Examl 2:l NSGl 434/l NSG434l (Latestl 2025/l
2026l Update)l Nursingl Carel ofl thel Childrearingl Familyl Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l GERD
Answer:
abnormall presencel ofl gastricl contentl inl thel esophagus,l upperl airways,l andl tracheobronchiall area ->causesl inflammationl andl stricturesl inl thel esophagus -mcl postl mealsl andl atl nights -peaksl atl 4l monthsl old,l gonel byl 1l yearl old -greaterl risk:l asthma,l CF,l cerebrall palsy,l bronchopulmonaryl dysplasia,l neurol disorder,l scoliosis,l prematurel ITl CAUSES -esophagitis -weightl lossl andl poorl growth
-recurrentl pneumonia:l bcl acidl andl stomachl contentl intol thel lungsl
-pulmonaryl diseases:l bcl ofl acidl inl lungs
-aspiration -recurrentl stridor:l bcl itl canl causel laryngitisl orl inflaml ofl vocall cordsl -chronicl cough ->canl causel chronicl bloodl lossl wl anemial andl hematemesis,l melenal bcl ofl thel bleeding,l
MANIFESTATIONS
-esophagitisl causesl chestl pain -infants:l irritable,l refusel tol feed,l respl problemsl (wheezing,l gagging,l coughing),l spittingl up,l recurrentl vomiting,l poorl weightl gain
-children:l occursl wl intermittentl vomiting
-olderl children:l adultl patternsl likel regurgitation,l heartl burn,l re-swallowing,l hypoproteinemial
TREATMENT-CONSERVATIVE
-thickenl liquidsl forl infants:l mixl itl withl ricel milk,l largerl nipple,l feedl theml upright -HOBl elevated,l wl loss -smallerl morel frequentl meals -avoid:l caffeine,l alc,l citrus,l tomato,l spicyl orl friedl food,l peppermint 1 / 4
-pharm:l H2l blockerl orl PPIl tol reducel gastricl acidl andl stimulatel sphincterl >givel PPIl 30l minl beforel breakfastl andl eveningl meals >takel daysl tol becomel effectivel NISSANl FUNDOPLICATION -wrapl thel upperl partl ofl thel stomachl (fundus)l aroundl thel lowerl esophagusl creatingl al sphincter -donel inl thosel wl severel complications:l recurrentl pneumonia,l failurel tol thrive,l apnea,l severel esophagitis -complications:l ifl tool tight->dysphagia,l gasl bloating,l andl smalll bowell obstruction,l orl tool loose->persistencel ofl s/s
Q:l acutel appendicitis
Answer:
occursl whenl thel lumenl tol thel appendixl isl occludedl commonlyl causedl byl swollenl lymphl tissue -mostl commonl inl 12-18,l >males EARLYl S/S -anorexia -fever,l n/v -firstl isl periumbilicall painl thatl isl colickyl andl crampy,l thenl RLQl painl wl reboundl tendernessl >McBurney'sl point -ifl painl subsidesl withoutl interventionl suspectl perforation
DIAGNOSE
-cbc
-urinel analysis:l rulel outl UTI
-HCGl tol rulel outl pregnancy
-CT/US
-savel light!l palpationl forl last,l havel personl pointl tol wherel itl hurtsl
APPENDECTOMY
willl bel laparoscopicl forl nonl perforatedl
-prel op:
>NPO,l IVl fluidl andl electrolytes >antibiotics
RUPTURED
-oftenl occursl inl youngerl kidsl bcl theyl cannotl communicatel symptoms -fecall andl bacteriall contaminationl spilll intol thel peritoneall cavity -s/sl peritonitis:l reliefl ofl painl followedl byl anl increasedl inl pain,l guarding,l abdominall distension,l pallor,l irritable,l restless,l tachycardia,l rapidl shallowl breathing -prel op:l antibiotics,l IVl fluids,l NPO,l NGl suctioning 2 / 4
-postl op:l antibiotics,l fluids,l NPOl andl NGl suctionl untill intestinall activityl returns.l willl stayl inl thel hospitall forl days,l mayl havel drain,l frequentl dressingl changes
Q:l inflammatoryl bowell disease
Answer:
al terml usedl forl threel chronicl intestinall inflammationl disorders 1.l crohns 2.l ulcerativel colitis 3.l inflammatoryl bowell diseasel unspecified:l diagnosedl tol peoplel withl colonicl diseasel butl thel featuresl dol notl alignl withl crohnsl orl UCl -alll havel periodsl havel remissionl andl exacerbationl withoutl completel resolutionl ofl symptoms,l ifl theyl occurl inl childhoodl theyl tendl tol bel morel aggressivel -nol knownl curel
CROHNS
-inflammatoryl andl ulcerativel diseasel thatl affectsl anyl partl ofl thel GIl tractl (mcl inl thel terminall ileum) -affectsl thel fulll thicknessl ofl thel intestinel -hasl inflammationl "skips"l (skipl lesions) -causesl fissures,l fistulas,l andl thickeningl ofl thel intestinall wall -causesl diarrheal andl occultl bloodl ifl thel intestinel isl involved -crampingl andl abdominall painl arel aggravatedl byl eating -growthl retardation -weightl loss,l fatigue -intestinall blockagel ULCERATIVEl COLITIS -al recurrentl inflammatoryl andl ulcerativel diseasel -mainlyl affectsl thel largel intestinel wl continuousl distributionl andl superficiall inflammationl (canl bel inl bothl thel colonl andl rectum) -frequent,l bloodyl stools -abdominall pain -anorexia,l pallor,l fatiguel -electrolytel imbalancel -10l tol 20l lbl weightl lossl inl 2l monthsl -causesl shorteningl ofl thel colon,l strictures,l andl megacolonl isl thel worstl form
Q:l IBDl diagnosel andl treatment
Answer:
DIAGNOSE 3 / 4
-cbc:l anemia,l ESR,l CRPl whichl showl inflammation
-stools:l bloodl andl WBC
-endoscopyl andl colonoscopy -CTl orl US
MANAGEMENT
*CDl isl worsel andl lessl treatablel thanl UC -becausel ICl isl confinedl tol thel colonl al colectomyl canl bel done -goall isl tol inducel remissionl andl thenl maintainl itl 1.l DRUGS -5l aminosalicaytes:l canl achievel andl maintainl remissionl inl moderatel UCl andl inducel remissionl inl mildl CD >decreasel inflammationl byl inhibitingl prostaglandins -corticosteroidsl (prednisone):l inducel remissionl inl modl tol severel UCl andl CD.l nol usedl longl terml bc->decreasel bonel density,l weightl gain,l growthl suppressionl
-immunomodulatorsl (azathrioprine):l usedl asl adjunctivel therapyl forl CD
-antibiotics:l forl CD
-biologicall therapies:l regulatel inflammationl andl anti-inflammatoryl cytokines.l usel anti- TNF-al likel infliximabl andl adalimumabl tol decreasel inflammationl andl causel healing
NUTRITION
-correctl deficienciesl -adequatel proteinl forl healing -adequatel nutrientsl forl growth -highl protein,l highl call dietl -supplementationl wl vitamins,l iron,l folicl acidl -mayl needl speciall enterall formulasl byl mouthl orl NG,l mayl needl TPN *growthl failurel isl commonl inl thisl disease->malabsorptionl ofl fats,l carbs,l lactose,l minerals,l B12,l andl folicl acid.l
SURGICAL
-colectomyl orl ileostomy:l UCl (canl bel curedl wl totall colectomy)
>connectsl tol al pouch
-intestinall resection:l CD
Q:l hypertrophicl pyloricl stenosis
Answer:
gastricl contentl cannotl emptyl bcl thel pyloricl sphincterl isl hypertrophied ->causesl thel babyl tol throwl upl (projectile,l nol bile)l 30-60l minl afterl andl bel hungryl andl fussy ->initiallyl thel babyl isl justl hungryl andl irritable->wl loss,l dehydration,l andl failurel tol thrive -diagnosedl inl firstl 4-6l weeks,l throwingl upl startsl atl 3l weeksl butl couldl startl asl earlyl asl 1l orl latel asl 5l weeksl
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