Flashcards in Pediatric Gastrointestinal Disorders (Part 1) - Unit 2 Deck (49)
Infants younger than 6 weeks do not produce tears. T/F?
In an infant, a sunken fontanel may indicate what? Also, what ages?
12-18 months is when it closes, and then it could mean dehydration.
Infants are dependent on others to meet their fluid needs and they also have limited ability to dilute and concentrate urine. T/F?
The smaller the child, the greater the proportion of body water to weight and proportion of extracellular fluid to intracellular fluid. T/F?
Infants have a smaller proportional surface area of the GI tract than adults. T/F?
FALSE - larger.
Infants have a greater body surface area and higher metabolic rate than adults. T/F?
TRUE - they also can lose more water through sweating, breathing, etc.
GI tract not mature until __ to ___ months.
Eruption of teeth at __ months.
Infants liver - mature. T/F?
Infant doesn't have as good of ability as we do at storing glycogen. T/F?
FALSE - it doesn't detoxify like ours.
Absorption - most occurs where? how?
Small intestine, via osmosis,carrier-mediated diffusion, active energy-drive transport (pump)
What does the large intestine absorb? What does bacteria do?
Water, sodium, bacteria are here (they help with the normal flora)
What causes an increased need for fluid?
Fever, diarrhea, vomiting, burns, shock, sickle cell disease
What causes a decreased need for fluid?
Renal failure/disease, CHF, post-op, increased ICP
What is the long holiday-segar calculation?
1st 10kg X 100 =
2nd 10kg X 50 =
20kg + x 20 =
Dehydration - what is the most common type?
Isotonic (meaning water and fluid are lost in the same proportion)
What are some signs of dehydration?
Dry skin and mucus membranes, poor skin turgor, sunken eyes, depressed anterior fontanel (but that closes at 12-18 months), gray or ashen in color, rapid and weak pulse, decreased BP (late), oliguria (maybe diapers aren't being changed as often, that's how you might catch it!), dry mucus membranes, irritability, delayed cap refill, modeling (visible veins).
With dehydration, BP is maintained until late stages. T/F?
What is the most common type of shock in children?
What kind of shock is characterized by reduction in peripheral vascular resistance, inadequate tissue perfusion, and decreased blood return to the heart?
What are the three types of distributive shock?
Sepsis, neurogenic, anaphylactic
What does compensated shock mean?
Cardiac output and BP are increased
How do we manage shock?
ventilation (lungs are very sensitive to shock), fluids, vasopressive support (improves pumping of heart - Epi, Dopamine, etc.)
We always bolus a child with D5W - T/F?
FALSE - we NEVER EVER EVER EVER EVER do it.
For shock, we give isotonic crystalloid, normal saline, or lactated ringers. T/F?
Bolus amount - what is it?
10-20 ml/kg over 15-20 minutes.
After bolus, what do we do?
Assess - cap refill, color, etc.
Don't add potassium to Dw5 until urinary output is seen. T/F?
What are some complications of shock?
Cerebral edema (D5W bolus), acidosis (shock creates lactic acid), renal ischemia (low blood flow), ARDS, GI perforation, DIC, electrolyte embalance
What is gastroenteritis?
A group of clinical syndromes manifested by nausea, vomiting, and diarrhea. It's inflammation of the stomach and intestines.
What virus typically causes gastroenteritis?