Peds - Chapter 20: Nursing Care of the Child With a Gastrointestinal Disorder

The nurse is taking a health history of a 2-year-old girl presenting with a sudden onset of severe vomiting. Which description would suggest an obstruction? a) Bloody vomiting b) Effortless vomiting c) Bilious vomiting d) Projectile vomiting

Bilious vomiting

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. What is the most important instruction to emphasize to the mother to avoid an emergency situation? a) "You may need adhesive remover to ease pouch removal." b) "You must be meticulous in caring for the surrounding skin." c) "Gather all of your supplies before you begin." d) "Call the doctor immediately if the stoma is not pink/red and moist."

"Call the doctor immediately if the stoma is not pink/red and moist."

A nurse is caring for a 6-year-old boy with a history of encopresis. What is the best way to approach the parents to assess for proper laxative use? a) "Describe his bowel movements for the past week." b) "Are you giving him the laxatives properly?" c) "Are the laxatives working?" d) "Tell me about his daily stool patterns."

"Describe his bowel movements for the past week."

The nurse is preparing an 18-month-old for discharge after treatment for dehydration following diarrhea. What instruction would the nurse most likely include in the discharge teaching? a) "Give her plenty of fruit juice or soda." b) "Encourage bananas, applesauce, and crackers." c) "Make sure she gets lots of clear liquids." d) "Offer her flavored gelatin if she is hungry."

"Encourage bananas, applesauce, and crackers."

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching? a) "I need to watch for pain, tenderness, or redness." b) "I can tape a quarter over the hernia to reduce it." c) "Incarceration is rare, but it can occur." d) "My son could have some appearance-related self-esteem issues."

"I can tape a quarter over the hernia to reduce it."

A nurse caring for Paulo, an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears the mother telling her husband that she "feels like crying" every time she looks at their son. What would be the best response from the nurse? a) "Many infants are born with this condition. Your son's palate is not nearly as bad as some cases." b) "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" c) "Your son needs you right now. You should put your negative feelings about his condition aside for his sake." d) "Keep in mind that your son's condition is not life-threatening and can be corrected eventually."

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?"

The nurse is providing instructions to the parents of a 10-year-old boy who has undergone a barium swallow/upper and lower GI for suspected inflammatory bowel disease. Which of the following instructions is most important? a) "Your child could have diarrhea for several days afterward." b) "Your child might have lighter stools for the next few days." c) "Please be aware of any signs of infection." d) "It is very important to drink lots of water and fluids after the test is finished."

"It is very important to drink lots of water and fluids after the test is finished."

A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching? a) "There is gluten hidden in unexpected foods." b) "My daughter is eating more vegetables." c) "There are many types of flour besides wheat." d) "My daughter can eat any kind of fruit."

"My daughter can eat any kind of fruit."

A 3-day-old infant presenting with physiologic jaundice is hospitalized and placed under phototherapy. Which response indicates to the nurse that the parent needs more teaching? 1. "My infant is at risk for dehydration." 2. "My infant needs to stay under the lights, except during feeding time." 3. "My infant can continue to breastfeed during this time." 4. "My infant has a serious liver disease."

"My infant has a serious liver disease."

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? a) "Offer him some orange juice." b) "Encourage him to have some soda." c) "Try some Anbesol or Kank-A." d) "Offer 'magic mouthwash' followed by a popsicle."

"Offer 'magic mouthwash' followed by a popsicle."

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome? a) "Even though milk and pudding are good for her, we don't give her those foods." b) "She loves hotdogs, and we always cut hers up into small pieces." c) "I have learned to make my own bread with no gluten." d) "The soup we eat at our house is all made from scratch."

"She loves hotdogs, and we always cut hers up into small pieces."

The nurse is collecting data on a 2 ½-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? a) "How many times a day does your child urinate?" b) "What foods has your child eaten during the last few days." c) "Tell me about the types of stools you child has been having." d) "How long has your child been toilet trained?"

"Tell me about the types of stools you child has been having."

A physician recommends a gastrostomy for a 4-year-old client with an obstruction. The parents ask the certified wound, ostomy, and continence nurse (CWOCN) what the surgery entails. What is the nurse's best response? a) "The surgery is performed to create an opening between the esophagus and the neck." b) "The surgery will create an opening to the large intestine." c) "The surgery creates an opening between the stomach and abdominal wall." d) "The surgery will create an opening to the small intestine."

"The surgery creates an opening between the stomach and abdominal wall."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? a) "Your child will be treated with oral iron preparations to correct the anemia." b) "The treatment for the disorder will be a surgical procedure." c) "We will give enemas until clear and then teach you how to do these at home." d) "Your child will receive counseling so the underlying concerns will be addressed."

"The treatment for the disorder will be a surgical procedure."

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? a) "We might notice some of the medication in her stool" b) "She might lose some weight initially." c) "This drug helps to control the abdominal cramping." d) "We should not stop this medication abruptly."

"We should not stop this medication abruptly."

The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond? a) "You will most likely have a blood test to check for certain antibodies." b) "You will most likely have viral studies." c) "You will most likely be tested for ammonia levels." d) "You will most likely have an ultrasound evaluation."

"You will most likely have a blood test to check for certain antibodies."

A father brings his 10-year-old daughter in to the physician's office with jaundice, headache, fever, and anorexia, symptoms she has had for the past few days. The nurse should suspect infection of which organ in this client? a) Stomach b) Small intestines c) Esophagus d) Liver

Liver

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as: a) The pharynx and esopagus b) Nerves throughout the abdomen c) The brain and spinal cord d) A protective cushion lining the organs

The pharynx and esopagus

Which client most likely has ulcerative colitis rather than Crohn disease? a) 14-year-old female with full-thickness chronic inflammation of the intestinal mucosa b) 18-year-old male with abdominal pain c) 16-year-old female with continuous distribution of disease in the colon, distal to proximal d) 12-year-old with oral temperature of 101.6° F (38.7° C)

16-year-old female with continuous distribution of disease in the colon, distal to proximal Ulcerative colitis is usually continuous through the colon while the distribution of Crohn disease is segmental. Crohn disease affects the full thickness of the intestine while ulcerative colitis is more superficial.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition? a) Skin tenting b) Perianal skin tags c) Abdominal pain and guarding d) A sausage-shaped mass in the upper midabdomen

A sausage-shaped mass in the upper midabdomen

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? Record your answer using a whole number. ____________mL

48 mL

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for which time frame? a) 7 to 14 days b) 3 to 5 days c) 1 to 3 days d) 5 to 7 days

7 to 14 days

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a) Acute upper GI bleeding b) GI tract obstruction c) Intussusception d) Gastroesophageal reflux

Acute upper GI bleeding

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? a) Explain to the parents that surgical intervention will fix the defect in the baby's lip. b) Ask the parents if they have any questions regarding the care of their child. c) Teach the mother the appropriate technique for breast-feeding an infant with cleft lip. d) Refer the family to a social worker or mental health practitioner.

Ask the parents if they have any questions regarding the care of their child.

The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment? 1. Determine the child's weight 2. Ask if the family has traveled outside of the country 3. Assess circulation and perfusion 4. Send a stool specimen to the lab

Assess circulation and perfusion

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? a) Potatoes b) Toast c) Oatmeal d) Bananas

Bananas

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? a) Endoscopic retrograde cholangiopancreatography b) Surgery c) Barium enema d) Upper endoscopy

Barium enema

In caring for an infant diagnosed with pyloric stenosis, the nurse would anticipate that she would: a) prepare the infant for surgery. b) assist in doing a barium enema procedure on the infant. c) medicate the infant with analgesics. d) change the infant's diet to lactose-free.

prepare the infant for surgery.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a) Determine esophageal contractility b) Detect Helicobacter pylori c) Evaluate gastric pH d) Confirm pancreatitis

Detect Helicobacter pylori a rapid diagnostic procedure used to identify infections by Helicobacter pylori, a spiral bacterium implicated in gastritis, gastric ulcer, and peptic ulcer disease. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a) Bouts of diarrhea with failure to gain weight b) Effortless vomiting just after the child has eaten c) Forceful vomiting followed by the child being eager to eat again d) Severe constipation with occasional ribbon-like stools

Effortless vomiting just after the child has eaten

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a) Effortless vomiting just after the child has eaten b) Severe constipation with occasional ribbon-like stools c) Bouts of diarrhea with failure to gain weight d) Forceful vomiting followed by the child being eager to eat again

Effortless vomiting just after the child has eaten

A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet? a) Rye toast and peanut butter b) Eggs and orange juice c) Cheerios (oat cereal) and skim milk d) Wheat toast and grape jelly

Eggs and orange juice

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a) Pyloric stenosis b) Cleft palate c) Esophageal atresia (EA) d) Hernia

Esophageal atresia (EA)

Inguinal hernia usually occurs in girls. a) True b) False

False

The pH of blood is normally slightly acidic, ranging from 6.85 to 6.95. a) True b) False

False

A nurse reads the medical history of a client who is scheduled for a hernia repair that is termed "reducible." What best describes this type of hernia? a) Its contents can be easily manipulated back into the peritoneal cavity. b) Intestinal obstruction and ischemia may occur. c) The abdominal contents have become trapped. d) The herniated intestines are twisted and edematous.

Its contents can be easily manipulated back into the peritoneal cavity.

A mother brings her 6-month-old infant to the clinic. The child has been vomiting since early morning and has had diarrhea since the day before. His temperature is 38C, pulse 140, and respiratory rate 38. He has lost 6oz since his well-child vist 4 days ago. He cries before passing a bowel movement. He will not breastfeed today. What is the priority? 1. Thermoregulation alteration 2. Pain (abdominal) related to diarrhea 3. Fluid volume deficit related to excess losses and inadequate intake 4. Alteration in nutrition, less than body requirements, related to decreased oral intake

Fluid volume deficit related to excess losses and inadequate intake

The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other patients, the nurse should a) Follow standard precautions b) Discourage anyone from visiting c) Sterilize thermometers between patients d) Wear a mask when handling articles contaminated with feces

Follow standard precautions

The nurse is collecting data on a child who has been brought to the clinic. The child has urticaria, pruritus, stomach pains, and respiratory symptoms. The nurse recognizes that the clinical manifestations noted in this child are commonly seen in which of the following disorders? a) Vitamin deficiency b) Food allergies c) Protein malnutrition d) Calcium insufficiency

Food allergies

A father brings Jacob, age 2, to the health clinic with complaints of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and Jacob is enrolled in a local daycare center. Based on this information, what gastrointestinal condition might the nurse suspect? a) Appendicitis b) Gastroenteritis c) Pancreatitis d) Hirschsprung disease

Gastroenteritis

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a) Sausage-shaped mass in the upper mid abdomen b) Perianal fissures and skin tags c) Abdominal pain and irritability d) Hard, moveable "olive-like mass" in the upper right quadrant

Hard, moveable "olive-like mass" in the upper right quadrant

A 2-month-old boy is admitted to the emergency room with severe diarrhea. Intravenous fluid is prescribed for him. Before adding potassium to this solution, which assessment would you record? a) He "attunes" to a music box. b) He has voided. c) His hands are restrained. d) He cries with tears.

He has voided.

An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? a) He will become fatigued easily. b) His urine will be dark and infectious. c) Hypothermia is common. d) He will be very irritable and perhaps require sedation.

He will become fatigued easily.

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease? a) Low calorie, high carbohydrate b) High carbohydrate, high protein c) High calorie, high fiber d) Low fiber, low calorie

High carbohydrate, high protein

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a) Short bowel syndrome (SBS) b) Hirschsprung disease c) Gastroenteritis d) Ulcerative colitis (UC)

Hirschsprung disease

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? a) Maintaining skin integrity b) Promoting comfort c) Improving hydration d) Preparing family for home care

Improving hydration

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most true about GER a) A partial or complete intestinal obstruction occurs. b) There are recurrent paroxysmal bouts of abdominal pain. c) A thickened, elongated muscle causes an obstruction at the end of the stomach. d) In this disorder the sphincter that leads into the stomach is relaxed.

In this disorder the sphincter that leads into the stomach is relaxed. Gastroesophageal reflux (GER) occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus.

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? a) Necrotizing enterocolitis b) Intussusception c) Volvulus with malrotation d) Short-bowel/short-gut syndrome

Intussusception

A 10-year-old girl with an intestinal virus has been vomiting and has become dehydrated. She says she is mildly thirsty, her skin turgor is poor, and her skin is dry and cool. Her serum sodium level is normal. The nurse recognizes that she has which type of dehydration? a) Isotonic b) Acidotic c) Hypotonic d) Hypertonic

Isotonic Signs and symptoms of isotonic dehydration include the following: mild thirst; poor skin turgor; dry, cool skin; decreased urine output; irritability; and a normal sodium level. Signs and symptoms of hypotonic dehydration include the following: moderate thirst; very poor skin turgor; clammy, cool skin; decreased urine output; lethargy; and a reduced sodium level. Signs and symptoms of hypertonic dehydration include the following: extreme thirst; moderate skin turgor; warm skin; decreased urine output; extreme lethargy; and an increased sodium level. Acidotic is not a type of dehydration.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition? a) History of hypoxia at birth b) Preterm birth c) Maternal use of acetaminophen in third trimester d) Mother age 42 with pregnancy

Mother age 42 with pregnancy

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: a) Dehydration b) Painless rectal bleeding c) Respiratory distress d) Ischemia

Painless rectal bleeding

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse consider as a diagnosis? a) Crohn disease b) Appendicitis c) Ulcerative colitis d) Pancreatitis

Pancreatitis pancreatitis typically has a complaint of abdominal pain, either epigastric, upper left, or upper right quadrant pain that may radiate to the back. Nausea and vomiting, fever, tachycardia, hypotension, and jaundice may be present. Abdominal signs such as abdominal distention, decreased bowel sounds, rebound tenderness, and guarding also may be noted.

he nurse is examining a 7-year-old with suspected appendicitis. Which physical findings would indicate the possibility of appendicitis? a) Tenderness that comes and goes in the lower abdomen b) Persistent, right lower quadrant pain with rebound tenderness c) Intermittent, left lower quadrant pain with rebound tenderness d) Diffuse, intermittent abdominal pain

Persistent, right lower quadrant pain with rebound tenderness

A 3-month-old infant presents with a history of vomiting after feeding. The plan for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention? 1. Poor weight gain 2. Has small "spits" after feeding 3. Sleeps through the night 4. Is difficult to burp

Poor weight gain

A 12-year-old boy has just undergone a liver transplantation and is recovering. After performing a finger stick puncture and assessing the results, the nurse administers a 10% solution of dextrose IV. What is the correct rationale for this intervention? a) Reduction of hypertension b) Prevention of T-cell rejection of the transplanted liver c) Maintenance of electrolyte balance d) Prevention of hypoglycemia

Prevention of hypoglycemia

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a) Frequent urination b) Projectile vomiting c) Explosive diarrhea d) Severe abdominal pain

Projectile vomiting

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? a) Gastroesophageal reflux b) Appendicitis c) Pyloric stenosis d) Peptic ulcer disease

Pyloric stenosis

A child presents with a 2-day history of fever, abdominal pain, occasional vomiting, and decreased oral intake. Which finding would the nurse prioritize for immediate reporting to the physician? 1. Temperature 101.9F 2. Rebound tenderness and abdominal guarding 3. Parents will be leaving the child alone in the hospital 4. Child can tolerate only sips of fluid without nausea

Rebound tenderness and abdominal guarding

If an adolescent has hepatitis B, what would be an important nursing action? a) Strict enforcement of standard precautions b) Conscientious collection of stool for ova and parasites c) Close observation to detect cerebral hallucinations d) Strict calculation of caloric and vitamin B intake

Strict enforcement of standard precautions

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F (40° C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention? a) Feed the child a cracker b) Take a stool culture c) Administer antibiotic therapy d) Administer IV potassium

Take a stool culture

Which of the following is most correct regarding the gastrointestinal system of the child? a) The child's gastrointestinal system is fully matured when the child is born. b) The enzymes secreted by the child's liver and pancreas are much greater in amount than in the adult. c) The child cannot break down and use complex carbohydrates in the same way the adult can. d) The speed with which food passes through the gastrointestinal tract in the child is much slower than in the adult.

The child cannot break down and use complex carbohydrates in the same way the adult can.

The nurse is caring for a 6-month-old girl with diarrhea and dehydration. The mother is concerned because the girl has some patches on her tongue. Which feature indicates a geographic tongue rather than thrush? a) The patches are thick, white plaques on the tongue. b) The patches are light in color on the tongue. c) There are white patches on the erupted teeth. d) There are plaques on the buccal mucosa.

The patches are light in color on the tongue.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of colic? a) In this disorder the sphincter that leads into the stomach is relaxed. b) A thickened, elongated muscle causes an obstruction at the end of the stomach. c) There are recurrent paroxysmal bouts of abdominal pain. d) A partial or complete intestinal obstruction occurs.

There are recurrent paroxysmal bouts of abdominal pain.

Constipation may be initially caused by psychological problems. a) True b) False

True

A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe? a) Vomiting immediately after feeding b) Vomiting about 2 hours after feeding c) Refusal to eat d) Chronic diarrhea

Vomiting immediately after feeding

Noah is an 18-month-old who is brought to the ER with flu-like symptoms. He is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a) cystic fibrosis. b) Hirschsprung disease. c) inflammatory bowel disease. d) gastroesophageal reflux disease.

gastroesophageal reflux disease.

You care for a 12-year-old girl with Crohn disease. A primary assessment you would want to make when caring for her would be to note if: a) she has a temperature. b) her joints are not swollen. c) she has a headache. d) lung sounds are clear.

she has a temperature.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply. a) Applesauce b) Bananas c) Oatmeal d) Corn flakes e) Rye bread f) Skim milk

• Bananas • Skim milk • Applesauce

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply. a) Steatorrhea b) Sunken abdomen c) Polycythemia d) Constipation e) Failure to thrive f) Diarrhea

• Constipation • Diarrhea • Failure to thrive • Steatorrhea

A child with cirrhosis of the liver is admitted to the acute care facility in preparation for a liver transplant. When completing the physical examination, what would the nurse expect to assess? Select all that apply. a) Spider angiomas b) Fatty stools c) Facial erythema d) Jaundice e) Ascites

• Jaundice • Ascites • Spider angiomas Assessment findings associated with cirrhosis include jaundice, ascites, spider angiomas, and palmar erythema. Fatty stools are associated with celiac disease.

The nurse is developing a teaching plan for the parents of an 11-month-old infant with gastroesophageal reflux disease (GERD). The child will be managed medically. What actions would the nurse incorporate into the teaching plan? Select all that apply. a) Burping the infant at the end of the feeding b) Giving the child small frequent feedings c) Thinning the formula with water to ease flow d) Keeping the child upright for 30 minutes after feeding e) Administering prokinetics to empty the stomach quickly

• Keeping the child upright for 30 minutes after feeding • Giving the child small frequent feedings • Administering prokinetics to empty the stomach quickly

12-year-old Hilary is brought to the emergency room by her parents with severe abdominal pain. The nurse performs a physical assessment to check for appendicitis. Which assessment parameters indicate appendicitis? Select all that apply. a) Normal to hyperactive bowel sounds early b) Rebound tenderness present with palpation in the left upper quadrant c) Distended abdomen with unperforated appendicitis d) Hypoactive bowel sounds with perforation e) Low-grade fever, nausea, anorexia, and vomiting f) Irritation and pain in the right lower quadrant

• Normal to hyperactive bowel sounds early • Hypoactive bowel sounds with perforation • Irritation and pain in the right lower quadrant • Low-grade fever, nausea, anorexia, and vomiting

The nurse is positioning an infant who has just had his left-sided cleft lip repaired. What positions are acceptable for this infant? Select all that apply. a) Right side lying b) Left side lying c) Supine d) Prone e) High fowlers

• Right side lying • Supine

The nurse caring for a patient with Crohn disease knows that long-term complications for this patient might include (select all that apply): a) Fistula b) Gallstones c) Pancreatitis d) Short-bowel syndrome e) Stricture f) Intra-abdominal abscess formation

• Stricture • Fistula • Intra-abdominal abscess formation • Short-bowel syndrome Long-term complications may include stricture, fistula, and intra-abdominal abscess formation. Individuals with severe disease who require extensive resection of diseased bowel may be left with short bowel syndrome and long-term dependence on PN.