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Pediatric Gastrointestinal Disorders Study
Guide
Based on Galen College of Nursing โ Caring for the Child with a Gastrointestinal Condition
General Pediatric GI Concepts
Important Developmental Facts
โ Infant stomachs are small and empty every 2โ3 hours , requiring frequent feedings. โ Liver and pancreas mature around 6 months. โ No solids before 4 months. โ Pancreatic lipase is immature until 1 year , making fat digestion difficult. โ Infants should: โ Double birth weight by 6 months โ Triple birth weight by 1 year โ Straining during stooling is normal in infants due to immature muscles.
Stool Differences
โ Breastfed infants โ watery stools โ Formula-fed infants โ soft/seedy stools
Toddler & Preschool Nutrition
โ Toddlers commonly have: โ decreased appetite โ food jags โ picky eating โ Never force-feed children. โ Offer nutritious choices repeatedly.
GI Assessment in Children
Least invasive โ most invasive
- Inspect
- Auscultate
- Palpate Children may be ticklish, so palpating through clothing may help.
Dehydration
Pathophysiology
Occurs when fluid output exceeds intake.
Clinical Manifestations
โ Tachycardia โ Hypotension โ Sunken fontanel โ Dry mucous membranes โ Weight loss โ Irritability โ Decreased tears โ Thirst
Nursing Interventions
โ Strict I&O โ Daily weights โ Replace fluids/electrolytes โ Monitor safety and mental status
NCLEX Tips
BEST indicator of dehydration:
โ Daily weight
โ Infection โ Food allergy โ Medications โ Toxic substances
Symptoms
โ Frequent stools โ Vomiting โ Fever โ Abdominal pain
Nursing Care
โ Hand hygiene โ Monitor electrolytes โ Strict I&O โ Daily weights โ IV/PO fluids โ Lactobacillus โ Metronidazole (Flagyl) if bacterial
NCLEX Tip
Priority concern = dehydration.
Chronic Diarrhea
Definition
โฅ3 stools/day lasting >14 days.
Signs/Symptoms
โ Weight loss โ Hyperactive bowel sounds โ Abdominal distention โ Blood in stool
โ Perineal irritation
Diagnostics
โ Stool culture โ Occult blood
Nursing Care
โ Hydration โ Reduce fruit juice intake โ Daily weights โ Identify underlying cause
Cleft Lip & Cleft Palate
Pathophysiology
Failure of facial structures to fuse during embryonic development.
Risk Factors
โ Male sex โ Native American ethnicity
Manifestations
โ Split lip/palate โ Feeding difficulty โ Poor suction
Nursing Interventions
โ Maintain nutrition โ Use special feeder: โ Haberman feeder โ Pigeon bottle
Diagnostics
โ Rectal biopsy (gold standard) โ Barium enema
Nursing Care
โ NG tube โ IV fluids โ Surgery โ Colostomy education
NCLEX Clue
Newborn who does NOT pass meconium in first 24โ48 hrs.
Pyloric Stenosis
Pathophysiology
Hypertrophy of pyloric sphincter obstructs gastric outlet.
Classic Signs
โ Projectile vomiting โ Olive-shaped abdominal mass โ Constant hunger โ Weight loss โ Dehydration
Diagnostics
โ Ultrasound
Treatment
โ NPO
โ IV fluids โ Pyloromyotomy surgery
Post-op Care
โ Feed within 6 hrs โ Small frequent feeds โ Vomiting may continue briefly
NCLEX Tip
Projectile vomiting + hungry infant = pyloric stenosis.
Intussusception
Pathophysiology
Part of bowel telescopes into another section.
Key Symptoms
โ Sudden severe abdominal pain โ Knees to chest โ Currant jelly stool โ Sausage-shaped mass โ Vomiting โ Lethargy
Treatment
โ Air/barium enema โ IV fluids โ Surgery if severe
Nursing Priorities
โ Monitor for shock/perforation
Appendicitis
Pathophysiology
Inflammation/obstruction of appendix.
Symptoms
โ Periumbilical pain โ RLQ pain โ Fever โ Vomiting โ Anorexia
Diagnostics
โ Elevated WBC โ CT scan
Nursing Care
โ NPO
โ IV antibiotics โ Appendectomy โ Pain management โ Wound care
NCLEX Tip
Never apply heat to abdomen โ may rupture appendix.
Anorectal Malformations
Examples
โ Imperforate anus โ Rectal stenosis
โ Rectal atresia
Diagnostics
โ X-ray โ MRI โ Ultrasound
Treatment
โ Surgery โ Colostomy care โ Anal dilation
Nursing Care
โ NPO before surgery โ IV fluids โ Pain management
Celiac Disease
Pathophysiology
Autoimmune gluten intolerance causing intestinal damage.
Symptoms
โ Steatorrhea โ Abdominal bloating โ Weight loss โ Irritability โ Diarrhea/constipation
Diagnosis
โ Small bowel biopsy
โ Frequent burping โ Upright positioning after feeds โ Smaller feeds
Medications
โ Proton pump inhibitors (PPIs)
Surgical Treatment
โ Nissen fundoplication โ Feeding jejunostomy
NCLEX Tip
Keep infant upright after feeding for GERD.
High-Yield NCLEX Memory Tricks
Disorder Key Clue Pyloric stenosis Projectile vomiting + olive mass Intussusception Currant jelly stool Hirschsprung No meconium Appendicitis RLQ pain
Celiac disease Steatorrhea GERD Arching after feeds Dehydration Sunken fontanel
Priority Nursing Concepts
Always Monitor:
โ Hydration โ Electrolytes โ Weight โ Nutrition โ Signs of infection
Important Pediatric Skills
โ Daily weights โ Strict I&O โ Family teaching โ Pain assessment โ Developmental support
