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201 Final
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
2 mins
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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
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
2 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
3 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min
Appendicitis Assessment
Mechanism
Obstruction of Appendix
Signs and Symptoms
Periumbilical Pain
RLQ Pain
Nausea/Vomiting/Anorexia
Increased White Blood Cells
Rebound Tenderness
Fever
Complications
Peritonitis
Sepsis
2 mins
Appendicitis Interventions
Treatment
Appendectomy
Preoperative Care
Antibiotics
IV Fluids
No Enema or Laxative
Postoperative Care
Semi-Fowler's Position
Nasogastric Tube
Diet as Tolerated
Pain Management
Early Ambulation
2 mins
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
2 mins
Ulcerative Colitis Assessment
Assessment
Cramping Abdominal Pain
Tenesmus
Bloody Diarrhea
Up to 10-20 / Day
Fever
Complications
Hemorrhage
1 min
Celiac Disease
Cause
Intestinal Mucosa Damage
Ingestion Wheat, Barley, Rye
Assessment
GI Distress
Steatorrhea
Weight Loss
Dermatitis Herpetiformis
Interventions
Gluten-free Diet
Considerations
Screening
2 mins
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
2 mins
Cleft Lip or Palate Interventions
Considerations
Encourage Bonding
Prosthodontic Device
Modified Nipple
Burping
Surgical Repair
Normal Saline Rinse
Elbow Restraints
Avoid Rigid Eating Utensils
2 mins
Tonsillitis
Cause
Bacterial or Viral Inflammation
Assessment
Sore Throat
Dysphagia
Interventions
Throat Culture
Antibiotics
Tonsillectomy
Considerations
Often Streptococcus
Monitor for Acute Glomerulonephritis
Monitor for Rheumatic Heart Disease
3 mins
Tonsillectomy
Indications
Recurrent Tonsillitis
Considerations
Saline Gargles
Ice Chips
Monitor for Bleeding
Within 24 Hours
After 5-7 days
Soft Foods
Do Not Cough, Clear Throat, or Blow Nose
Do Not Use Straws
2 mins
Otitis Media Assessment
Red or Bulging Tympanic Membrane
Ear Pain
Pulling at Ear
Fever
Upper Respiratory Infection
Considerations
More Common in Young Children
Eustachian Tube Narrower
Conductive Hearing Loss
Smoking Increases Risk
2 mins
Otitis Media Interventions
Antipyretics
Analgesics
Antibiotics
Irrigation
Position on Affected Side
Myringotomy
Tympanostomy Tube
2 mins
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
2 mins
Epiglottitis Assessment
Cause/Mechanism
Haemophilus Influenzae
Assessment
Drooling
Fever
Stridor
Restlessness
Dyspnea
Cough
Tripod Position
Considerations
Emergency Treatment
Do Not Examine Throat
2 mins
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