Pediatric Module 7 Pediatric Care PDF

Managing the Care for Pediatric Patients with Alterations in Gastrointestinal and Genitourinary Elimination or Alterations in Fluid and Electrolyte Balance NURS 445 Module 7  Object...

Managing the Care for Pediatric Patients with Alterations in Gastrointestinal and Genitourinary Elimination or Alterations in Fluid and Electrolyte Balance NURS 445 Module 7  Objectives Recall the concept of elimination and the anatomy and physiology of Describe the role of inflammation in the gastrointestinal and the gastrointestinal and genitourinary systems. genitourinary systems of the pediatric patient. Contrast the physiological differences with pediatric gastrointestinal Discuss the physiological differences with children gastrointestinal and genitourinary elimination and adult elimination. and genitourinary elimination vs. adult elimination. Demonstrate proficiency in the calculation of expected urine output Describe the effects of infectious gastrointestinal illnesses on based on weight. elimination in the pediatric population. Calculate fluid needs based on weight and kidney development. Apply previously learned pathophysiology, clinical manifestations, treatment options, and nursing care to the plan of care for a pediatric Identify nutritional needs for patients in the pediatric population. patient with gastroesophageal reflux disease. Identify the pathophysiology, etiology, clinical manifestations, Describe the nursing care for gastrointestinal structural and treatment strategies, and nursing considerations for patients with inflammatory changes, the effects on elimination, and treatment alterations in elimination. options for cleft lip or palate, hypertrophic pyloric stenosis, Describe how to measure urinary and gastrointestinal output in appendicitis, intussusception, and celiac disease. diaper dependent patients. Describe the nursing care for genitourinary and reproductive structural disorders of pediatric patients, the effects on elimination, and corrective methods for disorders, including hypospadias, epispadias, and testicular torsion.  Objectives Describe the nursing care for renal disorders in the pediatric population and the effect on elimination, growth, and development, including acute glomerulonephritis, hemolytic uremic syndrome, nephrotic syndrome, and renal failure. Adapt previous knowledge of infectious and inflammation processes within the genitourinary systems when providing nursing care for pediatric patients with urinary tract infections, such as cystitis or pyelonephritis. Connect common diagnostic exams performed to identify disorders of urinary elimination and assess developmental needs for successful examination, including urinalysis, voiding cystourethrogram, and renal ultrasound. Connect previous fluid and electrolyte knowledge with differences in the pediatric population, including treatment strategies for fluid and electrolyte imbalances. Describe how the role of dehydration affects potassium and sodium balance. Elimination Interrelated concepts  Anatomy Genitourinary system (GU) ureters are shorter  Anatomy Gastrointestinal system (GI) surface areas with age  All nephrons are present at birth body is rid of Kidney efficiency increases with age getting all electrolytes ! Immature glomeruli, tubules, and - nephrons lead to quicker dehydration Kidneys can’t adequately conserve water and Pediatric GU solutes effectively Unable to concentrate their urine until about age 2 considerations Specific gravity may not change on urinalysis (UA) Children become aware of and are interested in genitals between 3-6 years of age. ↳ NORMAL ↳ increases risk of germs in that area  suck SWALLON Sucking is a primitive reflex e BREATH The lower GI tract is relatively shorter in the newborn and early infancy period; due to the decreased intestinal surface area available to reabsorb water, newborns have more watery and looser stools compared to older children. Voluntary control of swallowing is not until 6 weeks of age What does this mean for our infants? Pediatric GI Suck, swallow, breathe Small stomach capacity & fast peristalsis =small considerations frequent meals needed Intestines grow and are closer to adult function by 2 years of age ↑ risk of jaundice Immature liver function & in kids Being able to sense a full rectum and attempt to control it starts around age 18 months Start ↳ potty training  Elimination measurement What does strict I&Os mean? How do you as the nurse record accurate I&Os? How do we measure urine output in patients who use diapers?  Infants vs. Adults Distribution of water between ICF and ECF changes with age. More in ECF; fluid volume deficit is rapid. By 5 years of age, water distribution is similar to adult ECF is lost first in children Cardiovascular problems seen in dehydration of infants more quickly  Sodium (135-145 mEq/L) Sodium Sodium Major ECF Na+ Maintains osmolarity Balance of ECF  Hyponatremia- 145mEq/L As sodium increases, fluid moves from ICF to ECF causing cells to shrink. Conditions related to Diabetes Mellitus, Hypernatremia Diabetes Insipidus Nursing care: Strict I&Os, SLOWLY correct imbalance  Potassium (3.5-5 mEq/L) Vital roles in body Acid/base balance Electrical conductivity Transmission of nerve impulses Potassium Contraction of skeletal and cardiac muscles K+ Any K+ imbalance will affect CARDIAC contraction!! ↳ EKG Will be seen on Echocardiogram  >5.0 mEq/L Results from crushing injuries, burns, tissue necrosis, renal failure, severe dehydration, rapid infusion of IV K+. - > will kill someone Metabolic acidosis shifts K+ from ICF to ECF Hyperkalemia Nursing care: Treat underlying cause Give insulin and glucose IV calcium Monitor K+ levels sample FALSE K + hemolysed cells in =