GI PEDS EXAM 3

Food allergy

-reproducible immune response to food

Types of Hepatitis

A: Immunization for this! Fecal-oral route: contaminated foods, fecal material, contact with infected person. Prevalent in poor sanitary conditions and poor food handling. Can be shed in stool B: Immunization for this! Transmitted person to person through blood, semen, other body fluids-sharing of needles-intentional or accidental sticks, mother to child C: Most common cause of chronic liver disease; occurs from exposure to Hep C infected blood or blood products D: Rarely in children; must already have HBV. Blood and sexual contact-drug abusers, hemophilia E: Used to be Non-A and Non-B. Fecal-oral contamination or contaminated water. Uncommon in children

Metabolic alkalosis.

An infant with pyloric stenosis experiences excessive vomiting that can result in: a. Hyperchloremia. c. Metabolic acidosis. b. Hypernatremia. d. Metabolic alkalosis.

Esophageal Atresia and TEF

Any infant who has excessive frothy saliva in mouth or or difficulty with secretions/unexplained apnea, cyanosis or O2 desaturation should be suspected of having

Cleft Lip and Cleft Palate

Facial malformations that occur during embryonic development May appear separately or together Requires surgical correction

Infants Gastroesophageal Reflux

Feed upright Keep upright 1 hr after feeds/avoid positions that increase intra-abd pressure Sufficient burping every 1-2 oz Thicken formula with rice cereal (1-2 teaspoons/ounce) Elevate when sleeping

lab testing, skin prick testing

Food Sensitivity dx

Diarrhea management Aquaphor or desitin

Rehydrate, correct fluid and electrolyte imbalances, reintroduce regular diet May need barrier agents such as ______ to protect skin

IBD

Small frequent meals, snacks, serve meals with medications, high protein, high cal foods-May need NGT feeds or TPN Aminosalicylates and corticosteroids

voided!! dehydration related

Potassium should not be administered because the child has not ______

Moderate dehydration

Start to be tachycardic, tachypneic, irritable, more thirsty, dry membranes, decreased tears, fontanels may be sunken, cap refill 2-4, oliguria

Irritable Bowel Syndrome (IBS)

Symptoms should be >6months & 3 days/month for 3 months for dx

CL/CP Care

These babies have feeding problems-unable to create lip seal prior to surgery Require special nipples Burp frequently they swallow excessive air Feed upright to minimize milk into the nasal cavity The breast actually fills in the palate and helps the infant create suction

Acute Appendicitis

Usually starts with periumbilical pain followed by nausea, RLQ pain, and later vomiting and fever

Intestinal bleeding may be mild or profuse.

Which statement is most descriptive of Meckels diverticulum? a. It is more common in females than in males. b. It is acquired during childhood. c. Intestinal bleeding may be mild or profuse. d. Medical interventions are usually sufficient to treat the problem.

Strangulated hernia

Which type of hernia has an impaired blood supply to the herniated organ? a. Hiatal hernia c. Omphalocele b. Incarcerated hernia d. Strangulated hernia

US Impacts feeding

____at 13-14 wks may detect Cleft lip

CT

confirms enlarged appendix

Kwashiorkor

deficiency of protein-diet high in carbs but low in protein

tests are not definitive for diagnosis, rather elimination of milk with improvement of symptoms is more accurate

dx Cow's Milk Allergy

Crohn's Disease-

entire GI tract; most affected is terminal ileum

Newborns Hirschsprung Disease

failure to pass meconium/abd distention/poor feeding

Marasmus

general malnutrition lacking calories and protein

food intolerance-

reproducible adverse reaction without immune response

antihistamines Epinephrine

should be kept with the allergic child at all times

Meckel Diverticulum

•Complications from: bleeding, obstruction, or inflammation •Present with painless rectal bleeding (red/currant jelly stools), abd pain, anemia

•Heart failure •Increased intracranial pressure

•Decreased fluid requirements

Cirrhosis liver biopsy liver transplant

•End stage of chronic liver disease Diagnosis management

Irritable Bowel Syndrome (IBS)

•Functional GI disorder •Alternating diarrhea and constipation •Flatulence •Bloating

Crohn

•Inflammation involves entire GI tract •Skip lesions •Ulcerations/fibrosis/adhesions/stiffening of wall/strictures formed/fistulas •More serious complications

Ulcerative Colitis

•Inflammation limited to colon and rectum •Mucosa and submucosa of bowel wall affected •Ulceration/edema/bleeding

Acute Appendicitis •McBurney point

•Inflammation of the vermiform appendix •Diagnostic evaluation

hernia

•Protrusion of portion of an organ through an abnormal opening

Esophageal Atresia and TEF Manifestations

•Respiratory distress •3 C's •Coughing •Choking •Cyanosis •Excessive salivation •Aspiration pneumonia

Volvulus

•Twisting of intestine around itself, thereby compromising blood supply to intestines

Ulcerative Colitis

•inflammation of colon/rectum

Children

heartburn, chest pain, chronic cough, recurrent pneumonia GERD: Symptoms or tissue damage occurs from GER

Intussusception

leak into the intestines resulting in red currant/jelly-like stools •Telescoping of one part of the intestine into another part • Partial to complete bowel obstruction and necrosi

Infants GER

spitting up, vomiting, irritability, crying, FTT,

acute diarrhea rotovirus

sudden onset of diarrhea that may be associated with infectious process, antibiotic therapy, or laxative use; usually self-limiting and subsides without treatment ex

ribbon like stool pallet like stool foul smelling stool

what are the symptoms of hirschsprugs disease

on the stomach

what position is recommended for infants after immediate post op of palete surgery

chronic diarrhea

•>14 days Malabsorption syndromes/IBD/food allergy/lactose intolerance

Constipation management

•Dietary changes/ increase fiber •Fruits (exception of bananas) •Veggies •Beans •Cheerios/Raisin Bran •Stool softeners/MiraLAX •Bowel routine Education

Management of Diarrhea

•Rehydrate: oral first (Pedialyte) •Maintenance •Slowly advance diet •Avoid high carb low electrolyte replacements (fruit juices, soft drinks, gelatin) •I&O/ Daily weights •Diaper care •Antidiarrheal medications not recommended

ORS - Oral rehydration is preferred! Oral rehydration solutions such as Pedialyte are available OTC. More severe dehydration may require IV fluid replacement - child is unable to tolerate adequate amount of fluid. Goal is to expand volume quickly

•Therapeutic management for dehydration

Necessary because it will be an adjustment.

A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is: a. Not necessary because of childs age. b. Not necessary because the colostomy is temporary. c. Necessary because it will be an adjustment. d. Necessary because the child must deal with a negative body image.

Thicken formula with rice cereal.

A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux? a. Place in Trendelenburg position after eating. b. Thicken formula with rice cereal. c. Give continuous nasogastric tube feedings. d. Give larger, less frequent feedings.

Reduce gastric acid production.

A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to: a. Prevent reflux. c. Reduce gastric acid production. b. Prevent hematemesis. d. Increase gastric acid production.

Not indicated.

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurses response should be based on knowledge that this drug is: a. Not indicated. Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 681 b. Indicated because it slows intestinal motility. c. Indicated because it decreases diarrhea. d. Indicated because it decreases fluid and electrolyte losses.

Encourage her to express her feelings.

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initialtherapeutic approach to the mother should be to: Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 674 a. Restate what the physician has told her about plastic surgery. b. Encourage her to express her feelings. c. Emphasize the normalcy of her baby and the babys need for mothering. d. Recognize that negative feelings toward the child continue throughout childhood.

Giardia lamblia.

A parasite that causes acute diarrhea is: a. Shigella organisms. c. Giardia lamblia. b. Salmonella organisms. d. Escherichia coli.

Bacterial gastroenteritis

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition? Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 667 a. Protein intolerance c. Fat malabsorption b. Parasitic infection d. Bacterial gastroenteritis

Intravenous fluids.

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with: a. Intravenous fluids. b. Oral rehydration solution (ORS). c. Clear liquids, 1 to 2 ounces at a time. d. Administration of antidiarrheal medication.

Refer to a nutritionist for detailed dietary instructions and education.

An important nursing consideration in the care of a child with celiac disease is to: a. Refer to a nutritionist for detailed dietary instructions and education. b. Help the child and family understand that diet restrictions are usually only temporary. c. Teach proper hand washing and Standard Precautions to prevent disease transmission. Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 677 d. Suggest ways to cope more effectively with stress to minimize symptoms.

Dehydration.

An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of: a. Overhydration. c. Sodium excess. b. Dehydration. d. Calcium excess.

Teaching the family signs of central venous catheter infection.

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include: a. Preparing the family for impending death. b. Teaching the family signs of central venous catheter infection. c. Teaching the family how to calculate caloric needs. d. Securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.

Childhood- Hirschsprung Disease

Constipation/Ribbonlike stool/distention/palpable fecal mass/visible peristalsis

A nasogastric tube fails to pass at birth.

For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia? a. A radiograph in the prenatal period indicates abnormal development. b. It is visually identified at the time of delivery. c. A nasogastric tube fails to pass at birth. d. The infant has a low birth weight.

Malrotation

Abnormal rotation of intestine around the superior mesenteric artery during embryologic development

Add iron fortified cereals

Fetal iron stores are depleted by 4 months:

Peptic Ulcer Disease

Pepcid and zantac); PPIs (prevacid, prilosec

Hepatitis

Prevention: handwashing, vaccines for A & B

Severe dehydr

Really tachycardic, deep and rapid breaths, hypotension, lethargic, absent tears, intense thirst, little to no urine output, sunken eyes, sunken fontanels, cool, clammy mottled skin

Cleansing of suture line, supine and side-lying positions, and arm restraints.

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include: a. Arm restraints, postural drainage, and mouth irrigations. b. Cleansing of suture line, supine and side-lying positions, and arm restraints. c. Mouth irrigations, prone position, and cleansing of suture line. Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 675 d. Supine and side-lying positions, postural drainage, and arm restraints.

•Surgical removal of diverticulum

Treatment Meckel Diverticulum

Hirschsprung surgery

Treatment usually involves surgery to remove the affected part of the bowel or pilling unaffected bowel through rectum, may result in need for a temporary colostomy.

high-quality, balanced diet

Treatment: for malnutrition diseases

Intussusception U/S enema

Vomiting Red, currant jelly-like stools Tender, distended abdomen Palpable sausage-shaped mass in upper right quad/empty lower right quadrant Fever ____ can confirm Many times intussusception can be corrected by with an ___

Decreased tear production

What's a worsening sign for a nurse to be notified of when assessing a toddler with diarrhea

Abdominal pain that is most intense at McBurneys point

Which clinical manifestation would most suggest acute appendicitis? a. Rebound tenderness b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 671 d. Abdominal pain that is most intense at McBurneys point

Ice cream

Which food is less likely for a lactose intolerant child to consume

Upper endoscopy and colonoscopy

are vital for diagnosing IBD

Mild Dehydration

decreased urine output, cap refill >2secs, thirsty, still have tears

Peptic Ulcer Disease

is a chronic condition that affects stomach and duodenum; Gastric-stomach; duodenal-pylorus or duodenum, may be primary or secondary Primary: may be related to H Pylori bacteria that colonizes in the gut Secondary: R/T underlying disease process Diagnosis: based on symptoms, Upper GI not usually helpful, biopsy can detect HPylori

Biliary Atresia (BA)

•If left untreated, will result in cirrhosis

Causes of Dehydration

•Impaired oral intake •Vomiting •Diarrhea •Ketoacidosis •Burns

•Radiant warmer •Shock

•Increased fluid requirements

Popcorn.

A high-fiber food that the nurse could recommend for a child with chronic constipation is: a. Popcorn. c. Muffins. b. Pancakes. d. Ripe bananas.

Antibiotic therapy.

Acute diarrhea is often caused by: a. Hirschsprungs disease. c. Hypothyroidism. b. Antibiotic therapy. d. Meconium ileus.

Rice, corn, millet

Advisable foods for celiac disease

Hypertrophic Pyloric Stenosis U/S

Dx - H&P, olive shaped mass, projectile vomiting 60-90 mins after feeding, ___to confirm

Infants Hirschsprung Disease

FTT/constipation/distention/watery diarrhea/vomiting

Vomiting Management

Fluid replacement Antiemetics Prevent aspiration Treat underlying cause Monitor electrolytes

24-36 "P"

Newborn's first stool within ____hrs -if not, suspect a problem and investigate further Infancy - often related to diet, uncommon in exclusively breastfed infants, they often stool with every feeding, may develop in formula-fed infants; change in milk source; can usually be corrected by increasing the amount of vegetables & fruit. Which fruits? ____fruits help with poop

Post op care and Discharge teaching Hirschsprung

No rectal temps Monitor for infection (abd distention/fever) No dietary restrictions once diet has been advanced Beefy red stoma normal

Eradicate Helicobacter pylori.

Bismuth subsalicylate, clarithromycin, and metronidazole are prescribed for a child with a peptic ulcer to: a. Eradicate Helicobacter pylori. c. Treat epigastric pain. b. Coat gastric mucosa. d. Reduce gastric acid production.

LFTs, X-rays-enlarged liver, U/S

Biliary Atresia (BA) dx

Hepatitis A

Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings? a. Irritable bowel syndrome c. Hepatic cirrhosis b. Ulcerative colitis d. Hepatitis A

•Give Epinephrine •Seek emergency care

Clinical Manifestations of Food Allergy: •Systemic - anaphylaxis, growth failure •GI - n/v/d, abd pain •Resp - cough/wheezing/rhinitis •Cutaneous - itching/rash, atopic dermatitis What do we do?

GER dx

History and physical are usually sufficient for diagnosis, upper GI may be helpful, Gold standard is 24-hr ph monitoring

Malrotation and Volvulus

History, physical and xrays are diagnostic, Upper GI is definitive

Celiac Disease

Intestinal intolerance to gluten which is a protein found in wheat, barley, rye and oats which damages the small intestine

•Give Epinephrine

Itchy/tight throat Barking cough Difficulty swallowing SOB/wheezing/stridor Anxiety/impending doom Syncope/brady/hypotension

Celiac Disease

Lab will be drawn to test for celiac markers, if positive: Upper scope with biopsies to confirm

Surgical Repair Care cclcp

Main goal is to protect the operative site Petroleum jelly to op site, medicate for pain, feed as tolerated Avoid objects around and in the mouth

Formula change

Management Cow's Milk Allergy

Biliary Atresia (BA)

No Known Cause-usually appear healthy at birth Suspect if jaundice persists beyond 2 weeks of age Early diagnosis is critical to survival Jaundice (2-3 wks)/Dark yellow urine from excretion of bilirubin/Light stools due to lack of bile pigment

B.Encourage the child to blow bubbles

The nurse is caring for a 3-year-old 2 days post appendectomy. The child has a fever of 101.8 and breath sounds are slightly diminished in the right lower lobe. Which action is most appropriate? A.Teach the child how to use an incentive spirometer B.Encourage the child to blow bubbles C.Obtain an order for IV antibiotics D.Obtain an order for pain medication

Fever.

Nurses must be alert for increased fluid requirements when a child has: a. Fever. c. Congestive heart failure. b. Mechanical ventilation. d. Increased intracranial pressure (ICP).

prevention with handwashing, proper food storage and handling, isolation of infected people

Teach Diarrhea

Liver transplantation.

The best chance of survival for a child with cirrhosis is: a. Liver transplantation. c. Treatment with immune globulin. b. Treatment with corticosteroids. d. Provision of nutritional support.

Hepatitis B vaccine

Which vaccine is now recommended for the immunization of all newborns? a. Hepatitis A vaccine c. Hepatitis C vaccine b. Hepatitis B vaccine d. Hepatitis A, B, and C vaccines

parent reports of fluid intake, urine output, diarrhea and emesis.

Diagnostics: How do we know? Detailed history of events is key in assessing for dehydration:

1g=1ml sunken in moderate to severe dehydration

As nurses, you will be expected to maintain accurate I&Os on your patients. There are many factors that contribute to this measurement. You have to consider: urine/stools-frequency, color, volume, consistency. When weighing diapers ____ of urine. vomiting-volume, frequency, type VS-may be tachypneic, tachycardic, hypotensive mucous membranes-moisture, color, sticky mouth, no tears fontanels-_______ sensory alterations may include the presence of thirst in an older children Also consider IVF, po intake.

Providing satisfaction of sucking needs.

Caring for the newborn with a cleft lip and palate before surgical repair includes: a. Gastrostomy feedings. b. Keeping the infant in near-horizontal position during feedings. c. Allowing little or no sucking. d. Providing satisfaction of sucking needs.

•Environmental at school , attempts to withhold stool

Childhood Constipation

Antihistamines.

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by: a. Diet. c. Antihistamines. b. Allergies. d. Emotional factors.

Remove restraints periodically to cuddle infant.

During the first few days after surgery for cleft lip, which intervention should the nurse do? a. Leave infant in crib at all times to prevent suture strain. b. Keep infant heavily sedated to prevent suture strain. c. Remove restraints periodically to cuddle infant. d. Alternate position from prone to side-lying to supine.

diarhea

History questions can help discover the possible cause, include questions about current symptoms, travel, exposure to contaminants or other ill people; Also also question the presence of fever, vomiting, character/frequency of stools (watery, blood, mucous), urine output, recent food intake Can occur with fecal oral contamination—esp in children who are may not wash hands well and put everything in their mouths!

gastroenteritis

Many times dehdration is a result of ___

Jaundice.

The earliest clinical manifestation of biliary atresia is: a. Jaundice. c. Hepatomegaly. b. Vomiting. d. Absence of stooling.

.After saline bolus complete, begin maintenance fluids of D51/2 NS with 10meq KCL/L.

The nurse is caring for a 2-year-old who was admitted to the pediatric unit for moderate dehydration due to vomiting/diarrhea. The child is restless, with periods of irritability, afebrile, heart rate of 148, blood pressure of 90/42. Na 152, cl 119, glucose 115. Parents state the child has not urinated in 12 hours. An IV has been established and a NS bolus has been initiated. Which order would the nurse question? A.May repeat saline bolus of 20mL/kg if no urination. B.Recheck serum electrolytes in 12 hours. C.After saline bolus complete, begin maintenance fluids of D51/2 NS with 10meq KCL/L. Clear liquid diet as tolerated

Notify the practitioner.

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to: a. Notify the practitioner. b. Measure abdominal girth. c. Auscultate for bowel sounds. d. Take vital signs, including blood pressure.

Elevating the head but giving nothing by mouth.

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: a. Elevating the head but giving nothing by mouth. b. Elevating the head for feedings. c. Feeding glucose water only. d. Avoiding suctioning unless the infant is cyanotic.

Visible peristalsis and weight loss

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? a. Abdominal rigidity and pain on palpation b. Rounded abdomen and hypoactive bowel sounds c. Visible peristalsis and weight loss d. Distention of lower abdomen and constipation

Brushing teeth or rinsing mouth after vomiting.

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include: a. Avoiding carbohydrate-containing liquids. b. Giving nothing by mouth for 24 hours. c. Brushing teeth or rinsing mouth after vomiting. d. Giving plain water until vomiting ceases for at least 24 hours.

Rotavirus.

The viral pathogen that frequently causes acute diarrhea in young children is: a. Giardia organisms. c. Rotavirus. b. Shigella organisms. d. Salmonella organisms.

Surgical removal of affected section of bowel.

Therapeutic management of most children with Hirschsprungs disease is primarily: a. Daily enemas. b. Low-fiber diet. c. Permanent colostomy. d. Surgical removal of affected section of bowel.

Oral rehydration solution (ORS).

Therapeutic management of the child with acute diarrhea and dehydration usually begins with: a. Clear liquids. b. Adsorbents such as kaolin and pectin. c. Oral rehydration solution (ORS). d. Antidiarrheal medications such as paregoric.

Choking Cyanosis Coughing

What are the symptoms of tracheoesophageal fistula of a newborn

Encopresis

What causes a child to often complain about involuntarily soiling and occurs without warning

Oatmeal

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching? a. Oatmeal c. Corn muffin b. Rice cake d. Meat patty

Crackers

What gluten protein food is bad for celiac disease

Crohns disease

What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 672 (GI) tract from mouth to anus? a. Crohns disease c. Meckels diverticulum b. Ulcerative colitis d. Irritable bowel syndrome

Electrolyte losses exceeds water losses

What is hypotonic dehydration

Wheat bread

What is not an advisable food for celiac disease

Chelation therapy

What is the appropriate action for a toddler who has a serum lead level of 6mcg/dl

Sudden relief of pain

What is the first indication of a perforated appendix

Teaching dietary modifications

What is the major focus of the therapeutic management for a child with lactose intolerance? a. Compliance with the medication regimen b. Providing emotional support to family members c. Teaching dietary modifications d. Administration of daily normal saline enemas

Teach the parents how to do infant cardiopulmonary resuscitation (CPR).

What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux? a. Teach parents to position the infant on the left side. b. Reinforce the parents knowledge of the infants developmental needs. c. Teach the parents how to do infant cardiopulmonary resuscitation (CPR). d. Have the parents keep an accurate record of intake and output.

antibiotic therapy

What is the most likely cause for an acute diarrhea

Currant jelly like stool

What is the most likely finding with acute intussusception

Update vaccination

What is the priority for three-year-old child at his wellness check up since his six months old check up

Soy based formula

What is the substitute for an infant who has an acute lactose intolerance

Corticosteroids

What is used to treat moderate-to-severe inflammatory bowel disease? a. Antacids c. Corticosteroids b. Antibiotics d. Antidiarrheal medications

metabolic acidosis

What problems should a nurse monitor for a child who is admitted with diarrhea

Projectile vomiting

What should be specifically asked for a child admitted with pyloric stenosis

Nutritional guidance and preventing constipation

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis? a. Preventing the spread of illness to others b. Nutritional guidance and preventing constipation c. Teaching daily use of enemas d. Coping with stress and avoiding triggers

Monitor infant following feeding for vomiting

What's the best action by nurse when caring for an infant who is in postop pyloric stenosis

c

When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is: a. Bradycardia. c. Sudden relief from pain. b. Anorexia. d. Decreased abdominal distention.

Right lower quadrant

Where is the location of pain for a child who is diagnosed with appendicitis

Currant jelly stools

Which description of a stool is characteristic of intussusception? a. Ribbon-like stools c. Currant jelly stools b. Hard stools positive for guaiac d. Loose, foul-smelling stools

Give the child a choice of beverage to mix with a laxative.

Which intervention should be included in the nurses plan of care for a 7-year-old child with encopresis who has cleared the initial impaction? a. Have the child sit on the toilet for 30 minutes when he gets up in the morning and at bedtime. b. Increase sugar in the childs diet to promote bowel elimination. c. Use a Fleet enema daily. d. Give the child a choice of beverage to mix with a laxative.

Onset is usually rapid and acute.

Which statement best characterizes hepatitis A? a. The incubation period is 6 weeks to 6 months. b. The principal mode of transmission is through the parenteral route. Test Bank - Maternal Child Nursing Care by Perry (6th Edition, 2017) 673 c. Onset is usually rapid and acute. d. There is a persistent carrier state.

Hypertonic dehydration

Which type of dehydration results from water loss in excess of electrolyte loss? a. Isotonic dehydration c. Hypotonic dehydration b. Isosmotic dehydration d. Hypertonic dehydration