PEDS GI/GU/Endo Exam Questions and 100% Correct Answers
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Course
GU Peds
Institution
GU Peds
What is the facial malformation (unilateral or bilateral) that develops in the embryonic period when the *maxillary & the median nasal process fail to fuse properly*? *cleft lip/palate* (started in the *6th week* of gestation & is completed around the *12th week* ---> so usually when a woman fin...
PEDS GI/GU/Endo Exam Questions and
100% Correct Answers
What is the facial malformation (unilateral or bilateral) that develops in the embryonic
period when the *maxillary & the median nasal process fail to fuse properly*? ✅*cleft
lip/palate* (started in the *6th week* of gestation & is completed around the *12th week*
---> so usually when a woman finds out she is pregnant, this has already started to
develop)
*could have both cleft lip & palate*
What does the lack of closure of the lips & the palate (cleft lip/palate) affect? ✅-speech
(language)
-swallowing
-hearing
-teeth development (dentation)
A child with cleft lip/palate is at a high risk for recurrent ____________
_______________? ✅otitis media
It is important to encourage women of child bearing age (14-44 yo) to increase the
intake of ____________ in their diet *before pregnancy *to decrease the risk of neural
tube defects. ✅*folate* (400 mcg/day) (increase amt more if previous child had NTD)
*reduces risk for cleft lip/palate by 50%-60%
With a cleft *lip* a scar revision is performed at what age? What age for a cleft *palate*?
✅*lip*: 3-6months
*palate*: 6 months - 1 yr
(less than 1 yr is preferred to prevent complications & *facilitate normal G&D*)
What is the purpose of using special feeding *devices* when feeding a baby with cleft
lip/palate? ✅-they close off the palate & allow the nipple to go further back into the
mouth, *reducing the risk of aspiration*
-they *maintain a seal* for effective sucking/feeding
-orthopedic devices are available to expand/realign the mouth
What are the feeding *techniques* involved in caring for a child with a cleft lip/palate?
✅-ensure baby gets adequate *rest periods* (tire easily b/c they work harder to feed)
-*spoon feeding* (pouring it into mouth from the spoon, not putting spoon into mouth)
-ensure baby is in an *upright position*
,-frequent *burping* (they swallow a lot of air)
What is the number one concern with an infant that is having trouble feeding (as with
cleft lip/palate)? ✅*aspiration* (before or after repair)
so assess *lungs/breath sounds* before AND after feedings
What is the *post-op* care associated with the repair of a cleft lip/palate? ✅-assess
lung/breath sounds (before/after feedings)
-special soft nipple or special syringe w/ soft tubing for feeding *first week*
-*palate repair*: 1-2 weeks of *full liquids* and then the 3rd week can have soft foods
(wait to introduce solids)
-*no bottles or pacifiers*
-enure child is lying on back or sitting up
-may have to use *elbow restraints* to avoid pulling at sutures
-*minimize crying* & control pain (prevents stress on sutures)
-*rinse sutures w/ water after feedings*
*ensure child is getting enough calories & not aspirating = main concerns*
What is the congenital anomaly that happens about the *4-5th week of gestation* in
which the *esophagus ends in a pocket* instead of in the stomach, and/or a *fistula*
develops between the esophagus & the trachea? ✅esophageal atresia w/
tracheoesphageal fistula (EA w/ TEF)
*considered an emergency*
(food can't go into stomach, instead it goes through the fistula into the trachea --> lungs)
What are the three signs that could indicate a child has *TEF*? ✅-choking
-coughing
-cyanosis
(noticed when feeding)
*KEEP NPO UNTIL STABLE ---> then surgery immediately!!!!*
*Polyhydramnios* during pregnancy may cause the nurse to suspect the baby/child to
have which GI disorder? ✅TEF
-also more common in children w/ down syndrome
What is involved with the pre-op/periop care of a child undergoing surgical correction of
TEF? ✅-monitor *resp. status* (primary concern)
-maintain *thermoregulation*
-keep *HOB elevated 30*-45* *
, -have suction catheter available for excessive salivation
-monitor VS
-monitor fluid balance
*lung sound assessment is vital for ruling out aspiration*
What is the *post-op* care involved with a child who has undergone surgery to repair
EA w/ TEF? ✅-child will have chest tube (chest tube care)
-NG tube present
-pain management (*paci - esp. dipped in sucrose* can provide *pain relief*)
-promote bonding
-give opportunity to suck to avoid losing the reflex (paci)
-ensure BF moms are continuing to pump/store milk
True or false:
A pacifier can be used as a method of *pain relief* in a child post-operatively because it
releases endorphins (especially if dipped in sucrose) ✅true (also child is NPO so it's
important to give an *opportunity to suck* to avoid losing the reflex)
What is *encopresis*? ✅fecal soiling/incontinence
-*primary*: child never had control when they were expected to
-*secondary*: child had control for at least several months but are now having
incontinence - *usually transitory* (can be RT GI disorders, diet, medications,
psychosocial factors, busy playing etc.)
What is the treatment/management involved with encopresis? ✅main focus is to
*identify & treat the cause*
-both primary & secondary may require a *bowel training program*
What is the most common cause of dehydration in children? ✅diarrhea (leading cause
of death in 3rd world countries --> 1.5 mil deaths worldwide)
What are the most frequent causes of infectious gastroenteritis in the US? ✅-ingestion
of contaminated food/water
-person-person contamination (*high risks:* children in daycare/preschool, pts long-term
care facilities, & immunocompromised)
*most diarrheas spread by fecal-oral route*
What is the most common cause of infectious gastroenteritis seen in children in
*daycare* settings? ✅*giardia*
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