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8/7/2019 Report Gerd

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Imperforate anus is congenital (present from birth)defect in which the opening to the anus is missing or

blocked.


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Causesy The problem is caused by abnormal development of

the fetus, and many forms of imperforate anus are

associated with other birth defects. It is a relativelycommon condition that occurs in about 1 out of 5,000infants.


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Symptomsy Anal opening very near the vaginal opening in girls

y Missing or misplaced opening to the anus

y No passage of first stool within 24 - 48 hours afterbirth

y Stool passes out of the vagina, base of penis, scrotum,or urethra

y Swollen belly area


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Symptomsy Effortless vomiting not projrctile

y heartburn, regurgitation, and nausea.

y Ulcers, strictures, esophageal cancery Inflammation of larynx and throat

y Inflammation and infection of lungs

y Fluid in the sinuses and middle ears


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Howto diagnosedy Endoscopy (fiberoptic endoscopy) esophagography

y Esophageal ph testing

yX-rayy Examination of throat and larynx

y Esophageal manometry- used to measure the strengthof the esophageal sphincter


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Treatmenty Formula or breqast milk with rice cereal

y Upright position while eating and an hour after eating

y Laparoscopic or surgical myotomy (narrowing of theesophageal sphincter)

y Ranitidine

y Omeprazole

y Avoid acidic, fatty and alcoholic foods

y Eat small portion of foods


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constipationy Difficulty of passing hardened stools, may occur in

children of any age

y Distressing to children (painful, and may have analfissures)

y May experience abdominal pain from force ofintestinal contractions


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Assessmenty Taking history

y Normal ( every other day or every 3 days)

y Hard with discomfort in defecatingy Examine the cause of constipation


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Therapeutic managementy Increase fluid intake

y Diet high in fiber

y Privacy in bathroomy Determine the cause of stress


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diarrheay Caused by virus which is the major cause of infant

gastroenteritis

y Common viral pathogens : rotavirus, adenovirus

y Common bacterial pathogens ; campylobacter jejuni,salmonella, giardia lamblia and clostridium difficile

y Acute associated by infection

y Chronic associated with malabsorption andinflammatory cause


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Assessmenty Frequency- unlimited number

y Color- green

y Effort of expulsion- effortless; may be explosivey pH- less than 7 (acidic)

y Odor- sweet or foul

y Occult blood- positive; blood may be overt

y Reducing saubstances- positive


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Assessment (mild diarrhea)y Anorectic and irritable

y Episodes of diarrhea 2-10 loose watery

yWith fever (38.4-39)yWarm skin

y Dry mouth

y Rapid pulse


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Therapeutic managementy Oral rehydration solution

y Rest the GI tract

y Breastfeedingy Zinc administration (zinc deficiencies)


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Assessment (severe diarrhea)y 39.5-40 temperature

y Pulse and respiration are weak and rapid

y Pale and cool skiny May appear apprehensive, listless and lethargic

y Depressed fontanelle, sunken eyes and poor skinturgor

y Elevated hemoglobin and hematocrit because ofdehydration

y Loss in body weight


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Therapeutic management

y Oral or IV rehydration therapy

y Antibiotic therapy

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