NUR379 Evolve: Pediatric Gastrointestinal System - Gastrointestinal Motility and Malabsorption Conditions

The nurse is giving discharge instructions to the parents of a 6-month-old boy who has been diagnosed with gastroesophageal reflux disease (GERD). Which statement by one of the parents shows a correct understanding of how to care for the infant?

"I will lay him on his back and give him a pacifier to help him sleep."

The nurse is teaching the parents of a child with encopresis about potential symptoms. Which statement by the parents indicates teaching was effective?

"Our child's feces will have a very foul odor most of the time."

After surgery to create a colostomy, a child who is still on NPO (nothing by mouth) status requests a meal. Which response is appropriate for the nurse?

"You cannot eat until I can hear your belly gurgle when I listen to it or when you pass gas."

The nurse is caring for an infant with gastroesophageal reflux disease (GERD). Which assessment findings indicate potential complications?

-10th percentile on the growth chart. -Crackles heard in the lungs on auscultation. -Elevated axillary temperature of 103.6 F.

A child with celiac disease presents with severe diarrhea, a thready pulse, and low blood pressure. Which actions should the nurse take?

-Administer intravenous saline. -Obtain serum electrolyte levels.

The nurse is caring for a child with Hirschsprung disease who has been diagnosed with colon inflammation. Which provider orders would the nurse anticipate?

-Begin preoperative checklist. -Initiate intravenous administration of normal saline.

A nurse is caring for a child recently diagnosed with celiac disease. Which lunch selections are most appropriate?

-Chicken stir-fry with white rice, carrots, onions, and broccoli. -Fresh ham on a corn tortilla with mashed potatoes and mandarin oranges.

The nurse is evaluating a patient with encopresis. Which findings would the nurse expect on assessment after taking patient history?

-Child has fecal stains in the underwear. -Child plays video games for hours alone. -Urinalysis reveals the child's fourth urinary tract infection in 16 months.

Which patient findings indicate to the nurse that treatment of encopresis complications has been effective?

-Child talks about the condition with the nurse. -The child's skin is clean, dry, and free of excoriation. -Parents report the child has a bowel movement every 6 to 8 hours.

Child has severe diarrhea from gastroenteritis. In which ways can the nurse determine whether the child is experiencing dehydration?

-Decreased urine output. -Tenting on the back of hand.

An infant who presents with suspected celiac crisis would have which assessment findings?

-Drowsiness. -Metabolic acidosis.

Which dietary modification should be made for a child with encopresis?

-Eat granola bars. -Increase water intake. -Eat whole-grain cereals.

Which action should the nurse take to decrease the spread of infection from a patient with Clostridium difficile infection?

-Enforce hand washing. -Enforce contact precautions.

The nurse is caring for a child with Hirschsprung disease who has abdominal distention and hard, dry stools. Which food choices would be most appropriate?

-Grapes and apple slices. -Boiled cabbage and broccoli. -Cinnamon raisin granola bars. All high fiber foods?

Match the complication with the appropriate intervention for a child with Hirschsprung disease.

-Impaired skin integrity related to colostomy and surgical repair = Clean the ostomy site. -Risk for deficient fluid volume or excess fluid volume related to surgical preparation = Administer fluid bolus. -Constipation related to ganglionic bowel and inadequate peristalsis = Increase dietary fiber.

The nurse is caring for a child with celiac disease who requires fluid resuscitation. Which assessment findings would the nurse anticipate after treatment has begun?

-Supple skin. -Skin elasticity.

The nurse is preparing a child and the parents for a colostomy. Which situations, facilitated by the nurse, are most appropriate?

-The child and parents are given the opportunity to see the equipment before surgery. -The child and parents are given the opportunity to manipulate the equipment before surgery.

An infant with gastroesophageal reflux disease (GERD) vomits after every feeding. Which provider orders would the nurse anticipate?

-Thicken formula feedings. -Daily abdominal assessment. -Refer infant for respiratory therapy.

The nurse is caring for an infant with gastroesophageal reflux disease (GERD). Which action by a parent, observed by the nurse, indicates teaching was effective?

A pacifier is clipped to the infant's car seat.

A parent of a 6-month-old infant calls the nurse hotline and reports that an infant has had loose stools for the past 12 hours. Which question is most pertinent in the nurse's assessment?

Can you describe the number and character of the stools?

When at home, which intervention is the most important for a child with gastroenteritis?

Encouraging frequent sips of water every few minutes.

A child presents with diarrhea after eating at a local restaurant. Which intervention should the nurse implement first?

Inform the health department.

The nurse is caring for a child with gastroesophageal reflux disease (GERD). Which medications would the nurse anticipate being ordered?

Omeprazole (PRILOSEC).

A 9-year old boy is brought into the health care provider's office with concerns about his reaction to his parent's divorce. The child has been unusually withdrawn and stays in his room, refusing to see anyone, often not even coming out to go to the bathroom. On assessment the nurse notes a foul fecal odor coming from the child. Which complication of constipation would the nurse suspect?

Secondary encopresis.

A child with gastroenteritis is receiving treatment for dehydration. Which assessment findings indicate treatment has been effective?

Serum potassium 3.9 mEq/L.

The nurse is caring for a child with gastroesophageal reflux disease (GERD). The child is feeding and begins to cough and gag. Which action should the nurse take first?

Stop the feeding.

The nurse is caring for a 3-month-old infant diagnosed with gastroenteritis. The parents report vomiting, diarrhea, poor skin turgor, and lethargy. Which additional finding supports the diagnosis of moderate dehydration?

Sunken or depressed fontanel.

The nurse is speaking with the family of a pediatric patient with celiac disease. Which patient symptom, reported by the parents, requires immediate action?

Tearless crying.

Several patients with encopresis are receiving bowel training. Which patient demonstrates successful use of this treatment method?

The child who sits on the toilet for 10 minutes during each visit to the bathroom.

An infant with gastroenteritis presents with severe diarrhea and vomiting. Which assessment finding is most concerning?

Two wet diapers in the last 12 hours.

The nurse is caring for a child with celiac disease. The mother reports that the child attended a birthday party and ate cake. Which assessment finding would the nurse anticipate?

Watery stools.