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NURS 115 Nursing Care of Child with GI Disorder

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Comprehensive and detailed notes on;Nursing Care of a family when a child has a Gastrointestinal Disorder.

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  • October 12, 2024
  • 12
  • 2021/2022
  • Class notes
  • Prof dunn
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• Nursing Care of a family when a child has a Gastrointestinal Disorder
• Heather M. Fowler, PhD, RN, CNE
• Module I
Section 6
Chapter 45

• 2030 National Health Goals-Related to GI

• Increase the contribution of fruits and vegetables to the diets of 2 and older
• Increase the number of states with nutrition standards for food and drink for preschool
• Increase proportion of schools that do not sell or offer soda
• Increase number or districts that require schools to make fruits and vegetables available with food service
• Food handling goals to reduce food borne illnesses- washing hands/surfaces when preparing foods, separate
cutting boards, safe temperatures, refrigeration,
• Reduce Norovirus outbreaks, and increase safe preparation/handling of deli foods
• Reduce Hepatitis A, Reduce acute Hepatitis B rates
• Increase vaccines for Hep A and Hep B

• Nursing care for gastrointestinal disorders
• Assessment
• Signs of fluid loss
• Poor skin turgor
• Dry mucus membranes
• Lack of tearing
• Ask parents EXACT amount of “spitting up” or “little vomit”
• Voiding times in 24hrs
• Less than usual?
• Compare weight to last visit
• X-ray with contrast medium barium
• Endoscopic examination
• Ultrasound
• MRI
• Laboratory testing
• Electrolyte imbalance
• Urinalysis
• Diagnosis
• Impaired parenting r/t interference with establishing the parent -infant bond
• Interrupted family process r/t chronic illness
• Risk for deficient fluid volume r/t chronic illness
• Imbalanced nutrition r/t malabsorption of necessary nutrients
• Situational low self-esteem r/t feelings of being different resulting from special dietary restrictions
• Outcome/Planning
• Include person who prepares or supervises child nutrition
• Contact school/meal exceptions or supervise nutritional intake
• MyPlate nutrition guide
• Support family following restrictions for child
• Parent comfortable feeding through nasogastric tube
• Implementation
• Support parents with restrictions
• Parenteral feeding
• Enteric feeding
• Gastrostomy feeding
• Colostomy needs
• Give clear, simple explanations
• Praise parent & child when demonstrated correctly
• Therapeutic paly for children before and after
• Outcome/Evaluation

, • Record child’s height and weight
• Make certain children learn gradually about nutritional measures
• Eventually become responsible for own intake
• Parents will eventually feel comfortable to let them stay overnight elsewhere
• Childs Self-esteem evaluated periodically
• Child lists examples of gluten free foods
• Parents list steps to take to seek medical care if child has diarrhea
• Family members state adjustments caring for child


• Anatomy and Physiology Review
• Occurs in same way as adults
• Newborns sphincter is immature
• Gastroesophageal reflux
• Some infant’s pyloric sphincter becomes narrowed (stenosed)
• Prevents food from flowing out of the stomach freely (pyloric stenosis)
• Stomach is not sterile
• Diagnostic/
Therapeutic Techniques
 Endoscopy
 Enteroscopy (capsule endoscopy)
 Colonoscopy
 Radiology studies
 Conscious sedation
 Clear and simple explanation of what will happen in procedure
 Parent can stay by side until they fall asleep
 Therapy may involve alternative ways of feeding to let the GI tract rest
 Colostomy may be used to let GI rest
 Ileostomy may be used to let GI rest


• Health Promotion/
Risk Management
 Can NOT be prevented
o Appendicitis cannot be prevented
o Celiac disease genetic aspects cannot be changed
o Crohn’s disease & ulcerative colitis associated with autoimmune response
 Can be prevented
o Vomiting
o Diarrhea
o Hepatitis A/B (through hand washing or immunization)
o Vitamin and protein deficiencies
o Rotavirus
 Help families adapt to new lifestyle
 Encourage at least one meal together “touch base”
 Urge child to table for social time (gastrostomy/parenteral feeding)
 Educate parents about normal nutrition and to distinguish illness from something normal
 Early interventions prevent child from dehydration or serious illness

• Fluid Imbalances
• Infants = 70%
• Children = 65%
• Adolescents/adults = 60%
• Fluid is distributed by 3 body compartments:
1. Intracellular (within cells) 35-40%
2. Interstitial (surrounding cells) 20% ECF extracellular fluid
3. Intravascular (blood plasma) 5% infants =45% adults/adolescents = 25% children =30%
• Fluid obtained by oral ingestion & breakdown of food
• Primarily lost by urine & feces
• Minor losses (insensible losses) evaporation from skin, lungs, and saliva
1. Only important in children w/ tracheostomy & nasopharyngeal suction
• Infants DON’T concentrate urine well
1. Lose greater amounts of fluid in their urine as a result

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