Gastrointestinal Disorders

NUR 2310
T. McDonald

As Children Grow
Stomach Capacity

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Cleft lip and cleft palate

Definition
Failure of the maxillary processes to fuse
the second palate between 5 and 12 weeks'
gestation
Failure of the tongue to move down at the
correct time prevents the palatine processes
from fusing
Multifactorial causes

Unilateral cleft lip.

Repaired unilateral cleft lip.

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Esophageal atresia and

tracheoesophageal fistula
Definition
Foregut fails to lengthen, separate, and
fuse into two parallel tubes (esophagus
and trachea) at 4 to 5 weeks' gestation
Associated with maternal polyhydramnios

Esophageal Atresia and

Tracheoesophageal Fistula
Nursing care
Identifying signs and symptoms of these
infants [3 Cs]

Pre- and postoperative care

Suction is important preoperatively
Care of the gastrostomy tube
postoperatively [teaching the care of GT to
the parents]

Esophageal Atresia and Tracheoesophageal

Fistula

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Pyloric stenosis
Definition
Etiology unknown
Hypertrophy of the circular pylorus
muscle
Stenosis occurs between stomach and
duodenum

Nursing care
Pre- and postoperative care

Pyloric Stenosis

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Gastroesophageal reflux Disease [GERD]

Definition
Three mechanisms allow reflux to occur
Lower esophageal relaxations
Incompetent lower esophageal sphincter
Anatomic disruption of esophagogastric junction

Reflux acidity damages the esophageal mucosa

Causes

Nursing care
Important education

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Hirschsprung disease
Definition
Congenital absence of ganglion cells in
the rectum and colon
Genetically acquired and occurs when
there is failure of the migration of neural
crest cells in utero
Colon becomes a "megacolon"

Types of Pathophysiology Associated with

Structural Defects of the Gastrointestinal System

Anorectal malformations
Anal stenosis [narrowing] and anal
atresia [body orifice that is either closed
or absent]
Failure of growth of urorectal septum,
lateral mesoderm structures, and
ectodermal structures
Associated anomalies up to 70% of the
time

Pathophysiology Associated with

Motility Disorders
Pathophysiology of motility disorders
Gastroenteritis [stomach and intestines]
Definition
Acute vs. chronic diarrhea caused by viruses
[rotavirus], bacteria, or parasites
Causes of diarrhea in children
Constipation can be caused by underlying
disease, diet, or psychological factors

Pathophysiology Associated with

Motility Disorders
Constipation and encopresis
Three types of constipation
Normal-transit constipation
Defecation disorders
Slow-transit constipation

Primary vs. secondary encopresis

Nursing care
Important education

Potential Signs of Gastrointestinal

Emergencies in Children

Abdominal pain
Changes in appearance of stool
Vomiting and/or anorexia
Changes in activity
Changes in level of consciousness