Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid
Stomach Digestion
- Chief Cells Secrete Pepsinogen
- Pepsinogen Turned to Pepsin By H+
- Protein Breakdown Begins
- Mucous Cells Secrete Mucus and Bicarbonate
- G Cells Secrete Gastrin
- Gastrin Stimulates Parietal Cell HCl Release
- Parietal Cells Secrete Intrinsic Factor
GI Absorption
- Stomach
- Alcohol
- Duodenum
- Iron
- Jejunum
- Folate
- Terminal Ileum
- Vitamin B12
- Bile Resorption
Small Intestine Digestion
- Brush border enzymes
- Pancreatic Enzymes are secreted via a Duct
- Pancreas secretes bicarbonate
- Brush Border activates Pancreatic Trypsin
- Trypsin activates Chymotrypsin
- Trypsin and Chymotrypsin digest Proteins
- Gallbladder Releases Bile
- Pancreatic Lipase breaks down Lipids
- Goblet cells secrete mucus
- Pancreatic Amylase breaks down Carbohydrates
- Pancreatic Nucleases breakdown DNA/RNA
- Digestion occurs in the Duodenum
Small Intestine Absorption
- Carbohydrates Undergo Active Transport
- Amino Acids Undergo Active Transport
- Small Lipids Undergo Passive Diffusion
- Epithelial Cells
- Intestinal Capillaries
- Hepatic Portal Transports Nutrients
- Liver
- Large Lipids Transported as Chylomicrons
- Lacteals Transport Chylomicrons
Large Intestine
- Colon
- Electrolyte Reabsorption
- Water Reabsorption
- Microflora Produce Vitamins
- Rectum Stores Feces
Hirschsprung's Disease
- Congenital Aganglionic Megacolon
- No Peristalsis
- No Meconium Within 24 Hours
- Refusal to Feed
- Abdominal Distention
- No Stool on Rectal Exam
- Forceful Expulsion of Fecal Material After Exam
- Surgical Resection
- Colostomy
Gastroesophageal Reflux Disease (GERD) Assessment
- Relaxed Lower Esophageal Sphincter
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
Irritable Bowel Syndrome (IBS) Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
Appendicitis Assessment
- Obstruction of Appendix
- Periumbilical Pain
- RLQ Pain
- Nausea/Vomiting/Anorexia
- Increased White Blood Cells
- Rebound Tenderness
- Fever
- Peritonitis
- Sepsis
Appendicitis Interventions
- Appendectomy
- Antibiotics
- IV Fluids
- No Enema or Laxative
- Semi-Fowler's Position
- Nasogastric Tube
- Diet as Tolerated
- Pain Management
- Early Ambulation
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Obstruction
- Fistulas
Ulcerative Colitis Assessment
- Cramping Abdominal Pain
- Tenesmus
- Bloody Diarrhea
- Up to 10-20 / Day
- Fever
- Hemorrhage
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Colonoscopy
- FOBT and FIT
Colorectal Cancer Interventions
- Surgical Colon Resection
- Radiation
- Chemotherapy
- Bowel Cleansing
- Screening
- Colostomy
- Dietary Consult
- Body Image
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
- H2 Receptor Blocker
- Suppress Gastric Acid Secretion
- Pneumonia
- Anti-androgen Effects
- CNS Changes
Omeprazole (Prilosec)
- "-prazole" Suffix
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Proton Pump Inhibitor (PPI)
- Inhibit H+/K+/ATPase
- Hip Fracture
- Pneumonia
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
Intestinal Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Absent Bowel Sounds
- Paralytic Ileus
Types of Intestinal Obstruction
- Adhesions
- Hernia
- Volvulus
- Intussusception
- Tumor
- Mesenteric Artery Occlusion
- Spinal Injury
- Paralytic Ileus
Hypertrophic Pyloric Stenosis (HPS) Assessment
- Hypertrophied Pylorus
- Macrolide Use
- 3-6 Weeks of Age
- Projectile Vomiting After Feeding
- No Pain or Discomfort
- Weight Loss
- Dehydration
- Hungry Baby
- Olive Mass
Hypertrophic Pyloric Stenosis (HPS) Interventions
- Pyloromyotomy
- Stabilize Fluid and Electrolyte Balance
- Nasogastric Tube
- Monitor Feeding
- Start Formula or Breastfeeding Within 24 Hours
- Feedings Every 4-6 hours
- Full Feeding Within 2 days
Intussusception
- Telescoping of Bowel Segments
- Lead Point
- Episodic Abdominal Pain
- Diarrhea
- Sausage-Shaped Mass
- Red Currant Jelly Stools
- Ultrasound/CT
- Target Sign
- More Common in Children
- Rotavirus Vaccine Contraindicated
- Air or Hydrostatic Enema
- Surgical Reduction
Celiac Disease
- Intestinal Mucosa Damage
- Ingestion Wheat, Barley, Rye
- GI Distress
- Steatorrhea
- Weight Loss
- Dermatitis Herpetiformis
- Gluten-free Diet
- Screening
Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Diet Education
Hepatitis A (HAV) Assessment
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- 4 Weeks
- Fever
- General Malaise
- Hepatomegaly
- Self-Limiting
- Proper Hand Washing
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Strangulation
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Scrotal Support