| Assessment sabado1.A home health nurse is providing teaching about post seizure management to theparents of a school age child who has epilepsy and experiences tonic-clonic seizures.Which of the following instructions should the nurse include in the teaching? (Selectall that apply.)"Hyperextend your child's head for 5 minutes following a seizure.""Immediately following a seizure, give your child 6 ounces of water.""Following a seizure, record the length and characteristics of your child's seizure.""Administer rectal diazepam to your child following a seizure.""Call for emergency medical services if the size of your child's pupils are unequal after aseizure."
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Infants who have effortless spit-ups, who are growing normally, and who have no other symptoms (sometimes referred to as "happy spitters") have gastroesophageal reflux and require no further evaluation.
Because spitting up is so common, many infants with serious disorders also have a history of spitting up. Red flags that infants have something other than reflux include forceful emesis, abdominal distention, emesis containing blood or bile, fever, poor weight gain Failure to Thrive (FTT) Failure to thrive is weight consistently below the 3rd to 5th percentile for age and sex, progressive decrease in weight to below the 3rd to 5th percentile, or a decrease in 2 major growth percentiles... read more , blood in the stools, persistent diarrhea Diarrhea in Children Diarrhea is frequent loose or watery bowel movements that deviate from a child’s normal pattern. Diarrhea may be accompanied by anorexia, vomiting, acute weight loss, abdominal pain, fever,... read more , and abnormal development or neurologic manifestations (eg, bulging fontanelle, seizures). Infants with such findings require prompt evaluation. Bilious emesis Nausea and Vomiting in Infants and Children Nausea is the sensation of impending emesis and is frequently accompanied by autonomic changes, such as increased heart rate and salivation. Nausea and vomiting typically occur in sequence;... read more in an infant is a medical emergency because it may be a symptom of malrotation of the intestines Diagnosis Malrotation of the bowel is failure of the bowel to assume its normal place in the abdomen during intrauterine development. Diagnosis is by abdominal x-ray. Treatment is surgical repair. (See... read more
Irritability has many causes, including serious infections and neurologic disorders, which should be ruled out before concluding that the irritability is caused by GERD.
Infants who have symptoms consistent with GERD and no severe complications may be given a therapeutic trial of medical therapy for GERD; improvement or elimination of symptoms suggests GERD is the diagnosis and that other testing is unnecessary. Infants can also be given an extensively hydrolyzed (hypoallergenic) formula for 2 to 4 weeks to see whether the symptoms are caused by a food allergy.
Infants who fail to respond to a therapeutic trial, or who present with signs of complications of GERD, may require further evaluation. Typically, an upper GI series is the first test; it may help diagnose reflux and also identify any anatomic GI disorders that cause regurgitation. Finding barium reflux into the mid or upper esophagus is much more significant than seeing reflux into only the distal esophagus. For infants with regurgitation hours after eating, who may have gastroparesis, a liquid gastric emptying scan may be appropriate.
Upper GI endoscopy and biopsy are sometimes done to help diagnose infection or food allergy and detect and quantify the degree of esophagitis. Laryngotracheobronchoscopy may be done to detect laryngeal inflammation or vocal cord nodules. Previously, the presence of lipid-laden macrophages and/or pepsin in bronchial aspirates was thought to help diagnose reflux and aspiration. However, lipid-laden macrophages are now recognized to be of no benefit, and pepsin measurement has low sensitivity and specificity. URL of this page: https://medlineplus.gov/refluxininfants.html
Also called: GER in Infants, GERD in infants, Pediatric Gastroesophageal Reflux The esophagus is the tube that carries food from your mouth to your stomach. If your baby has reflux, his or her stomach contents come back up into the esophagus. Another name for reflux is gastroesophageal reflux (GER). GERD stands for gastroesophageal reflux disease. It is a more serious and long-lasting type of reflux. Babies may have GERD if their symptoms prevent them from feeding or if the reflux lasts more than 12 to 14 months. There is a muscle (the lower esophageal sphincter) that acts as a valve between the esophagus and stomach. When your baby swallows, this muscle relaxes to let food pass from the esophagus to the stomach. This muscle normally stays closed, so the stomach contents don't flow back into the esophagus. In babies who have reflux, the lower esophageal sphincter muscle is not fully developed and lets the stomach contents back up the esophagus. This causes your baby to spit up (regurgitate). Once his or her sphincter muscle fully develops, your baby should no longer spit up. In babies who have GERD, the sphincter muscle becomes weak or relaxes when it shouldn't. How common are reflux and GERD in infants?Reflux is very common in babies. About half all babies spit up many times a day in the first 3 months of their lives. They usually stop spitting up between the ages of 12 and 14 months. GERD is also common in younger infants. Many 4-month-olds have it. But by their first birthday, only 10% of babies still have GERD. What are the symptoms of reflux and GERD in infants?In babies, the main symptom of reflux and GERD is spitting up. GERD may also cause symptoms such as:
NIH: National Institute of Diabetes and Digestive and Kidney Diseases How do doctors diagnose reflux and GERD in infants?In most cases, a doctor diagnoses reflux by reviewing your baby's symptoms and medical history. If the symptoms do not get better with feeding changes and anti-reflux medicines, your baby may need testing. Several tests can help a doctor diagnose GERD. Sometimes doctors order more than one test to get a diagnosis. Common tests include:
What feeding changes can help treat my infant's reflux or GERD?Feeding changes may help your baby's reflux and GERD:
What treatments might the doctor give for my infant's GERD?If feeding changes do not help enough, the doctor may recommend medicines to treat GERD. The medicines work by lowering the amount of acid in your baby's stomach. The doctor will only suggest medicine if your baby still has regular GERD symptoms and:
The doctor will often prescribe a medicine on a trial basis and will explain any possible complications. You shouldn't give your baby any medicines unless the doctor tells you to. Medicines for GERD in babies include:
If these don't help and your baby still has severe symptoms, then surgery might be an option. Pediatric gastroenterologists only use surgery to treat GERD in babies in rare cases. They may suggest surgery when babies have severe breathing problems or have a physical problem that causes GERD symptoms.
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A nurse is caring for an infant who has gastroesophageal reflux. which of the following actions
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