You are delivering teaching about the newborn infant GI system to a first time mother.
Which of the following statements shows that MORE teaching is needed?
"My baby's GI system is immature. This includes the liver."
"Babies have a shorter large and small intestine. This causes them to absorb less nutrients from food."
"Babies can only consume 20 mL of food at one time, and it takes 3 hours for the stomach to empty."
"They have a stronger constriction and relaxation of their GI muscles."
You have delivered teaching about digestive enzymes in infants to a first-time mother.
"My baby has less of an enzyme called amylase. Because of that, I shouldn't give my baby cereal until she's between 4-6 months old."
"Since my baby can handle breast milk, it stands to reason that she can handle pasteurized cow's milk."
"My baby has less of an ability to absorb and digest fats due to less of an enzyme called lipase."
"I should breast feed because breast is best."
You have a 3 month old baby that is a failure to thrive.
What symptoms would lead you to believe that this infant has GI dysfunctions?
Spitting up/regurgitation, nausea, and vomiting
Jaundice
Both diarrhea and constipation
Abdominal distension and hypoactive, hyperactive, or absent bowel sounds.
GI bleeding
Dysphagia
Lack of attachment to parental figures.
Inconsolable irritability and crying
When should the first meconium be passed?
Within 24 hours of birth.
12-24 hours after birth.
Within 12 hours of birth.
24-36 hours after birth.
An infant that is 2 days old has not passed his first meconium.
What disorders would you assess for?
Hirschsprung disease.
Hypothyroidism.
Meconium plug.
Meconium ileus.
Cystic fibrosis.
Hyperthyroidism.
You are talking to a woman of Asian descent with a male child who has a bilateral cleft palate.
Select the correct teaching to give to this woman.
"This malformation occurred during embryonic development."
"If a baby has a cleft palate, they cannot have a cleft lip."
"Cleft palates and lips are more common in people of Asian and Native American descent."
"Females are more likely to have it than males are."
"Bilateral cleft palate or lip, which is what your baby has, is not as common as unilateral cleft palate or lip."
Which of the following women would NOT be at risk for delivering a baby with a cleft palate or lip?
A 16-year-old hospitalized with conformed folic acid and iron-deficiency anemia.
A 30-year-old who had a cleft palate corrected in infancy and gave birth to a baby with a severe cleft palate 2 years prior.
A 36-year-old whose baby has been confirmed to have Downs syndrome.
A 25-year-old who has been diagnosed with gestational diabetes.
Development of a cleft palate or lip is normally complete by the end of the first trimester of pregnancy.
Cleft lip is more common than cleft palate, and the two disorders occur together about 45% of the time.
What discharge teaching is needed for a mother who gave birth to a child with a cleft lip and/or palate?
Teaching about breastfeeding and the different special bottles that are available for feeding.
Teaching about future speech issues.
Teach how to effectively bond with the baby.
Teach about prevention of future self-esteem concerns.
Teach about the need for genetic testing.
Teach about special sleep safety needs.
A 10-month-old has just undergone surgery to correct his cleft lip and palate. The baby has a Logan bow.
What does this mean?
The baby has a device in place to stabilize the cheeks and reduce suture stress.
The baby has a device in place to prevent the suture from re-opening.
The baby has a device in place to correct the cleft lip and palate.
The baby has a device in place to improve the functional and cosmetic appearance of scars.
You have a non-emergency patient admitted to the pediatric unit following a Z-plasty.
What is a Z-plasty?
A cosmetic surgery that is performed to improve the functional and cosmetic appearance of scars due to cleft lip and/or palate closure.
A cosmetic surgery used to close a cleft lip and/or palate.
A cleft lip and/or palate has been repaired and this surgery places a device to stabilize the cheeks and reduce suture stress.
A cleft lip and/or palate has been repaired and this child had adverse effects and needed another surgery.
A woman with gestational diabetes mellitus and polyhydramnios has delivered a baby with esophageal atresia and tracheoesophageal fistula.
Which of the following statements, made by the mother, shows that teaching about this defect has been RECEIVED?
"My baby's esophagus, which is responsible for delivering swallowed food to the stomach, did not develop as a continuous passage."
"My baby's pharynx, which is responsible for delivering swallowed food to the stomach, did not develop as a continuous passage."
"My baby's esophagus, which is responsible for delivering swallowed food to the stomach, does not connect to the stomach."
"My baby's esophagus, which is responsible for delivering swallowed food to the stomach, is connected to the wrong place."
A newborn baby is breast feeding for the first time.
What symptoms would lead you to request testing for esophageal atresia and/or transesophageal fistula?
Coughing
Choking
Cyanosis
Vomiting
Crying
You have a newborn admitted to the PICU following surgery to repair a transesophageal fistula.
What are the nursing considerations for this baby?
Frequent suctioning is needed.
The head of the infant's bed should be elevated.
The baby should be prescribed a broad-spectrum antibiotic.
Normal post-operative care as per hospital policy needs to be completed.
Keep the infant NPO for at least 48 hours following surgery.
These infants are always medically fragile.
You have a 1 month old male admitted to the PICU with severe protein-calorie malnutrition and infant failure to thrive. The mother reports that the infant vomits within 1 hour of every feed and is hungry after. The child's front fontanelle is depressed, and the skin tents when pulled up. Upon abdominal assessment, you can see a mass in the ULQ and visible peristalsis.
Which of the following diagnoses would you expect for this child?
Transesophageal fistula
Hyperthrophic pyloric stenosis
Gastroesophageal reflux
Intussusception
How can you explain hypertrophic pyloric stenosis to a mother whose baby has been diagnosed with it?
"Something called the pyloric sphincter is constricted, causing the part of the stomach connected to the small intestine to be blocked."
"The esophagus, which is the tube that connects the mouth to the stomach, did not develop as a continuous passage like it should have."
"The contents of the stomach are being pushed back into the esophagus, which is the tube that connects the mouth to the stomach."
"One part of the intestine has been pushed into another part of the intestine."
First born males are most affected by hyperthrophic pyloric stenosis.
