inflammation of the stomach and intestines

intestinal lining must be introduced to


vitamin k cannot be used until what is established

normal flora

newborns receive vitamin k to support

clotting factors

birth stomach capacity

15-20 ml

stomach capacity by 2nd week of life

90 ml

physical assessment

ht, wt, bowel elimination, routine, last bm, hydration status, inspection of abd, auscultation, percussion, palpation

place child in what pos during GI assessment

comfortable supine pos


level of anemia from bleeds or deficiencies

liver profile

liver in the inflammatory process

ESR (erythrocyte sedimentation rate)

denotes severity of bowel inflammation

CRP (C-reactive protein)

presence and severity of inflammation

fecal fat collection

demonstrates how the body processes dietary fat

stool examination

presence of ova, parasites, and culture

during a home visit the mother of a 2 week old infant is upset because the child will not drink entire bottle when feeding. what should the nurse emphasize to the mother

infants stomach capacity is 3 oz (90 ml)

reasons for receiving enteral feedings

congenital intestinal function, oral malformations, dysphagia, FTT

nutritionalist determines

caloric needs

risk factors of enteral feedings

aspiration, neurological impairment, inadequate cough

pt teaching guidelines for enteral feedings

mix feeding w solutionsafely administering the solutionworking the feeding tubemaintaining patencymonitor: bloating, diarrhea, constipation, vomit

nasogastric tube (NGT)

short term requirements

gastrostomy tube

extended feeds, surgically placedabdominal wall to the stomach

jejunostomy tube

extended feeds, surgically placedabdominal wall through the stomach into the jejunum, used when the upper GI tract needs to be bypassed

checking residual

slowly aspirate stomach contents for volume remaining in childs stomach. check order for residual amount and return residual to stomach

pt teaching for enteral feedings

check order for feeding procedurewash handsmix feed correctlyattach feeding bag to connective tubingcheck placement of tubecheck for residual feeding solutionflush tubing w 3-10 ml of clean water for patencymonitor child for aspiration


complete order: solution, amt, time, period, frequency, length, residual, medsensure formula is correct and NOT expired

how often should the tubing and bag be changed for feeding

q 24 hr. (daily)


confirm placement of NGT and patencymonitor: feed for tolerance and aspiration


disconnect tubing and flush NGTmonitor: distension, discomfort, diarrhea, assess tolerance

feeds left at room temp longer than 4 hrs are at risk for

bacterial contamination

vomiting can be caused by

increased intracranial pressurefood allergies and intolerancestoxic substance ingestionchemotherapy

GI disorders causing vomiting are

reverse peristalsis from pyloric sphincter blockesophageal refluxoverdistension gastoenteritis

meds that reduce vomiting by working on the chemoreceptor trigger zone in the medulla


wet burps

spit ups of breast milk, formula, or indigested food

projectile vomiting

pyloric stenosis

do antiemetic meds help w nonretractable N/V


vomit characteristics

blood, bile, mucus, undigested food

what do we look for in dehydration

skin tugormucus membranethirsttachycardia

aspiration interventions for pt w decreased consciousness

NPO for 12-24 hrsupright pospresence of suckingintroduce fluids first- then progressgive meds rectally

fluid imbalance interventions

maintain strict input and output

vomiting+ headache +change in LOC

CNS/metabolic disorder

forceful vomiting

hypertrophic pyloric stenosis




anatomic obstruction

vomiting+localized abd pain

appendicitis or pancreatitis

caused by poorly developed or incompetent cardiac sphincter

gastroesophageal reflux disease (GERD)decreased muscle tone


return of stomach contents through the eosphagus, the acidity of stomach contents can cause pain for the child

how to determine GERD

barium swallow or an upper GI series

meds prescribed to reduce stomach acid


nissens pfundoplication surgery

creates anti-reflux valve using the fungus of the stomach to reduce reflux of stomach acid


increased frequency, decreased consistency of stool

diarrhea is caused by

infection, food allergies, and toxins


water and NA are proportional


NA is low, <130


NA is high, >150