Case study...Peds...GI

[hopefornursing]

Hey all,

Been assigned a case study for Peds....

Would appreciate any insight, but I will tell you what I have thought of thus far and am trying to narrow it to top two choices.....We were to try to come up with possible Dx and tests we might anticipate ordered, etc...

Number one dx would be Hiatal Hernia although not too frequent in kids

Numer two dx GERD But i wonder if it's not something more since it's unresponsive to on H2 and two PPI's...

Tests I would anticipate would be another barium swallow, a gastric motility, perhaps a 24 hour pH, maybe an H. Pylori breath test...

Here are the details that were given to us, I want to see if I am missing anything, Thanks!!

7 year old male, 59 pounds, normal neuro signs. C/O daily regugitation post meals, up to 20 times per day, quantity usually a mouthful...Sometimes vomitus in nature and sometimes undigested from meals 4 hours prior.

Unresponsive to Zantac, Prevacid and Prilosec. Prior dx of reflux at age of two with a barium swallow. Hx of occasional bouts of wheezing Tx with albuterol..

I am trying to give this my best shot, but it seem too vague??? Any thoughts would be greatly appreciated!!!

Thanks!

[leslie :-D]

Ok, we have been given "the rest of the story" by our instructor...

Apparently, when the child finally got to a ped. GI, that is who zeroed in on constipation, and an abd xray was done, which showed significant fecal matter in the intestines.....

i certainly understand what your instructor is saying...no brainer, actually.

but what i don't understand is how could you have arrived at this dx if you didn't have this info in your case study?

or was it included, about fecal matter in (LG) intestines?

leslie

[hopefornursing]

i certainly understand what your instructor is saying...no brainer, actually.

but what i don't understand is how could you have arrived at this dx if you didn't have this info in your case study?

or was it included, about fecal matter in (LG) intestines?

leslie

Nope, it was not in the initial info, I am just so glad that this thing was not graded, but really, part of me could say "a bit of a waste of time" and another part says, "I really learned alot, but geez I wish all of this would have been given to us with the info."

AGH, one more year of this, repeat one more year of nursing school (unless of course I decide to go for a BSN_MSN) which I really am thinking about......

Sometimes I think these instructors have been at it so long, they forget how easy it is to frustrate a nursing student!