peds - GI test yourself

1. A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. The child vomits, finds the pain relieved and calls the nurse. What is the nurse's priority action? A. Cancel the ultrasound and obtain an order for oral Zofran (ondanstron). B. Immediately notify the physician of the child's status. C. Cancel the ultrasound and prepare to administer an intravenous bolus. D. Prepare for probable discharge of patient.

b

1. The nurse is caring for a 7-week-old infant scheduled for a pleurotomy (surgery to treat pyloric stenosis) in 24 hours. Which would the nurse expect to see in the plan of care? A. Keep infant NPO; begin intravenous fluids at ½ maintenance. B. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube (NGT) to low wall suction. C. Obtain serum electrolytes; keep infant NPO; do not attempt to pass NGT due to obstruction. D. Offer infant small, frequent feedings; keep NPO 2-4 hours before surgery.

b

1. The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? A. Feed the infant in the supine position. B. Provide more frequent, smaller feedings. C. Burp the infant less frequently during feedings. D. Thin the feedings by adding water to the formula.

b

Which should be included in the plan of care of 14-month-old whose cleft palate was repaired 12 hours ago? Select all that apply. A. Once liquids have been tolerated, encourage a bland diet such as Jell-O and saltine crackers. B. Administer pain medication on a regular schedule as opposed to an as-needed schedule. C. Use a Yankauer suction catheter on the infant's mouth to decrease the risk of aspiration of oral secretions. d. When discharged, remove elbow restraints. E. Allow the infant to have familiar items of comfort, such as a favorite stuffed animal and a soft, short tipped "sippy" cup.

b, e

1. The nurse is caring for a 3-month-old infant with short bowel syndrome (SBS). The parent asks how the disease will affect their child. The best response by the nurse would be: A. "Because your child has a shorter intestine than most, your child will likely experience constipation and will need to be placed on a bowel regimen." B. "Unfortunately, most children with this diagnosis do not do very well." C. "Because your child has a shorter intestine than most, he will not be able to absorb all the nutrients and vitamins in food and will need to get nutrients in other ways." D. "The prrognosis and course of the disease have changed because hyperalimentation is available."

c

1. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation of this disorder? A. Bile-stained fecal emesis B. The passage of currant jelly-like stools C. Failure to pass meconium stool in the first 24 hours after birth Sausage-shaped mass palpated in the upper right abdominal

c

1. The nurse knows that the Nissen fundoplication involves which of the following? A. The fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter. B. The fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach. C. The fundus of the stomach is wrapped around the inferior esophagus, mimicking a cardiac sphincter. D. The fundus of the stomach is dilated, decreasing the likelihood of reflux.

c

1. Which manifestations would the nurse expect to see in a 4-week-old infant with biliary atresia? A. Abdominal distention, multiple bruises, and hematuria. B. Yellow sclera and skin tones, excessively oily skin, and prolonged bleeding times. C. Abdominal distention, enlarged liver, enlarged spleen, clay-colored stool, and tea-colored urine. D. No manifestations until the disease has progressed to the advanced stage.

c

1. You are caring for a child with cystic fibrosis who receives pancreatic enzymes with large snacks and meals. Which statement by the mother demonstrates good understanding of the proper administration of the supplemental enzymes? A. "I will stop the enzymes if my child is given any antibiotics." B. "I will decrease the dose by half if my child is having greasy stools." C. "I will give the enzymes between meals to provide the best absorption." D. "I will give the enzymes at the beginning of every meal and large snack."

d

A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take? A. Keep NPO until the diarrhea subsides. B. Start hypertonic IV solution C. Offer chicken broth. D. Initiate oral rehydration therapy

d

what are complications of intussusceptiuon

perforation, perotinitis, sepsis, shock, death

what would be pre-op nursing care for a diaphragmatic hernia?

position with head up and abdominal and ft down ngt - decompression positive pressure ventilation - ET tube

adding milk and rice cereal can partially treat what?

GER and may help GERD

nerve cells missing from the last part of the intestine. what is the name of this disorder?

Hirschsprung

pellet like stools may indicate what disease/disorder?

Hirschsprung disease

1. A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy and the anterior fontanel is sunken. The nurse notes that the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? A. Analysis of serum electrolytes B. Urinalysis obtained by bagged specimen C. Urinalysis obtained by sterile catheterization D. Analysis of CBC

a

1. Which child may need extra fluids to prevent dehydration? Select all that apply. A. 7-day-old receiving phototherapy B. A 13-year-old who has just started her menses C. 6-week-old with newly diagnosed pyloric stenosis D. 2-year-old with pneumonia E. 2-year-old with full-thickness burns to chest, back and abdomen

a, c, d, e

mass @ RUQ - what disease/disorder might this finding may be related to

pyloric stenosis

what GI disorder relates with increased peristalsis (think waves and what might that might signifiy in the GI system)

pyloric stenosis

to confirm the diagnosis of HD (hirschpsrung disease), the nurse prepares the child for which of the following tests? barium enema upper GI series rectal biopsy esophagoscopy

rectal biopsy

identify five nursing goals in the post op period for cleft repair

sutute line cleanse suture line with 1/2 st H2O2 elbow/arm restraints (Release on a regular basis to allow movement and cuddling, release one arm at a time in the active child - may need for 4-6 weeks) oral packing - cleft palate repair - will seem like child is having difficulty breathing blended or soft diet when home

what is the purpose of the logan bar

to hold the suture line intact withoput undue pressure. promotes less scarred healing. steri strips are sometimes used.

complications of pyloric stenosis

dehydration obstruction of GI Tract possible aspiration associated with vomiting metabolic alkalosis

when children do not practice pooping on the toilet and they go elsewhere, what is this called? what must be the age of the child for this to be considered this problem?

encopresis; 4 years old

in celiac disease, what is harmful to the patient

gluten

what disease may ribbon-like stools signify

hirschsprung disease

1. A nurse is caring for a child who is suspected to have Enterobius vermicularis. Which of the following actions should the nurse take? A. Initiate IV fluids B. Test the stool for occult blood C. Perform a tape test D. Collect a stool specimen for culture.

c

1. Sarah's parents ask the nurse what will need to be done to relieve her constipation. What is the nurse's best response? A. "Sarah likely has an obstruction and will need surgery." B. "Sarah will likely be given IV fluids." C. "Sarah will likely be given MiraLAX." D. "Sarah will be placed on a clear liquid diet."

c

A nurse is assessing a child who has a rotavirus infection. Which of the following are expected findings? Select all that apply. A. Confusion B. Bloody stools C. Vomiting D. Fever E. Watery stools

c, d, e

this solution is often used for a complication of this condition which causes people to "run to the BR." what is the name of the solution and how is it administered?

ORS (oral hydrating solution)

1. A nurse is caring for a child who has Hirschsprung's disease. Which of the following actions should the nurse take? A. Prepare the family for surgery. B. Initiate bed rest C. Place an NG tube for decompression Encourage a high-fiber, low protein, low calorie diet.

a

1. Sarah's parents ask the nurse in the CF clinic how best to meet her increased nutritional needs when she was an infant. What is the nurse's best response? A. "You may need to change Sarah to a higher calorie formula." B. "You may need to increase the number of fresh fruits and vegetables you give Sarah." C. "You may need to advance Sarah's diet to whole cow's milk because it is higher in fat than formula." D. "You may need to increase Sarah's carbohydrate intake."

a

1. A nurse is teaching a group of parents about Salmonella. Which of the following should the nurse include in the teaching? Select all that apply. A. It is a bacterial infection B. Bloody diarrhea is common C. Incubation period is nonspecific. D. Antibiotics are always used for treatment. Transmission can be from house pets

a, b, e

what defect may require this team of care providers? pediatrics rugery otolaryngology audiology speech and language pathology dentistry (orthodontics)

cleft lip and/or cleft palate

the nurse would expect to see what clinical manifestations in the older infant diagnosed with Hirschsprung disease? A. History of bloody diarrhea, fever, and vomiting. B. Irritability, severe abdominal cramps, fecal soiling. C. Decreased hemoglobin, increased serum lipids, and positive stool for O & P (ova and parasites). D. History of constipation, abdominal distention, and passage of ribbon-like, foul-smelling stools.

d

to differentiate between gastroesophageal reflex (GER) and gastroesophageal reflex disease (GERD) the nurse knows that: a. GER includes symptoms of tissue damage. b. GERD includes development of complications such as failure to thrive, bleeding, and dysphagia. c. GER is associated with respiratory conditions such as bronchospasm and pneumonia. d. GERD may occur without GER.

b. GERD includes development of complications such as failure to thrive, bleeding, and dysphagia

A nurse is teaching a group of parents about E. Coli. Which of the following information should the nurse include in the teaching? Select all that apply. A. It is a foodborne pathogen. B. Severe abdominal cramping occurs. C. It can lead to hemolytic uremic syndrome. D. Watery diarrhea is present for more than 5 days. E. Antibiotics are given for treatment.

a, b, c

1. The clinical manifestations common to the child with cystic fibrosis include. Select all that apply. A. Meconium ileus at birth (blockage of the small intestine in a newborn caused by excessively thick intestinal contents (meconium) B. Delayed growth C. Bulky, greasy stools D. Voracious appetite E. Increased weight F. Chronic cough ???????? G. Barrel-shaped chest ??????????

a, b, c, d, f, g

1. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse would most likely expect to see which common presentation of this condition documented in the EHR? A. Incessant crying B. Choking with feedings C. Coughing at nighttime D. Severe projectile vomiting

b

1. Which discharge instruction for a child diagnosed with encopresis should the nurse question?** A. Limit the intake of milk. B. Offer a diet high in protein. C. Obtain a complete dietary log.

b

1. Which manifestation suggests that an infant is developing necrotizing enterocolitis (NEC)?** A. Decreased residuals prior to feedings B. Bloody diarrhea C. Hyperactive bowel sounds D. Decreased abdominal girth prior to feedings

b

1. A nurse is caring for a child who has Meckel's Diverticulum. Which of the following manifestations should the nurse expect? Select all that apply. A. Rapid, shallow breathing. B. Mucous, bloody stools. C. Abdominal pain. D. Fever E. Dark, tarry stools

b, c

1. Which interventions should the nurse include when preparing a care plan for a child with hepatitis? Select all that apply A. Notifying the health care provider (HCP) if jaundice is present. B. Providing a low-fat, well-balanced diet. C. Teaching the child effective hand-washing techniques. D. Instructing the parents to avoid administering medications unless prescribed. E. Arranging for indefinite home schooling because the child will not be able to return to school.

b, c, d

1. The nurse is caring for a 2-year-old child who was admitted to the pediatric floor for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. The parents state that the child has not had a wet diaper for 12 hours. After establishing a saline lock, the nurse reviews the physician's orders. Which order should the nurse question?** A. After the saline bolus, begin maintenance fluids of D5 ¼ NS with 10 mEq KCL/L B. Administer a saline bolus of 10ml/kg, which may be repeated if the child does not urinate. A. Recheck serum electrolytes in 12 hours. B. Give clear liquid diet as tolerated.

a

1. How does the nurse interpret the laboratory analysis of Sarah's stool sample containing excessive amounts of azotorrhea and steatorrhea? A. She is not compliant with taking her vitamins. B. She is not compliant with taking her enzymes. C. She is eating too many foods high in fat. D. She is eating too many foods high in fiber.

b

produces distention proximal to affected segment - megacolon - bowel is hypertrophied and dilates - 25% of all neonatal obstructions. which disorder?

hirschsprung disease

what is the bulging area called in hirschsprung's disease and what is it dilated from?

megacolon, from collection of feces and gas

what are the 3 C's of TEF disorders that represent clinical manifestations

coughing choking cyanosis

1. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? A. Diarrhea B. Metabolic acidosis C. Hyperactive bowel sounds D. Metabolic alkalosis

d

1. A nurse is caring for an infant who is 4 hours postoperative following cleft lip and palate repair. Which of the following actions should the nurse take? A. Offer a pacifier with sucrose. B. Remove the packing in the mouth C. Assess the mouth with a tongue blade D. Place the infant in an upright position

d

treatment of choice for hirschsprung disease

colostomy

1. The nursing management of a child with cystic fibrosis should include (select all that apply): A. Minimizing pulmonary complications B. Promoting growth and development C. Facilitating coping of child and family D. Promoting child's self-esteem

a, b, c, d

A. Follow up with a child psychologist. 1. The nurse is caring for a 4-month-old with gastroespohageal reflux (GER). The infant is due to receive Prevacid (lansoprazole). Based on the medication's mechanism of action, when should this medication be administered? A. Immediately before a feeding B. 30 minutes after the feeding C. In the morning on an empty stomach D. At bedtime

a