1. Ricci, pp. 1523-1525; 1537-1538

2.  Telescoping of bowel into itself  Usually occurs as a complication of another bowel disorder  Occurs more often in infant males

3.  Sudden onset of intermittent, severe, abdominal pain  V/D—bilious vomiting indicates obstruction  Currant jelly stools  Lethargy  Dehydration  Sausage-shaped mass  Watch for peritonitis

4.  Barium enema is both diagnostic and therapeutic. May reduce intussusception.  Check labs for signs of dehydration and peritonitis  IVF and antibiotics  If can’t be reduced by barium enema, must be reduced surgically.  If necrosis has occurred, bowel resection must be done. Then routine postop nsg care.

5.  Twisting of bowel either in utero or after birth.  Can occur when bowel gets malrotated during during embryonic development.  Infection and necrosis can occur with resulting peritonitis and sepsis.

6.  Bilious vomiting  Abdominal pain and distention  Hypoactive bowel sounds  Guarding, rebound  Hematochezia, melena  Shocky with tachycardia and hypotension  + abd x-ray or UGI shows corkscrew appearance of bowel

7.  IVF  Antibiotics, pain meds  NG tube to suction  Surgery to release or resect the bowel  Routine postop nursing care

8.  Intolerance to gluten  Immunologic disorder—higher incidence in those with other autoimmune diseases.  Villi in intestine that normally absorb nutrients become damaged by the immune response to gluten and malnutrition results.  May have genetic component. Genetic testing may be done.

9.  Diarrhea, steatorrhea, constipation  FTT, wt loss, poor muscle tone  Delay of sexual maturation  Abdominal distention  Irritability, listlessness  Nutritional deficiencies, anemia  +Antibody test to gluten  EGD with +intestinal bx

10.  Elimination of gluten from diet for life  Most gluten-containing foods are in the grain family  Educate family about foods to avoid (p. 1538)  Better if entire family adopts diet to make it easier for child to cope.