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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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Gastrointestinal Disorders

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Gastrointestinal Disorders
25 Picmonics to Learn | 53 mins
Imperforate Anus
Mechanism
Congenital Anorectal Malformation
Signs and Symptoms
No Anal Opening
Absence of Meconium
Gradual Increase in Abdominal Distention
Considerations
Surgical Repair
Bowel Management
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2 mins
Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
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3 mins
Intussusception
Pathophysiology
Telescoping of Bowel Segments
Lead Point
Assessment
Episodic Abdominal Pain
Diarrhea
Sausage-Shaped Mass
Red Currant Jelly Stools
Diagnosis
Ultrasound/CT
Target Sign
Considerations
More Common in Children
Rotavirus Vaccine Contraindicated
Management
Air or Hydrostatic Enema
Surgical Reduction
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3 mins
Hirschsprung's Disease
Mechanism
Congenital Aganglionic Megacolon
No Peristalsis
Assessment
No Meconium Within 24 Hours
Refusal to Feed
Abdominal Distention
No Stool on Rectal Exam
Forceful Expulsion of Fecal Material After Exam
Interventions
Surgical Resection
Colostomy
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2 mins
Meckel's Diverticulum
Pathophysiology
True Diverticulum
Vitelline Duct
Yolk Stalk
Contain Ectopic Tissue
Pancreatic And Gastric Mucosa
Signs and Symptoms
Hemorrhage
Intussusceptions
Volvulus
Diagnosis
2 Feet From Ileocecal Valve
2 Inches Long
2% Population
First 2 Years Of Life
Pertechnetate T99
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2 mins
Appendicitis
Mechanism and Characteristics
Fecalith leading to obstruction and infection
Most commonly affects teenagers
Presentation
Initial peri-umbilical visceral pain
Subsequent somatic right lower quadrant pain
Diagnosis
Rebound tenderness
Positive psoas sign
Pain at McBurney's point
Leukocytosis
Fever
Treatment
Appendectomy
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1 min
Acute Appendicitis Treatment
Diagnosis
CT Scan
Treatment
Immediate Appendectomy
NPO
IV Fluids
Antibiotics
Perforation
Tertiary Intention
Antibiotics Until Afebrile
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2 mins
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Assessment
Mechanism
Hypertrophied Pylorus
Risk Factor
Macrolide Use
Assessment
3-6 Weeks of Age
Projectile Vomiting After Feeding
No Pain or Discomfort
Weight Loss
Dehydration
Hungry Baby
Olive Mass
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2 mins
Hypertrophic Pyloric Stenosis (HPS) Interventions
Treatment
Pyloromyotomy
Preoperative Care
Stabilize Fluid and Electrolyte Balance
Nasogastric Tube
Monitor Feeding
Postoperative Care
Start Formula or Breastfeeding Within 24 Hours
Feedings Every 4-6 hours
Full Feeding Within 2 days
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2 mins
Rotavirus
Characteristics
Reovirus
Non-enveloped
Double-Stranded
RNA Virus
Linear
11 Segments
Triple Icosahedral Capsid
Most Common Cause of Diarrhea Worldwide
Villous Atrophy
Winter Months
Day Care Centers
Treatment
Oral Rehydration
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2 mins
Ulcerative Colitis Characteristics
Autoimmune
Mucosal and Submucosal Only
Rectal Involvement
Stepwise Lesions
Friable Pseudopolyp
Crypt Abscess
Loss of Haustra
Lead Pipe Appearance
Bloody Diarrhea
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2 mins
Ulcerative Colitis Associations
Associations
Toxic Megacolon
Colorectal Carcinoma
Anterior Uveitis
Pyoderma Gangrenosum
Ankylosing Spondylitis
Primary Sclerosing Cholangitis
P-ANCA
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1 min
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
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2 mins
Crohn's Disease Characteristics
Terminal Ileum and Colon
Rectal Sparing
Transmural Inflammation
Granulomas
Skip Lesions
Cobblestone Mucosa
Fissures
Fistulas
Perianal Disease
Creeping Fat
Lymphoid Aggregates
String Sign on Barium Swallow
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2 mins
Crohn's Symptoms and Associations
Diarrhea
Malabsorption
Bile-Wasting
Pigment Gallstones
Oxalate Kidney Stones
Ankylosing Spondylitis
Erythema Nodosum
Uveitis
Migratory Polyarthritis
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2 mins
Lactose Intolerance
Pathophysiology
Lactase Deficiency
Decreased Lactose Absorption
Increased Osmotic Load
Presentation
Abdominal Pain
Flatulence
Diarrhea
Diagnosis
Positive Hydrogen Breath Test
Decreased Stool pH
Management
Avoid Dairy
Lactase Supplementation
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2 mins
Enterohemorrhagic E. Coli (EHEC)
Characteristics
O157:H7
Non-Sorbitol Fermenting
Hamburger Meat
Produces Shiga-like Toxin
Gram-negative
Lysogeny
Inactivates 60S Ribosome
Disease
Bloody Diarrhea
Hemolytic Uremic Syndrome (HUS)
Hemolytic Anemia
Acute Renal Failure
Thrombocytopenia
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2 mins
Gastroenteritis
Cause/Mechanism
Viruses
Bacteria
Food Intolerances
Assessment
Flu-Like Symptoms
GI Distress
Bloody Stool
Interventions
Oral Rehydration
Considerations
Self-Limiting
Prevention
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2 mins
Omphalocele
Characteristics
Herniation of Abdominal Organs via Umbilicus
Covered by Peritoneum
Defect of Lateral Fold Closure
Associations
Trisomy Syndromes
Beckwith-Wiedemann Syndrome
Diagnosis
Increased AFP
Management
Surgery
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2 mins
Gastroschisis
Characteristics
Herniation of Abdominal Organs via Abdominal Wall
Not Covered by Peritoneum
Right Side of Umbilicus
Associations
Prematurity
Diagnosis
Increased AFP
Management
Surgery
Complications
Necrotizing Enterocolitis
Short Bowel Syndrome
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2 mins
Necrotizing Enterocolitis Diagnosis and Management
Diagnosis
Complete Blood Count (CBC)
Blood Cultures
Pneumatosis Intestinalis
Increased Bowel Wall Thickness
Management
NPO with NG Tube to Suction
Broad Spectrum Antibiotics
Surgery
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2 mins
Necrotizing Enterocolitis Characteristics and Clinical Features
Characteristics
Bowel Wall Inflammation
Prematurity
Early Clinical Features
Failure to Thrive
Vomiting
Rectal Bleeding
Late Clinical Features
GI Perforation
Peritonitis
Sepsis and Shock
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2 mins
Annular Pancreas
Characteristics
Congenital Anomaly
Fusion of Ventral and Dorsal Pancreatic Buds
Circumferential Duodenal Compression
Associations
Down Syndrome
Clinical Features
Polyhydramnios
Poor Feeding
Vomiting
Diagnosis
Double Bubble Sign
Management
Surgery
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2 mins
Congenital Diaphragmatic Hernia
Clinical Features
Bowel in the Chest
Pulmonary Hypoplasia
Respiratory Distress
Classification
Bochdalek Hernia
Morgagni Hernia
Diagnostic Workup
Chest X-ray
Ultrasound
Treatment
Corticosteroids ± Surfactant
Mechanical Ventilation
Surgery
Considerations
Bowel Incarceration or Perforation
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4 mins

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