Diagnosis and Management of Gastrointestinal Disorders
Gastrointestinal disorders are a significant cause of stress for pediatric patients and their families. Symptoms of these disorders range from mild to severe and may include complaints such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can result in these same symptoms, it is important to carefully assess patients to develop differential diagnoses. Depending on the age of the patient, assessments can sometimes be difficult because younger children are not always able to clearly communicate their symptoms. Pediatric patient evaluations must involve a combination of patient input, parent input, and your own observations from physical exams and diagnostics. As you read the following three case studies, consider the source (i.e., patient, parent, or practitioner) of the provided patient information.
• Review “Gastrointestinal Disorders” of the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
Case Study 1:
Jordan is a 4-year-old with a 1-day history of vomiting and diarrhea. His mother reports he awoke this morning vomiting and his vomitus contained last night’s dinner. He vomited three more times this morning but has not vomited in 5 hours. Approximately one hour ago, he had a large diarrhea stool that did not contain blood or mucus. He has had small sips of sports drinks since this morning. His last urination occurred 3 hours ago and the volume was small and the color dark yellow. Physical examination reveals a quiet and tired child with normal exam except for increased bowel sounds, but no abdominal distension, pain with palpation, or masses.
Please address the below following in bold headings
-Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
– Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
o Chapter 32, “Gastrointestinal Disorders” (pp. 739–788)
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.
• American Academy of Pediatrics, Subcommittee on Acute Gastroenteritis, Provisional Committee on Quality Improvement. (1996). Practice parameter: The management of acute gastroenteritis in young children. Pediatrics, 97(3), 424–435. Retrieved fromhttp://pediatrics.aappublications.org/content/97/3/424.abstract?sid=cc35023c-502d-474a-9856-bfb5e38eed54
This article explores management options for children from ages 1 month to 5 years diagnosed with acute gastroenteritis. It also examines methods of rehydration, refeeding after rehydration, and the use of antidiarrheal agents.
• 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.
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
This article presents the epidemiology and clinical presentation of acute gastroenteritis among infants and children as well as assessment and treatment strategies.