GI disorders

Intussusception
• Invagination of intestine
• Signs/symptoms: intense
abdominal pain, vomiting,
blood in stool “currant jelly”,
abdominal distention (sausage
shaped mass)
• Intestinal NECROSIS presents
with: fever, tachycardia, rigid
abdomen
• Diagnosis: ultrasound shows
“coiled spring” appearance
• Management:
– Barium enema (reduction by
hydrostatic pressure),
– surgery
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Nursing Diagnosis: Nursing Care
• Pain related to 1. Provide comfort measures
abnormal - pacifier for infants
abdominal
peristalsis 2. NPO
• Risk for deficient
fluid volume 3. Adequate hydration via IV
related to bowel therapy
obstruction
4. Promote parent-infant
bonding

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 Pyloric Stenosis
• Pyloric stenosis is an uncommon
condition in infants that blocks
food from entering the small
intestine.
• Normally, a muscular valve
(pylorus) between the stomach
and small intestine holds food in
the stomach until it is ready for
the next stage in the digestive
process.
• In pyloric stenosis, the pylorus
muscles thicken and become
abnormally large, blocking food
from reaching the small
intestine.
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 Pyloric Stenosis
• Signs & symptoms:
– Forceful non-billous vomiting,
– dehydration
– weight loss,
– abdominal distention, “olive”
sized mass Right Upper
Quadrant, visible peristalsis
– Baby seems hungry all the
time
• Diagnosis:
– Xray
– Ultrasound
– endoscopy
• Management: surgery
5
Nursing Diagnosis:
• Risk for deficient fluid volume related to inability
to retain food
• Risk for infection at site of surgical incision
related to danger of contamination from feces d/t
proximity of incision to diaper area

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 Nursing care
• Hydration
• Pacifier to comfort the child
• may give thickened feedings on upright position then NPO
just before surgery
• Monitor Input and Output, weight, and vomiting

Postop
1. Clear liquids   post-operatively; then advance to solid diet.
2. Nurse with Head of bed elevated to minimize gastric reflux.
3. Side lying position
4. Monitor weight and return of peristalsis
5. Wound care
6. Pain management

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 Diaphragmatic Hernia
• Herniation of intestinal
content into the thoracic
cavity
• Left side
• S/sx:respiratory
difficulty, cyanosis,
retractions, (-) breath
sounds affected side,
scaphoid abdomen
• Causes: pulmonary HPN
Management:’E’ surgery

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Nursing Diagnosis:
Risk for ineffective airway clearance related to
displaced bowel
Risk for imbalanced nutrition, less than body
requirements, related to NPO status

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 Nursing Care
Preop
• Elevate head
• Low intermittent suction

Postop
1. Semi-fowlers
2. Maintain warm, humidified envt – lung fluid drainage
3. Suction prn
4. Chest pptx
5. NPO – prev pressure on diaphragm

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