Daily weight is the most accurate measure of fluid loss in a child.
Not plain water or juice — oral rehydration solution.
💡 The one idea
Dehydration is the pediatric emergency behind most GI illness. Children have a higher
proportion of body water and lose it faster.
Weight change is the most accurate measure of fluid loss in a child.
Sign
Mild
Moderate
Severe
Weight loss
3–5%
6–9%
≥10%
Mucous membranes
Slightly dry
Dry
Parched, no tears
Cap refill
<2 s
2–3 s
>3 s
Urine
Slightly down
Reduced, dark
Minimal / none
Behavior
Normal / thirsty
Irritable
Lethargic, sunken fontanelle
In an infant, the earliest reliable signs are fewer wet diapers and no tears when crying. Ask about both, every time.
First-line treatment for mild to moderate is oral rehydration solution, given in small
frequent amounts. Not plain water, not juice, not sports drinks - the sugar load worsens diarrhea.
Condition
Signature
Key point
Pyloric stenosis
Projectile vomiting, hungry right after, olive-shaped mass
3–6 weeks old; metabolic alkalosis; surgical
Intussusception
Currant-jelly stool, drawing knees up, sausage mass
Emergency; a normal brown stool may mean it reduced — report it
Hirschsprung
No meconium in 48 h, ribbon stools, distension
Absent ganglion cells; surgical
Appendicitis
Pain at McBurney’s point, rebound tenderness
Sudden pain relief = rupture
Cleft lip/palate
Feeding difficulty
Special bottle; upright feeding; frequent burping
In appendicitis, sudden relief of pain is not improvement - it means the appendix has ruptured. Never apply heat and never give an enema.
⭐ High-yield — what the exam actually asks
Show 5 moreHide these 5
Normal pediatric urine output is 1 mL/kg/hr. The math is two steps: volume ÷ hours, then ÷ kilograms.
Dehydration staging: mild 3–5% with cap refill just over 2 sec; moderate 6–9% with refill 2–4 sec and dry mucous membranes; severe >10% with refill beyond 4 sec, no tears, sunken fontanel and oliguria → IV.
Oral rehydration is always first line: 40–50 mL/kg over 4 hours for mild to moderate. Severe gets an isotonic 20 mL/kg bolus (10 mL/kg if cardiac).
High urine specific gravity means concentrated urine and supports dehydration.
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Pyloric stenosis: projectile non-bilious vomiting at 4–6 weeks, olive-shaped RUQ mass. Pyloromyotomy, with very slow post-op feeding advancement.
Intussusception: episodic severe pain with the child drawing knees up, completely normal between episodes, currant jelly stool, sausage-shaped mass. Air or barium enema reduction.
Hirschsprung: no meconium in the first 24–48 hours plus bilious emesis and distention. Rectal biopsy showing absent ganglion cells is diagnostic. Pre-op diet is high-protein, high-calorie, low-fiber.
Appendicitis: McBurney's point pain with rebound tenderness. No heat packs pre-op — they raise rupture risk. Sudden relief of pain can mean rupture, not improvement.
Celiac: lifelong gluten-free diet avoiding wheat, rye and barley. Small intestine biopsy is the gold standard.
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Cleft lip repaired at 2–3 months, palate at 6–12 months before speech develops. Elbow restraints and nothing rigid in the mouth post-op. Cleft palate usually prevents an effective breastfeeding seal.
GERD vs normal reflux: a "happy spitter" who gains weight is normal. Poor growth, forceful vomiting, arching or respiratory symptoms is GERD.
Cleft lip is repaired at 3–6 months; cleft palate at 6–12 months. Two different windows, and they get asked together.
After repair, nothing rigid goes near the mouth — no straws, tongue depressors, hard pacifiers, rigid utensils, hard-tipped sippy cups or suction catheters. No sucking on a nipple or pacifier either.
Clean the suture line with sterile 0.9% sodium chloride and keep the elbows out of reach of the face.
Feeding after repair: NPO, then liquids for the first days to weeks, then a soft diet — never straight back to normal food.
Gastroesophageal reflux is self-limiting and usually resolves by 1 year. The confirming study is a 24-hour intraesophageal pH probe.
📚 From your Maternal & Child textbook
Pillitteri, Maternal and Child Health Nursing — ch. 45 (gastrointestinal).
Vomiting causes alkalosis; diarrhea causes acidosis. Worth memorizing as one line.
Children lose proportionately more fluid than adults, so imbalance develops fast — and weight is the quickest measure of it.
Pyloric stenosis: projectile vomiting in a hungry infant, and it is surgical. Intussusception is telescoping bowel; volvulus is twisting.
NEC occurs almost exclusively in preterm infants, and incidence falls with human milk feeding.
Hepatitis A and E travel fecal-oral; B, C and D by blood and body fluids. The vowels go through the gut. Vaccines exist for A and B.
⚠️ Exam traps
Bilious (green) vomit means a LOWER/obstructive problem; non-bilious means the obstruction is at or above the pylorus.
The pain-free intervals in intussusception make the child look completely well. That is the trap.
Enemas are not first line for simple constipation.
🧠 Mind maps 2
One per disorder, built from the structure of your ATI chapter.
Acute Infectious Gastrointestinal Disorders
🎯 Who gets it
Irregular elimination pattern, lack of clean water, poor hygiene, crowded living conditions, poor sanitation, and nutritional deficiency
👀 What you see
Fatigue, behavior change such as lethargy or restlessness, three or more loose stools in 24 hr, poor appetite, weight loss, abdominal pain
Rotavirus: most common cause of diarrhea under 5 years, affects all ages — fever, watery stools for 5-7 days, vomiting about 2 days, fecal-oral spread, 48 hr incubation
Yersinia enterocolitica: mucoid and possibly bloody diarrhea, abdominal pain, fever, vomiting, spread by pets and food, incubation 1-3 weeks
Escherichia coli: watery diarrhea 1-2 days then cramping and bloody diarrhea, can progress to hemolytic uremic syndrome, incubation 3-4 days, transmission varies by strain
🧪 What confirms it
CBC with differential for anemia and infection
Hematocrit, hemoglobin, BUN, creatinine, and urine specific gravity are usually elevated with dehydration
Stool analysis for occult blood and cultures; urinalysis and comprehensive metabolic panel if dehydration is suspected
Organism-specific testing: rotavirus enzyme immunoassay on stool, E. coli on sorbitol-MacConkey agar, Gram-stained stool culture for Salmonella, stool culture for C. difficile and Shigella, blood and stool culture for C. botulinum, organism identification in stool, blood, food, or aspirate for Staphylococcus, and enzyme immunoassay for Giardia
🩺 What you do
Obtain baseline height and weight, then weigh at the same time each day
Avoid rectal temperatures
Monitor intake and output including urine and stool
Start IV fluids as ordered
💊 Drugs
Metronidazole and tinidazole for C. difficile and Giardia lamblia
💬 What you teach
Tape test: place transparent tape over the anus at bedtime after the child is asleep and remove it before waking and before toileting or bathing, then take the specimen to the lab to look for pinworm ova, using good hand hygiene throughout
Notify school or daycare of the infection and keep the child home during the incubation period
Use commercially prepared oral rehydration solution for diarrhea
⚠️ What goes wrong
Mild dehydration: 5% weight loss in infants and 3% in children, normal behavior, mucous membranes, fontanel, pulse, and blood pressure, capillary refill over 2 seconds, possible slight thirst
Moderate dehydration: 5-10% loss in infants and 6% in children, capillary refill 2-4 seconds, thirst and irritability, slightly raised pulse with normal to orthostatic blood pressure, dry mucous membranes, decreased tears and turgor, slight tachypnea, normal to sunken fontanel
Severe dehydration: over 15% loss in infants and 9% in children, capillary refill over 4 seconds, tachycardia with orthostatic blood pressure progressing to shock, extreme thirst, very dry mucous membranes with tented skin, hyperpnea, absent tears with sunken eyes, sunken fontanel, oliguria or anuria
Try oral rehydration first for mild and moderate dehydration — mild receives 50 mL/kg over 4 hr
Read left to right: who gets it → what you see → what confirms it → what you do → what goes wrong. Cover a column and rebuild it out loud.
Gastrointestinal Structural and Inflammatory Disorders
🎯 Who gets it
Cleft lip and palate: genetic syndromes, combined maternal and environmental factors, family history
Cleft lip and palate: pregnancy exposure to alcohol, cigarette smoke, anticonvulsants, retinoids, or steroids; folate deficiency, with folic acid supplementation being protective
Cleft lip appears as an open split running from the upper lip up toward the nostril; cleft palate is an opening in the palate, seen or felt, that connects mouth and nasal cavity
GERD in infants: forceful vomiting or spitting up, blood in the vomitus, excessive crying and irritability, arching and stiffening of the back, apnea, respiratory problems, and failure to thrive
Pyloric stenosis: vomiting after a feeding or up to several hours later, becoming projectile as obstruction worsens; nonbilious vomitus that may be blood-tinged; constant hunger
🧪 What confirms it
Blood electrolytes, CBC, urinalysis, and metabolic panel
Upper GI endoscopy for structural abnormalities, with biopsy to detect esophagitis and strictures
24-hr intraesophageal pH study measures acid reflux into the esophagus
Scintigraphy identifies the cause of gastric content aspiration
🩺 What you do
Inspect the lip and palpate the palate with a gloved finger, assess sucking ability, obtain a baseline weight
Observe family-infant interaction, assess emotional needs, support caregivers, and promote bonding and healthy self-esteem
Refer to support groups and consult social services for financial and insurance needs
Teach proper feeding and care and start strategies for successful feeding; encourage breastfeeding for isolated cleft lip
💬 What you teach
GERD: offer frequent feedings, thicken formula with rice cereal, use a one-way valve bottle, and hold the infant upright after feeding
Follow incision care instructions and watch for signs of infection
Watch for signs of pneumonia
⚠️ What goes wrong
Ear infection and hearing loss from altered structure and recurrent otitis media — feed upright, monitor temperature, treat ear infections early, and consider pressure-equalizing tubes to drain middle ear fluid
Speech and language impairment, more common with cleft palate — refer to speech therapy as early as possible
Dental problems with abnormal tooth eruption usually requiring later orthodontia — promote hygiene and early dental care
Recurrent pneumonia, weight loss, and failure to thrive from repeated reflux eroding the esophagus or aspiration of stomach contents
Read left to right: who gets it → what you see → what confirms it → what you do → what goes wrong. Cover a column and rebuild it out loud.
🎥 Lecture recordings 2
Tap a card to open that recording in Google Drive. The same list lives in the lecture library.
📋 Acute Infectious Gastrointestinal Disorders6 parts
ATI Active Learning Template — System DisorderAcute Infectious Gastrointestinal Disorders
Filled from ATI chapter 22, row by row from that chapter’s own sections — 12 of 12 rows have content.
🧭 What it isAlterations in Health (Diagnosis) · Health Promotion & Disease Prevention
Alterations in Health (Diagnosis)
Diarrhea ranges from mild to severe and acute to chronic and can produce dehydration. Acute diarrhea is a sudden rise in stool frequency with a change in consistency, usually from a GI infection, upper respiratory or urinary tract infection, antibiotics, or laxatives. Chronic diarrhea lasts more than 14 days and stems from malabsorption syndrome, food allergy, or inflammatory bowel disease. Dehydration is fluid loss through skin, respiratory tract, urinary tract, or GI tract, and pure water loss produces hypernatremia.
Health Promotion & Disease Prevention
From this module — built from the notes above on this page, not a section of the ATI chapter.
Handwashing — and note that alcohol gel does not kill norovirus or C. difficile; those need soap and water.
Rotavirus vaccine is oral and live, given on a strict age schedule that cannot be started late.
Safe food and water; careful diaper-changing and surface cleaning.
Teach oral rehydration at home before the child needs it — small volumes, often.
Exclude from nursery per local rules, usually until 48 hours after the last episode.
👀 How it shows upAssessment — Risk Factors · Assessment — Expected Findings
Assessment — Risk Factors
Irregular elimination pattern, lack of clean water, poor hygiene, crowded living conditions, poor sanitation, and nutritional deficiency
Assessment — Expected Findings
Fatigue, behavior change such as lethargy or restlessness, three or more loose stools in 24 hr, poor appetite, weight loss, abdominal pain
Rotavirus: most common cause of diarrhea under 5 years, affects all ages — fever, watery stools for 5-7 days, vomiting about 2 days, fecal-oral spread, 48 hr incubation
Yersinia enterocolitica: mucoid and possibly bloody diarrhea, abdominal pain, fever, vomiting, spread by pets and food, incubation 1-3 weeks
Escherichia coli: watery diarrhea 1-2 days then cramping and bloody diarrhea, can progress to hemolytic uremic syndrome, incubation 3-4 days, transmission varies by strain
Nontyphoidal Salmonella: nausea, vomiting, cramping, bloody diarrhea, and fever (infants may be afebrile), diarrhea up to 10 days, possible headache, confusion, drowsiness, seizures, and progression to meningitis or septicemia; spread person to person and by undercooked meat and poultry, incubation 6-72 hr
Pinworm (Enterobius vermicularis): perianal itching, enuresis, sleeplessness, restlessness, irritability; ingested or inhaled eggs hatch in the upper intestine, worms migrate out to lay eggs, and eggs survive 2-3 weeks on surfaces
Giardia intestinalis: in children 5 years and under diarrhea, vomiting, anorexia; in older children abdominal cramps and intermittent loose, malodorous, pale, greasy stools; spread person to person and through food and animals, with the nonmotile cyst surviving months in the environment
🧪 How it is confirmedLaboratory Tests · Diagnostic Procedures
Laboratory Tests
CBC with differential for anemia and infection
Hematocrit, hemoglobin, BUN, creatinine, and urine specific gravity are usually elevated with dehydration
Stool analysis for occult blood and cultures; urinalysis and comprehensive metabolic panel if dehydration is suspected
Organism-specific testing: rotavirus enzyme immunoassay on stool, E. coli on sorbitol-MacConkey agar, Gram-stained stool culture for Salmonella, stool culture for C. difficile and Shigella, blood and stool culture for C. botulinum, organism identification in stool, blood, food, or aspirate for Staphylococcus, and enzyme immunoassay for Giardia
Diagnostic Procedures
Tape test to detect Enterobius vermicularis
🩺 What you doNursing Care · Medications · Therapeutic Procedures
Nursing Care
Obtain baseline height and weight, then weigh at the same time each day
Avoid rectal temperatures
Monitor intake and output including urine and stool
Start IV fluids as ordered
Give antibiotics for Shigella, C. difficile, and Giardia lamblia
Avoid antibiotics with E. coli and Salmonella, and avoid antimotility agents with E. coli, Salmonella, and Shigella
Oral rehydration: solution containing 60-90 mEq sodium/L at 50-100 mL/kg over 4 hr, then reassess the need for further rehydration and start maintenance therapy per protocol
Alternate oral rehydration solution with breast milk, formula, or milk
Medications
Metronidazole and tinidazole for C. difficile and Giardia lamblia
Therapeutic Procedures
From this module — built from the notes above on this page, not a section of the ATI chapter.
Oral rehydration solution is first line, even with vomiting — 5 mL every few minutes by syringe.
Not water, juice, or sports drinks alone — wrong osmolality, and juice makes diarrhea worse.
IV fluids for shock, or where oral rehydration genuinely fails.
Resume normal feeding early; breastfeeding continues throughout.
Strict enteric precautions in the hospital.
💬 Around the patientClient Education · Interprofessional Care
Client Education
Tape test: place transparent tape over the anus at bedtime after the child is asleep and remove it before waking and before toileting or bathing, then take the specimen to the lab to look for pinworm ova, using good hand hygiene throughout
Notify school or daycare of the infection and keep the child home during the incubation period
Use commercially prepared oral rehydration solution for diarrhea
Avoid fruit juice, carbonated soda, and gelatin — high carbohydrate, low electrolyte, high osmolality
Avoid chicken and beef broth — high sodium and inadequate carbohydrate
Follow prevention measures including rotavirus immunization, and clean toys and childcare areas thoroughly to prevent spread or reinfestation
Interprofessional Care
From this module — built from the notes above on this page, not a section of the ATI chapter.
Provider for assessment of dehydration and the fluid plan.
Infection prevention for isolation and outbreak control.
Dietitian for prolonged diarrhea or faltering growth.
Public health for notifiable organisms and nursery outbreaks.
⚠️ What goes wrongComplications
Complications
Mild dehydration: 5% weight loss in infants and 3% in children, normal behavior, mucous membranes, fontanel, pulse, and blood pressure, capillary refill over 2 seconds, possible slight thirst
Moderate dehydration: 5-10% loss in infants and 6% in children, capillary refill 2-4 seconds, thirst and irritability, slightly raised pulse with normal to orthostatic blood pressure, dry mucous membranes, decreased tears and turgor, slight tachypnea, normal to sunken fontanel
Severe dehydration: over 15% loss in infants and 9% in children, capillary refill over 4 seconds, tachycardia with orthostatic blood pressure progressing to shock, extreme thirst, very dry mucous membranes with tented skin, hyperpnea, absent tears with sunken eyes, sunken fontanel, oliguria or anuria
Try oral rehydration first for mild and moderate dehydration — mild receives 50 mL/kg over 4 hr
📋 Gastrointestinal Structural and Inflammatory Disorders6 parts
ATI Active Learning Template — System DisorderGastrointestinal Structural and Inflammatory Disorders
Filled from ATI chapter 23, row by row from that chapter’s own sections — 12 of 12 rows have content.
🧭 What it isAlterations in Health (Diagnosis) · Health Promotion & Disease Prevention
Alterations in Health (Diagnosis)
Structural disorders covered here are hypertrophic pyloric stenosis, cleft lip and palate, intussusception, Hirschsprung disease, and gastresophageal reflux disease; the inflammatory disorders are appendicitis and Meckel diverticulum. Cleft lip is incomplete fusion of the oral cavity in utero and cleft palate is incomplete fusion of the palates; they can occur together or alone and be unilateral or bilateral. GER is reflux of gastric contents into the esophagus, is self-limiting, and usually resolves by 1 year; GERD is the resulting tissue damage. Hypertrophic pyloric stenosis is thickening of the pyloric sphincter producing obstruction, usually in the first weeks of life. Intussusception is telescoping of a proximal bowel segment into a distal one, causing lymphatic and venous obstruction, edema, then ischemia and increased intestinal mucus, most often between 3 months and 6 years. Appendicitis is inflammation of the vermiform appendix from luminal obstruction, average age 10 years. Meckel diverticulum results from failure of the omphalomesenteric duct to fuse in embryonic development.
Health Promotion & Disease Prevention
From this module — built from the notes above on this page, not a section of the ATI chapter.
Folic acid before conception reduces some structural defects.
Teach the presentations that need urgent attention: bilious (green) vomiting is a surgical emergency at any age.
Projectile non-bilious vomiting in a hungry infant of 3–6 weeks suggests pyloric stenosis.
Currant-jelly stool with a sausage-shaped mass and episodic drawing up of the legs suggests intussusception.
Nutrition and growth monitoring in chronic inflammatory disease, where growth failure is often the first sign.
👀 How it shows upAssessment — Risk Factors · Assessment — Expected Findings
Assessment — Risk Factors
Cleft lip and palate: genetic syndromes, combined maternal and environmental factors, family history
Cleft lip and palate: pregnancy exposure to alcohol, cigarette smoke, anticonvulsants, retinoids, or steroids; folate deficiency, with folic acid supplementation being protective
Cleft lip appears as an open split running from the upper lip up toward the nostril; cleft palate is an opening in the palate, seen or felt, that connects mouth and nasal cavity
GERD in infants: forceful vomiting or spitting up, blood in the vomitus, excessive crying and irritability, arching and stiffening of the back, apnea, respiratory problems, and failure to thrive
Pyloric stenosis: vomiting after a feeding or up to several hours later, becoming projectile as obstruction worsens; nonbilious vomitus that may be blood-tinged; constant hunger
Intussusception: sudden episodic abdominal pain with screaming and knees drawn to chest, sausage-shaped abdominal mass, red currant jelly stools mixed with blood and mucus, fever, tender distended abdomen
Appendicitis: right lower quadrant pain, rigid abdomen, reduced or absent bowel sounds, anorexia, lethargy, tachycardia, rapid shallow respirations, possible vomiting, and either constipation or diarrhea
🧪 How it is confirmedLaboratory Tests · Diagnostic Procedures
Laboratory Tests
Blood electrolytes, CBC, urinalysis, and metabolic panel
Diagnostic Procedures
Upper GI endoscopy for structural abnormalities, with biopsy to detect esophagitis and strictures
24-hr intraesophageal pH study measures acid reflux into the esophagus
Scintigraphy identifies the cause of gastric content aspiration
Ultrasound in pyloric stenosis shows an elongated mass around an elongated pyloric canal
Rectal biopsy confirms absent ganglion cells in Hirschsprung disease
🩺 What you doNursing Care · Medications · Therapeutic Procedures
Nursing Care
Inspect the lip and palpate the palate with a gloved finger, assess sucking ability, obtain a baseline weight
Observe family-infant interaction, assess emotional needs, support caregivers, and promote bonding and healthy self-esteem
Refer to support groups and consult social services for financial and insurance needs
Teach proper feeding and care and start strategies for successful feeding; encourage breastfeeding for isolated cleft lip
After cleft lip repair: monitor the protective device, position on back or side, apply elbow restraints removed periodically for skin assessment, movement, and comfort
Clean the lip incision with sterile 0.9% sodium chloride or sterile water and diluted hydrogen peroxide, applying antibiotic ointment if prescribed; gently aspirate mouth and nasopharyngeal secretions
After cleft palate repair: change position frequently and place side-lying to drain secretions and prevent aspiration
Keep IV fluids until eating and drinking; NPO first, then liquids only for days to weeks, then a soft diet
Never place a straw, tongue depressor, hard pacifier, rigid utensil, hard-tipped sippy cup, or suction catheter in the mouth after palate repair
Medications
From this module — built from the notes above on this page, not a section of the ATI chapter.
IV fluids and electrolyte correction before surgery — the metabolic alkalosis of pyloric stenosis is corrected first, not after.
Aminosalicylates, corticosteroids, immunomodulators and biologics for inflammatory bowel disease.
Proton pump inhibitors for reflux esophagitis.
Nutritional supplements, iron, and vitamin D; enteral nutrition as primary therapy in some Crohn disease.
Antibiotics for perforation or abscess; analgesia that does not mask a deteriorating abdomen.
Therapeutic Procedures
Cleft lip repair usually at 3-6 months, with additional lip and nose surgeries for severe defects
Cleft palate repair usually at 6-12 months, with most children needing further surgery for speech and appearance
Nissen fundoplication — laparoscopic wrap of the gastric fundus around the distal esophagus to reduce reflux in severe GERD
💬 Around the patientClient Education · Interprofessional Care
Client Education
GERD: offer frequent feedings, thicken formula with rice cereal, use a one-way valve bottle, and hold the infant upright after feeding
Follow incision care instructions and watch for signs of infection
Watch for signs of pneumonia
Reinforce the plan of care with the family
Appendicitis preoperative teaching covers NPO status and pain medication; postoperative teaching covers early ambulation, diet advancement, wound care, and infection monitoring
Interprofessional Care
Cleft lip and palate care draws on nursing, pediatrics, plastic surgery, otolaryngology, orthodontics, audiology, speech-language pathology, social work, and psychology
⚠️ What goes wrongComplications
Complications
Ear infection and hearing loss from altered structure and recurrent otitis media — feed upright, monitor temperature, treat ear infections early, and consider pressure-equalizing tubes to drain middle ear fluid
Speech and language impairment, more common with cleft palate — refer to speech therapy as early as possible
Dental problems with abnormal tooth eruption usually requiring later orthodontia — promote hygiene and early dental care
Recurrent pneumonia, weight loss, and failure to thrive from repeated reflux eroding the esophagus or aspiration of stomach contents
Enterocolitis — treat by resolving inflammation, preventing perforation, maintaining hydration, giving antibiotics, and surgery for colostomy or ileostomy with extensive bowel involvement
Enterocolitis monitoring: vital signs, abdominal girth measured with paper tape at the umbilicus or widest point and marked for consistency, plus watching for sepsis, peritonitis, and shock, with fluid, electrolyte, and blood product replacement
Anal stricture and incontinence — bowel retraining and possible dilatation
📝 Notes & key concepts
The lines from this module that carry a number, a dose or an absolute rule — the ones that decide questions. Everything else is on the cards above.
Normal pediatric urine output is 1 mL/kg/hr. The math is two steps: volume ÷ hours, then ÷ kilograms.
Dehydration staging: mild 3–5% with cap refill just over 2 sec; moderate 6–9% with refill 2–4 sec and dry mucous membranes; severe >10% with refill beyond 4 sec, no tears, sunken fontanel and oliguria → IV.
Oral rehydration is always first line: 40–50 mL/kg over 4 hours for mild to moderate. Severe gets an isotonic 20 mL/kg bolus (10 mL/kg if cardiac).
Pyloric stenosis: projectile non-bilious vomiting at 4–6 weeks, olive-shaped RUQ mass. Pyloromyotomy, with very slow post-op feeding advancement.
Hirschsprung: no meconium in the first 24–48 hours plus bilious emesis and distention. Rectal biopsy showing absent ganglion cells is diagnostic. Pre-op diet is high-protein, high-calorie, low-fiber.
Cleft lip repaired at 2–3 months, palate at 6–12 months before speech develops. Elbow restraints and nothing rigid in the mouth post-op. Cleft palate usually prevents an effective breastfeeding seal.
🎯 Module quiz
Questions for this module. They also feed the Mega Quiz.