Chapter 45: Gastrointestinal Disorders in Children Nursing Care

Gastrointestinal Disorders in Children Nursing Care on pediatric gastrointestinal (GI) disorders outlines the profound physical and psychosocial changes children undergo when affected by illnesses impacting nutrient absorption and excretion, emphasizing the critical role of nursing care informed by the nursing process and Quality and Safety Education for Nurses (QSEN) competencies,. A primary focus is on fluid, electrolyte, and acid-base imbalances, as infants and young children are acutely vulnerable to rapid dehydration—losing a high proportion of fluid from the extracellular compartment—with symptoms like poor skin turgor and dry mucous membranes necessitating immediate intervention,. The text details how excessive vomiting leads to metabolic alkalosis due to hydrochloric acid loss, while severe diarrhea results in metabolic acidosis from sodium loss, highlighting the need for urgent correction through oral rehydration solutions (ORS) or intravenous (IV) therapy,. Key structural and functional disorders of the upper GI tract are explored, including gastroesophageal reflux disease (GERD), often managed conservatively with thickened feedings, and pyloric stenosis, a hypertrophy of the pyloric sphincter typically presenting as projectile vomiting in early infancy, requiring surgical correction (pyloromyotomy),. Peptic ulcer disease is discussed, often linked to Helicobacter pylori infection, treated with a combination of antibiotics and gastric acid suppressants like proton pump inhibitors (PPIs),. Hepatic disorders, such as viral hepatitis (A and B prevention emphasized through routine vaccination), biliary atresia (an obliterative disorder of the bile ducts), and resulting cirrhosis, are reviewed, noting the potential need for complex interventions like liver transplantation due to impaired detoxification and bilirubin processing,. Additionally, the chapter covers intestinal emergencies like intussusception (bowel invagination leading to episodic pain and "red currant jelly" stools), and volvulus (twisting of the intestine), alongside appendicitis, the most common surgical emergency in children, presenting with anorexia, followed by nausea/vomiting, and then localized pain near McBurney point,. Chronic management conditions, such as celiac disease—an immune response to gluten requiring a lifelong gluten-free diet—and Inflammatory Bowel Disease (IBD), encompassing Ulcerative Colitis (UC) and Crohn Disease (CD), are detailed, focusing on nutritional support and long-term medical therapy,. Finally, common lower bowel issues like functional constipation (defined by Rome IV criteria), and congenital anomalies like Hirschsprung disease (lacking nerve innervation in the colon) are addressed, alongside deficiency disorders like Kwashiorkor (protein lack) and nutritional marasmus (starvation), underscoring the necessity of nutritional education and family-centered support across all stages of care.