Many gastrointestinal (GI) disorders have overlapping symptoms, making diagnosis difficult, especially for those disorders that are less common among pediatric patients. This was the case for 8-year-old Erin. After becoming sick with flu-like symptoms, Erin’s parents took her to their family health care provider, who diagnosed her with a viral infection that would simply run its course. However, after 3 weeks, Erin had lost all energy and 25 pounds. She was so weak, her parents had to carry her into the emergency room. Diagnostic tests revealed a massive bleeding lesion in her colon, confirming a suspected diagnosis of Crohn’s disease (Nationwide Children’s Hospital, n.d.). Like Crohn’s, many GI disorders initially present with flu-like symptoms. As an advanced practice nurse, you must identify when to treat these symptoms, when to order diagnostics, and when to refer for specialized care.
This week you explore gastrointestinal disorders in pediatric patients. You also examine differential diagnoses for these disorders, as well as the impact of patient culture on treatment, management, and education.
By the end of this week, students will:
Assess pediatric patients for gastrointestinal disorders
Evaluate differential diagnoses for pediatric gastrointestinal disorders
Analyze treatment and management plans for pediatric patients with gastrointestinal disorders
Analyze strategies for educating patients and families on the treatment and management of gastrointestinal disorders
Evaluate the impact of culture on the treatment and management of gastrointestinal disorders
Understand and apply key terms, principles, and concepts related to gastrointestinal disorders in pediatric patients
Assess pediatric patients with signs of gastrointestinal disorders
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier.
Chapter 33, “Gastrointestinal Disorders” (pp. 833-887)
This chapter presents information related to the anatomy and physiology of the gastrointestinal system. It also covers assessment and management strategies for upper and lower gastrointestinal tract disorders and inflammatory bowel disease.
Diagnosis, management, and prevention of rotavirus gastroenteritis in children by Parashar, U.D., Nelson, E.A., Kang, G. in BMJ. 2013 Dec 30;347:f7204. doi: 10.1136/bmj.f7204.
Copyright 2013 by BMJ Publishing Group. Reprinted by permission of BMJ Publishing Group via the Copyright Clearance Center.
Blackmer, A. B., & Farrington, E. A. (2010). Constipation in the pediatric patient: An overview and pharmacologic considerations. Journal of Pediatric Health Care, 24(6), 385–399.
Note: Retrieved from the Walden Library Databases.
This article describes complications of chronic constipation in pediatric patients. It also explores causes of constipation and strategies for assessing, managing, and treating patients.
Centers for Disease Control and Prevention. (2003). Managing acute gastroenteritis among children: Oral rehydration, maintenance, and nutritional therapy. Morbidity and Mortality Weekly Report, 52(RR-16), 1–20. Retrieved from http://www.cdc.gov/mmwr/PDF/RR/RR5216.pdf
Assignment: Practicum – SOAP Note #3: Comprehensive
Your Well Child Note is due by Day 7 of Week 8. Take some time to review the provided example. Select a patient who you examined during the last 4 weeks. With this patient in mind, address the following in a SOAP Note:
Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent, as well as possible reasons for these discrepancies.
Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?
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