Nursing Care of the Child with Gastrointestinal System Disorder

Vocabulary flashcards for the Nursing Care of the Child with Gastrointestinal System Disorder lecture.

Mouth (Oral Cavity)

Parts: Teeth, tongue, salivary glands. Functions: Mechanical digestion (chewing). Chemical digestion begins (salivary amylase breaks down starch). Forms bolus for swallowing.

Pharynx

Function: Passageway for food from mouth to esophagus. Initiates swallowing reflex.

Esophagus

Function: Transports food to the stomach via peristalsis. Lower esophageal sphincter prevents acid reflux.

Stomach

Parts: Cardia, fundus, body, pylorus. Functions: Stores food temporarily. Mechanical digestion (churning). Chemical digestion of proteins (pepsin, HCl). Converts bolus into chyme.

Small Intestine

Parts: Duodenum, jejunum, ileum. Functions: Major site of digestion and absorption. Duodenum receives bile and pancreatic enzymes. Jejunum absorbs nutrients. Ileum absorbs bile salts, vitamin B12.

Large Intestine (Colon)

Parts: Cecum, ascending, transverse, descending, sigmoid colon, rectum. Functions: Absorbs water and electrolytes. Forms and stores feces. Houses gut microbiota.

Rectum and Anus

Function: Stores feces. Controls defecation through anal sphincters.

Liver

Produces bile to emulsify fats. Processes nutrients, detoxifies substances.

Gallbladder

Stores and concentrates bile. Releases bile into duodenum.

Pancreas

Produces digestive enzymes (lipase, amylase, proteases). Secretes bicarbonate to neutralize stomach acid.

Ingestion

Definition: The process of taking food into the mouth. Key Structures Involved: Mouth, teeth, tongue, salivary glands. Functions: Mechanical breakdown via chewing (mastication). Chemical breakdown begins with saliva (amylase).

Propulsion

Definition: Movement of food through the GI tract. Key Processes: Swallowing (deglutition) – voluntary phase in the mouth. Peristalsis – involuntary, rhythmic muscular contractions that move food along the GI tract.

Mechanical Digestion

Definition: Physical breakdown of food into smaller pieces. Processes Include: Chewing in the mouth. Churning in the stomach. Segmentation in the small intestine (mixes food with digestive juices).

Chemical Digestion

Definition: Breakdown of food into simpler nutrients using enzymes. Sites and Enzymes: Mouth: salivary amylase. Stomach: pepsin (protein digestion). Small intestine: enzymes from pancreas and intestinal lining (carbohydrates, proteins, fats).

Absorption

Definition: The transport of nutrients from the GI tract into the bloodstream or lymph. Major Site: Small intestine (especially the jejunum). Absorbed Substances: Nutrients: glucose, amino acids, fatty acids, vitamins, minerals. Water and electrolytes (also in large intestine).

Elimination (Defecation)

Definition: Removal of indigestible substances and waste products as feces. Structures Involved: Large intestine, rectum, anus.

Fiberoptic endoscopy

Medical procedure used to examine the digestive tract. It involves inserting a flexible tube with a light and camera (endoscope) through the mouth (upper endoscopy) or rectum (lower endoscopy) to visualize and diagnose conditions such as ulcers, inflammation, tumors, or bleeding.

Colonoscopy

A procedure used to examine the large intestine (colon) and rectum. A long, flexible tube with a camera (colonoscope) is inserted through the rectum to check for abnormalities such as polyps, tumors, inflammation, or bleeding.

Barium Enema

A diagnostic imaging test used to examine the colon and rectum. It involves inserting a liquid contrast material containing barium into the colon through the rectum, followed by X-ray imaging to detect abnormalities such as polyps, tumors, or inflammation.

Enteral Feeding (Nasogastric or Gastrostomy)

A method of providing nutrition directly into the gastrointestinal tract when a person cannot consume food normally. Nasogastric feeding involves passing a tube through the nose into the stomach, while gastrostomy feeding involves surgically creating a small opening in the abdomen and inserting a feeding tube directly into the stomach.

Total Parenteral Nutrition (TPN)

A method of providing nutrition intravenously (through a vein) when the digestive tract cannot absorb nutrients properly. TPN delivers a balanced mixture of nutrients, including carbohydrates, proteins, fats, vitamins, and minerals, directly into the bloodstream.

IV Therapy

Intravenous therapy involves administering fluids, medications, or nutrients directly into a vein using a needle or catheter. It's commonly used for hydration, administering medications, blood transfusions, chemotherapy, or delivering nutrients in cases where oral or enteral feeding is not feasible.

Colostomy or Ileostomy

Surgical procedures that involve creating an artificial opening (stoma) in the abdomen to divert fecal waste from the colon (colostomy) or the small intestine (ileostomy) to an external pouch (ostomy bag) worn on the abdomen.

Isotonic Dehydration

Occurs when the body loses more water than it absorbs or absorbs less fluid than it excretes. Common causes: Diarrhea, nausea, vomiting. Result: Decrease in the volume of blood serum. Symptoms: May include thirst, dry mouth, decreased urine output, sunken Eyes, lethargy, rapid heart rate, and cool, clammy skin.

Hypertonic Dehydration

Occurs when water loss is greater than electrolyte loss. Causes: Nausea, fever (increased perspiration), profuse diarrhea, renal diseases with polyuria (e.g., nephrosis). Result: Concentration of electrolytes (sodium, chloride, bicarbonate) in the blood increases. Blood characteristics: Elevated red blood cell count and hematocrit due to blood becoming more concentrated than usual.

Hypotonic Dehydration

Disproportionately high loss of electrolytes compared to fluid loss. Causes: Excessive loss of electrolytes from vomiting, increased salt loss from diuresis, adrenocortical insufficiency, diabetic acidosis. Blood characteristics: Low plasma concentration of sodium and chloride.

Overhydration

Excessive body fluid intake, potentially as serious as dehydration. Common occurrence: Children receiving IV fluids. Risk: Can lead to cardiovascular and cardiac failure. Causes: Ingestion of large quantities of salt-poor fluid (hypotonic solutions) such as tap water, or administration by enema.

Metabolic Acidosis

Results from diarrhea due to excessive loss of sodium (Na⁺) with stool. Mechanism: Body conserves hydrogen ions (H⁺) to maintain balance between positive and negative ions in serum. Arterial blood gas analysis: Reveals decreased pH (under 7.35) and low bicarbonate (HCO₃) value (near or below 22 mEq/L).

Metabolic Alkalosis

Result from loss of hydrochloric acid (HCl), primarily via loss of chloride ions (Cl⁻). Mechanism: Body decreases the number of hydrogen ions (H⁺) to maintain balance between positive and negative charges, causing the child to become alkalotic. Lung response: Attempts to conserve carbon dioxide (CO₂) and water by slowing respirations (hypopnea).

Regurgitation

Occurs with feeding. Runs out of mouth with little force. Smells barely sour; only slightly curdled. Nonpainful; child does not appear to be in distress and may even smile as if sensation is enjoyable. Occurs once per feeding. 1-2 tsp.

Vomiting

Timing unrelated to feeding. Forceful; often projected 1 ft away from the infant; projectile vomiting—projected as much as 4 ft (most often related to increased intracranial pressure in newborns. Extremely sour smelling, appearing curdled, yellow, green, clear or watery, or black. Possible crying before vomiting as if abdominal pain is present, and after vomiting. Continuing until stomach is empty Amount Full stomach contents

Diarrhea

Caused by virus (rotaviruses or adenoviruses). Most common pathogens: Campylobacter jejuni, Salmonella, Giardia lamblia, Clostridium difficile, Escherichia coli. Caused by malabsorption or inflammation

Salmonella

One of the Salmonella bacteria. Incubation period: 6 to 72 hours for intraluminal type; 7 to 14 days for extraluminal type. Mode of transmission: Ingestion of contaminated food, especially chicken and raw eggs.

Listeriosis

Causative agent: Listeria monocytogenes. Incubation period: Variable, ranging from 1 day to more than 3 weeks. Mode of transmission: Ingestion of unpasteurized milk or cheeses or vegetables grown in contaminated soil.

Shigellosis (Dysentery)

Causative agent: Organisms of the genus Shigella. Incubation period: 1 to 7 days. Mode of transmission: Contaminated food, water, or milk product.

Staphyloccocal Food Poisoning

Causative agent: Staphylococcal enterotoxin produced by some strains of Staphylococcus aureus. Incubation period: 1 to 7 hours. Mode of transmission: Ingestion of contaminated food (creamed foods)

Gastroenteritis

A disturbance of the intestinal tract that alters motility and absorption and accelerates the excretion of intestinal contents

Gastroesophageal Reflux Disease (GERD)

The cardiac sphincter and lower portion of the esophagus are weak, allowing regurgitation of gastric contents back into the esophagus.

Pyloric Stenosis

The pylorus muscle becomes thickened causing constriction of the pyloric canal between the stomach and the duodenum.

Hiatal Hernia

Is the intermittent protrusion of the stomach up through the esophageal opening in the diaphragm.

Peptic Ulcer Disease

Is a shallow excavation formed in the mucosal wall of the stomach, the pylorus, or the duodenum. Primarily caused by H. Pylori

Hepatitis

Inflammation and infection of the liver

Hepatitis A

Causative agent: A picornavirus, hepatitis A virus (HAV). Mode of transmission: In children, ingestion of fecally contaminated water or shellfish; day care center spread from contaminated changing tables.

Hepatitis B

Causative agent: A hepadnavirus; hepatitis B virus (HBV). Mode of transmission: Transfusion of contaminated blood and plasma or semen; inoculation by a contaminated syringe or needle through IV drug use; may be spread to fetus if mother has infection in third trimester of pregnancy.

Cirrhosis

Fibrotic scarring of the liver

Intussuception

Bowel telescopes within itself invagination of one portion of the intestine into another

Volvulus

A twisting of the bowel that leads to a bowel obstruction and compromise the blood supply to the loop of intestine involved

Necrotizing Enterocolitis

The bowel develops necrotic patches, interfering with digestion and possibly leading to a paralytic ileus. Perforation and peritonitis may follow. Result from ischemia or poor perfusion of blood vessels in sections of the bowel

Appendicitis

Inflammation of the lumen of the appendix which becomes quickly obstructed causing edema, necrosis and pain.

Meckel’s Diverticulum

A small pouch of this duct remains, located off the ileum, approximately 18 inches from the ileum– colon junction. In this structure, there may be some misplaced gastric mucosa, which secretes gastric acids that flow into the intestine and irritate the bowel wall.

Celiac Disease

Sensitivity or abnormal immunologic response to protein, particularly the gluten factor of protein found in grains— wheat, rye, oats, and barley. When children with the disorder ingest gluten, changes occur in their intestinal mucosa or villi that prevent the absorption of foods

Constipation

Less than 3 bowel movements per week Difficulty of passing hardened stool May cause anal fissures

Inguinal Hernia

Is a protrusion of a section of the bowel into the inguinal ring

Hirschsprung's Disease

The distal portion of the bowel lacks nerve innervations because there is no peristalsis in this narrowed segment; the bowel proximal to it distends markedly. Also known as megacolon. It is the result of an absence of ganglion cells in the rectum and, to varying degrees, upward in the colon.

Ulcerative Colitis

It is the inflammation that involves the rectum and usually extends in the lower part of the colon. Assessment: Diarrhea and steatorrhea, Melena Fever Diagnosis: barium swallow and colonoscopy

Crohn’s Disease

The wall of the colon becomes thickened and the surface is inflamed, leading to cobblestone appearance of mucosa

Irritable Bowel Syndrome

Involves intermittent episodes of loose and normal stools to recurrent abdominal pain

Lactose intolerance

The inability to metabolize lactose, because of a lack of the required enzyme lactase in the digestive system.

Kwashiorkor

It is a disease caused by protein deficiency. There is a severe wasting of the muscles, but this is marked by edema. Severe hypoproteinemia

Nutritional Marasmus

Caused by a deficiency of all food groups, basically a form of starvation

Vitamin A Deficiency

Caused by lack of yellow vegetables in diet. Signs and Symptoms: Tender tongue, cracks at the corners of the mouth, night blindness, xeropthalmia (dry and lustreless conjunctiva), keratomalacia

Vitamin B1 Deficiency

Caused by eating polished rice as dietary staple. Signs and Symptoms: Beri-beri (tingling and numbness of extremities, heart palpitations, exhaustion)

Niacin Deficiency

Those who eat corn as a dietary staple. Signs and Symptoms: Pellagra (dermatitis which resembles sunburn) Diarrhea and mental confusion

Vitamin C Deficiency

Lack of fresh fruit in the diet. Signs and Symptoms: Scurvy (muscle tenderness and petechiae)

Vitamin D Deficiency

Lack of sunlight. Signs and Symptoms: Poor muscle tone, Delayed tooth formation, rickets (poor bone formation), craniotabes (softening of the skul), swelling of joints, bowed legs, tetany

Iodine Deficiency

Lead to either hypothyroidism, or overgrowth of the thyroid gland (goiter) as the gland struggles to produce thyroxine. Signs and Symptoms: Enlarged thyroid gland