Professional Documents
Culture Documents
Dysfunction
Objectives
¾ Identify common dysfunctions of the small bowel.
¾ Describe the risk factors that can lead to the development of these
dysfunctions.
¾ Identify causes, mechanism and treatment of small bowel dysfunctions.
¾ Describe the pathophysiology, clinical manifestations and treatment for
small bowel dysfunctions upper GIT dysfunctions.
¾ Describe the pathophysiology of common disorders of the liver and
gallbladder.
¾ Understand the pharmacological interventions related to the liver and
gallbladder.
1
PYLORIC STENOSIS
Illustration copyright 2000 by Nucleus Communications, Inc. All rights reserved. http://www.nucleusinc.com
2
MANAGEMENT PAEDIATRIC FLUID REQUIREMNTS
¾ Stabilize child ¾ 1st week –80-100 ml/kg/day
¾ IV fluids, ¾ 2nd week – 125-150 mls/kg/day
¾ NG tube. ¾ 3 months - 140-160 mls/kg/day
¾ Assessment of hydration ¾ 6months - 130-155 mls/kg/day
¾ Surgery – pyloromyotomy. ¾ 9months – 125-145 mls/kg/day
¾ Discharged in 72 hours. ¾ 1 year – 120-135 mls/kg/day
¾ 2 years – 115-125 mls/kg/day
¾ Premature infants will require slightly
INTRAVENOUS FLUIDS more/hour
¾ N/2 saline and 2.5% dextrose
¾ commonly used to rehydrate children.
¾ N/4 Saline and 3.75% dextrose
¾ used for maintenance – not as common
¾ N/Saline – seen more commonly these days for general IV fluids
¾ All fluids in 500mls bags.
¾ Other fluids not really used in paediatrics
University of Western Sydney 5
2009 UANE&S
3
What causes coeliac disease?
¾ the cells of the small bowel (intestine) are damaged (villous atrophy).
¾ This causes a flattening of the tiny, finger like projections, called villi,
which line the inside of the bowel
¾ The function of the cells on normal villi is to break down and absorb nutrients in food.
¾ In coeliac disease, these cells become
¾ flat and inflamed and
¾ the surface area, which enables the absorption of nutrients and minerals from food, is
seriously depleted.
Risk Factors
¾ a family history of the disease
¾ being of European descent; and
¾ having another medical condition that is related to problems with the
immune system,
¾ such as certain types of thyroid disease, type 1 diabetes, lupus erythematosus, or
rheumatoid arthritis.
4
DIAGNOSIS TREATMENT
¾ Relies on proving that the small bowel ,
lining shows the typical damage ¾ No Cure
(villous atrophy).
Diagnostic Tests
5
(Brown and Edwards, 2005, p.1111)
Hepatitis Prevention
¾HAV
¾Vaccine
¾NHIG
¾HBV
¾Vaccine
¾Post exposure HBIG & vaccination
¾HCV
¾No vaccine
¾Drug therapy
¾Antivirals
¾Interferons
6
Liver Disorders - Cirrhosis
¾ End stage chronic liver disease that results in extensive hepatocellular
damage leading to liver failure.
¾ Laennec’s cirrhosis
¾ Cardiac cirrhosis
¾ Post necrotic cirrhosis
¾ Biliary cirrhosis
Laennec’s Cirrhosis
¾ Ascites
¾ Signs and symptoms are somewhat
non-specific and tend to be the
¾ Hepatic failure same as those that occur for
cirrhosis and hepatitis.
7
Gallbladder Disorders
Risk Factors
* Cholecystitis
¾ Family history
¾ Hyperalimination
¾ Race or ethnicity
¾ Female
¾ Age
8
Diagnosis and Treatment
Pancreatitis
Cholecystitis and Chloelithiasis
¾ Surgery
9
Pancreatic Cancer
Clinical manifestations
¾ 10th most common cancer.
¾ Slow onset
¾ Flatulence
¾ Mostly adenocarcinomas
¾ Ultrasound
¾ CT Scan
¾ ERCP
¾ CA19-9
¾ Whipples procedure
¾ Palliative care
10
Bibliography
¾ Black, J. M., Hawks, J., & Keene, A. M. (2004). Medical-surgical nursing: Clinical
management. (7th ed.). Philadelphia: W. B. Saunders.
¾ Brown, D., & Edwards, H. (Eds.). (2008). Lewis’s medical-surgical nursing
assessment and management of clinical problems. (2nd ed.). Sydney: Elsevier.
¾ Crisp, J., & Taylor, C. (Eds.). (2005). Potter and Perry’s fundamentals of nursing.
Sydney: Elsevier.
¾ Lehne, R. A .(2007). Pharmacology for nursing care. (6th ed.). St. Louis: Saunders
Elsevier.
¾ Lemone, P., & Burke, K. (2008). Medical surgical nursing. Critical thinking
in client care. (4th ed.). Upper Saddle River, New Jersey: Prentice Hall.
¾ Marieb, E. N. (2007). Human anatomy and physiology (7th ed.). California: Pearson
Education.
¾ Porth, C. M. (2005). Pathophysiology: Concepts of altered health states. (7th
ed). Philadelphia:Lippincott.
¾ Sarikas, S. N. (2007). Laboratory investigations in anatomy and physiology. San
Francisco: Pearson.
11