    What is a potential method to improve lactose intolerance?

    <p>Probiotic intake</p> Signup and view all the answers

    What is a necessary supplementation due to reduced dairy intake in individuals with lactose intolerance?

    <p>Calcium and vitamin D</p> Signup and view all the answers

    What is a characteristic of lactose intolerance?

    <p>Manifests as an anaphylactic-type reaction</p> Signup and view all the answers

    What is a potential consequence of inadequate dairy intake in individuals with lactose intolerance?

    <p>Increased risk of bone fractures</p> Signup and view all the answers

    What is a viable option for lactose intolerance?

    <p>Lactase-treated dairy products</p> Signup and view all the answers

    What is the primary diagnostic method for lactose intolerance?

    <p>Breath hydrogen test</p> Signup and view all the answers

    What may happen if children with lactose intolerance avoid dairy products?

    <p>Reduced bone mineral density and osteoporosis</p> Signup and view all the answers

    What is a viable option for managing lactose intolerance?

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

    What is a potential consequence of inadequate skin care postoperatively in short-bowel syndrome?

    <p>Skin breakdown and infection</p> Signup and view all the answers

    What is a potential life-threatening complication of short-bowel syndrome if not promptly diagnosed and treated?

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

    What is necessary due to reduced dairy intake in individuals with lactose intolerance?

    <p>Supplementation of calcium and vitamin D</p> Signup and view all the answers

    What is the aim of treatment for lactose intolerance?

    <p>Eliminating or reducing dairy products</p> Signup and view all the answers

    What is a potential effect of probiotics in lactose intolerance?

    <p>Improvement in symptoms</p> Signup and view all the answers

    What is often mistaken for lactose intolerance but is triggered by various factors in addition to lactose?

    <p>Irritable Bowel Syndrome (IBS)</p> Signup and view all the answers

    What is the most common symptom of lactose intolerance?

    <p>Abdominal pain</p> Signup and view all the answers

    What is a potential consequence of lactose intolerance?

    <p>Abdominal pain and bloating</p> Signup and view all the answers

    What is a malabsorptive disorder resulting from decreased mucosal surface area?

    <p>Short-bowel syndrome</p> Signup and view all the answers

    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.

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