Daily intake
0-11 kg 100mL/kg
11-20 kg. 1000mL + 50mL/kg
>20 kg 1500mL + 20mL/kg
Hourly Output
Normal pediatric output is 1-3 mL/kg/hr
Diarrhea
Types
o Gastroenteritis
o Enteritis
o Colitis
o Enterocolitis
Dehydration management
o Correct fluid imbalance, treat underlying cause
o Oral fluids used for mild to moderate dehydration – Pedialyte
o Vomiting is not a contraindication for oral rehydration unless
severe
o Introduce regular diet as tolerated
Hirschsprung Disease
Also called congenital aganglionic megacolon
Mechanical obstruction from inadequate motility of intestine
Absence of ganglion cells in colon
Manifestations
Newborn
o Failure to pass meconium stool with 24-48 hours after birth
o Feeding intolerance
o Bilious vomiting
o Abdominal distention
Infancy
o FTT
o Constipation
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https://www.coursehero.com/file/251344913/Unit-8-Pedsdocx/
, o Abdominal distention
o Diarrhea and vomiting
o Ominous sign-explosive diarrhea, fever=enterocolitis
Childhood
o Constipation, ribbon like, foul-smelling stools
o Abdominal distention
o Visible peristalsis, palpable fecal mass
o Undernourished
Diagnostics
o Rectal biopsy
Therapeutic management
o Surgery – removal of aganglionic portion
o Soave pull-through
Preop bowel cleanout
Postop – may require daily rectal dilatation
Nursing considerations
o Assist with ostomy care parents will perform at home
Gastroesophageal Reflux (GER)
Transfer of gastric contents into esophagus
Called GER when complications/tissue damage occurs
Can occur throughout the day, but months frequently after meals and
at night
Peak incidence occurs at 4 months of age; resolves spontaneously in
most infants before 12 months of age
Diagnostic
o Vomiting, weight loss, FTT
o Excessive crying, irritability, arching of back, stiffening
o Respiratory problems
o Upper GI series, 24 hr pH probe
Therapeutic management
o No therapy for normally growing infants without respiratory
complications
o Lifestyle mods – small freq meals; no vigorous play after meals
o Meds – ranitidine, famotidine, PPIs
o Surgical management – Nissen fundoplication
Cleft Lip/ Cleft Palate
This study source was downloaded by 100000897367967 from CourseHero.com on 09-02-2025 04:59:49 GMT -05:00
https://www.coursehero.com/file/251344913/Unit-8-Pedsdocx/
0-11 kg 100mL/kg
11-20 kg. 1000mL + 50mL/kg
>20 kg 1500mL + 20mL/kg
Hourly Output
Normal pediatric output is 1-3 mL/kg/hr
Diarrhea
Types
o Gastroenteritis
o Enteritis
o Colitis
o Enterocolitis
Dehydration management
o Correct fluid imbalance, treat underlying cause
o Oral fluids used for mild to moderate dehydration – Pedialyte
o Vomiting is not a contraindication for oral rehydration unless
severe
o Introduce regular diet as tolerated
Hirschsprung Disease
Also called congenital aganglionic megacolon
Mechanical obstruction from inadequate motility of intestine
Absence of ganglion cells in colon
Manifestations
Newborn
o Failure to pass meconium stool with 24-48 hours after birth
o Feeding intolerance
o Bilious vomiting
o Abdominal distention
Infancy
o FTT
o Constipation
This study source was downloaded by 100000897367967 from CourseHero.com on 09-02-2025 04:59:49 GMT -05:00
https://www.coursehero.com/file/251344913/Unit-8-Pedsdocx/
, o Abdominal distention
o Diarrhea and vomiting
o Ominous sign-explosive diarrhea, fever=enterocolitis
Childhood
o Constipation, ribbon like, foul-smelling stools
o Abdominal distention
o Visible peristalsis, palpable fecal mass
o Undernourished
Diagnostics
o Rectal biopsy
Therapeutic management
o Surgery – removal of aganglionic portion
o Soave pull-through
Preop bowel cleanout
Postop – may require daily rectal dilatation
Nursing considerations
o Assist with ostomy care parents will perform at home
Gastroesophageal Reflux (GER)
Transfer of gastric contents into esophagus
Called GER when complications/tissue damage occurs
Can occur throughout the day, but months frequently after meals and
at night
Peak incidence occurs at 4 months of age; resolves spontaneously in
most infants before 12 months of age
Diagnostic
o Vomiting, weight loss, FTT
o Excessive crying, irritability, arching of back, stiffening
o Respiratory problems
o Upper GI series, 24 hr pH probe
Therapeutic management
o No therapy for normally growing infants without respiratory
complications
o Lifestyle mods – small freq meals; no vigorous play after meals
o Meds – ranitidine, famotidine, PPIs
o Surgical management – Nissen fundoplication
Cleft Lip/ Cleft Palate
This study source was downloaded by 100000897367967 from CourseHero.com on 09-02-2025 04:59:49 GMT -05:00
https://www.coursehero.com/file/251344913/Unit-8-Pedsdocx/
