Page 962 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 33

Gastrointestinal Problems

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Priority Concepts
Elimination; Nutrition

I. Vomiting
A. Description

1. The major concerns when a child is vomiting

are the risk of dehydration, the loss of fluid and
electrolytes, and the development of metabolic
alkalosis.
2. Additional concerns include aspiration and the
development of atelectasis or pneumonia.
3. Causes of vomiting include acute infectious diseases,
increased intracranial pressure, toxic ingestions, food
intolerance, mechanical obstruction of the
gastrointestinal tract, metabolic disorders, and
psychogenic disorders.
B. Assessment
1. Character of vomitus

2. Signs of aspiration

3. Presence of pain and abdominal cramping
4. Signs of dehydration and fluid and electrolyte
imbalances
5. Signs of metabolic alkalosis

C. Interventions

1. Maintain a patent airway.
2. Position the child on the side to prevent aspiration.
3. Monitor the character, amount, and frequency of
vomiting.
4. Assess the force of the vomiting; projectile vomiting
may indicate pyloric stenosis or increased intracranial
pressure.
5. Monitor strict intake and output.
6. Monitor for signs and symptoms of dehydration, such

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