GastroIntestinal(GI) Pediatrics

What makes the mouth a common infection entry in children?

Tissue is highly vascular.

When does the LES fully develop?

At 1 month of age.

When does stomach HCl reach adult levels?

By 6 months of age.

How long are intestines at birth vs adulthood?

250 cm at birth, 600 cm in adult.

When do pancreatic enzymes reach adult levels?

At 2 years old.

Why are infants at higher risk for dehydration?

Higher body water, immature kidneys, ↑BSA to mass, ↑insensible losses.

What should be included in health history?

Past illness, present illness, family history, growth patterns.

What should be checked on physical exam?

Color, hydration, abdomen, mental status, auscultation, percussion, palpation.

What is cleft lip/palate?

Failure of lip/palate fusion in utero.

When does lip vs palate normally fuse?

Lip: 5-6 weeks; Palate: 7-9 weeks gestation.

What are complications of cleft lip/palate?

Feeding difficulty, speech delay, altered dentition, otitis media.

When is cleft lip repaired?

2-3 months of age.

When is cleft palate repaired?

6-9 months of age.

Key nursing post-op concern for cleft repair?

Protect suture line, prevent infection, pain control.

What causes Meckel's diverticulum?

Incomplete fusion of the omphalomesenteric duct.

What are key assessment findings?

Colicky pain, distention, occult blood, abdominal mass.

What test confirms Meckel's diverticulum?

Meckel scan.

How is it treated?

Surgical correction if complications.

What is an inguinal hernia?

Abdominal contents protrude into inguinal canal.

What is the main assessment finding?

Bulging mass in groin (esp. crying/straining).

What is the risk if untreated?

Incarceration and strangulation.

Treatment for inguinal hernia?

Surgical repair.

What is an umbilical hernia?

Intestinal contents herniate through umbilical ring.

When do most resolve?

By age 4.

When is surgery needed?

If persistent or very large.

Why are children more prone to dehydration?

↑BSA, immature kidneys, ↑fluid losses.

Complication of untreated dehydration?

Hypovolemic shock.

Treatment for mild/moderate dehydration?

Oral rehydration therapy (ORT).

Treatment for severe dehydration?

IV bolus 20 mL/kg fluids.

What causes thrush?

Candida albicans infection.

How does it appear?

White plaques on tongue/mucosa that don't wipe off.

Treatment for thrush?

Antifungal medication (treat mom if breastfeeding).

What is hypertrophic pyloric stenosis?

Thickened pylorus muscle → obstruction.

Classic symptom?

Projectile, non-bilious vomiting.

Palpable sign?

Olive-shaped mass RUQ.

Treatment?

Pyloromyotomy.

What is intussusception?

One segment of bowel telescopes into another.

Classic stool finding?

Currant-jelly stools.

Classic assessment finding?

Sausage-shaped mass, colicky pain, knees-to-chest.

Treatment?

Reduction with barium enema or surgery.

Where is pain localized in appendicitis?

RLQ (McBurney's point).

What does sudden relief of pain mean in appendicitis?

Perforation/rupture.

Diagnostics for appendicitis?

CT scan, ↑WBC, ↑CRP.

Treatment for appendicitis?

Appendectomy, IV antibiotics if perforated.

What is Hirschsprung disease?

No ganglion cells in colon → no peristalsis.

Classic newborn finding?

Failure to pass meconium in first 24h.

Complication to monitor for?

Enterocolitis (fever, distention, diarrhea, bleeding).

Treatment for Hirschsprung disease?

Surgical resection with ostomy, later reversal.

What causes celiac disease?

Autoimmune reaction to gluten → villi damage.

Classic symptoms of celiac disease?

Diarrhea, steatorrhea, FTT, distention, anemia.

Treatment for celiac disease?

Strict gluten-free diet.

Safe foods for celiac disease?

Rice, potato, corn, soy, fruits, meats.

What is pancreatitis?

Inflammation of pancreas (acute reversible, chronic permanent).

Causes of pancreatitis?

Trauma, infection, obstruction, drugs, metabolic issues.

Classic symptoms of pancreatitis?

Epigastric pain radiating to back, vomiting, fever.

Labs for pancreatitis?

↑Amylase, ↑Lipase, ↑CRP.

Treatment for pancreatitis?

NPO, NG suction, IV fluids, pain mgmt.