Gastro intestinal system (Essential concepts):
Development:
1.development of a primitive system begins during the fourth weeks of gestation , with the most extensive development occurring in the last few weeks before birth.
2 .A newborn s stomach capacity is only 10 to 20 ml at birth and peristalsis is rapid , resulting in frequent regurgitation .
3 .Normal newborns pass one to six a day.
Function :
1.Digestion involves physical and chemical breakdown of food into absorption substance .
2.Asorption involves transfer of the end products of digestion across the intestinal wall into the circulation for use by cells.
Gastrointestinal system overview:
A. Assessment :
1.Assessing a child s GI system involves obtaining a complete health history and performing a physical assessment , particularly of the abdomen.
2.Abnormal findings indicating possible GI dysfunction include :
A. Growth and development height and weight below standard age related norms .
B. skin pallor. Jaundice , carotenemia,
C. Hair , abnormal texture and sparseness.
D. Head , microcephaly , craniotabes.
E. Mouth , caries , periodontal disease.
F. Abdomen : distention or depression , umbilical hernitation , visible peristaltic wave , tenderness , masses , splenomegaly , hepatomegaly and increased , decreased or absence bowel sounds.
G. Anus rectal bleeding , no patency.
Laboratory studies and diagnostic tests performed to evaluate GI function include :
1.Stool cultures.
2. Stool sample evaluation for the presence of blood , mucus , fat , urobilinogen, tyrosine , leukocytes.
3.Stool sample evaluation for the presence of ova and parasites.
4.Stool-reducting substance and PH tests.
5.Complete blood count with differential ,hemoglobin and hematocrit .
6.Urine specific gravity.
7.Bowel studies upper GI series , bartium enema , biopsy , rectosigmoidoscopy.
8. Liver and endocrine function tests.
9. Abdominal radiographs.
Psychosocial implications:
1.Infants : oral gratification may be compromised by an infant s inability to suck well due to cleft lip or palate , surgery and alternate feeding methods the child may develop inappropriate ways to meet his or her oral needs (e.g sucking on a blanket , hand ,or other object).
2.Toddlers : Locomotion is compromised in a child receiving long-term hyper alimentation or IV drug therapy.
3. Preschooler :Malnourishment may interfere with development of normal motor skill(e.g skipping)
4. School-age children and adolescents body image and self-concepts development may be challenged by a child s altered body function and health maintenance needs.