Chapter 38: The Child with a Gastrointestinal/Endocrine Disorder

The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first?

"Has your toddler been having different colored stools?

The nurse is instructing new parents on caring for their infant if gastroenteritis symptoms should occur. Which parental statement indicates understanding of appropriate care?

"I should take the baby's temperature and call my health care provider.

The client calls the health care provider's office stating that her preschooler drank laundry detergent from under the sink. Which statement by the parent needs further instruction?

"I will use syrup of ipecac to get it out of my child's system.

The nurse is talking with a parent of an adolescent who is newly diagnosed with type 2 diabetes and asks, "How could this happen? No one in our family has diabetes." What response would be appropriate

"This is caused by insulin resistance from previous pancreatic injury or generalized infection.

The nurse is caring for a child prescribed vancomycin 15 mg/kg IV every 6 hours for peritonitis. The child weights 45 lb (20.5 kg). How many milligrams will the nurse administer to this child in 24 hours?

1230

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition?

Barium enema

Which is most important for caregivers to consider when caring for a newborn with colic?

Colic is temporary; disappears around 3 months of age.

The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. What recommendation would the nurse include in the teaching plan?

Fruit juice

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next?

Give 10 to 15 grams of a simple carbohydrate

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find?

Hard, moveable, olive-shaped mass in the right upper quadrant

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

Hormonal secretion

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?

Intussusception

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care

Maintaining the intravenous (IV) fluid rate as ordered

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?

Regular insulin

A mother brings her 3-month-old infant to the community clinic with complaints of diarrhea for the past week. The infant's vital signs are normal and there are no signs of dehydration. When questioned about her baby's diet, the mother who is bottle-feeding states that she has been giving her baby some baby cereal at night to help her sleep through the night. What teaching intervention would be appropriate for this mother?

Teach the mother that infants are relatively intolerant of starches and may have diarrhea if cereal is offered too soon

The nurse is presenting information related to intestinal parasite infections to a group of community health nurses. One member of the group asks the nurse how she might know if a child had a pinworm infestation. The nurse correctly answers this question by stating which of the following?

The primary symptom of pinworms is intense perianal itching.

What occurs in the gastrointestinal system of the child with Hirschsprung disease?

There is a partial or complete mechanical obstruction in the intestine.

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

A child is diagnosed with gastroesophageal reflux disease and is prescribed drug therapy. The primary health care provider prescribes medication that suppresses acid secretion. The nurse would anticipate administering which drug?

esomeprazole

The nurse teaches a parent to differentiate between regurgitation and vomiting in the infant. The parent correctly states which characteristic of regurgitation? Select all that apply.

occurs with feeding no appearance of distress

Which type of nutrition does the nurse anticipate initiating when an infant with gastroenteritis and dehydration begins solid foods?

oral rehydration solutions

Which congenital condition leads to the infant being hungry, irritable, losing weight, and rapidly becoming dehydrated with the potential of metabolic alkalosis?

pyloric stenosis

The nurse is assessing a 5-year-old child whose parent reports the child has been vomiting lately, has no appetite, and has had an extreme thirst. Laboratory work for diabetes is being completed. Which symptom would differentiate between type 1 diabetes from type 2 diabetes?

recent weight loss

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has

severe dehydration

The mother of a 3-month-old infant is distraught because the child vomits after every feeding. After an assessment, the nurse determines that the infant is experiencing regurgitation and not vomiting. What did the nurse assess in the infant? Select all that apply.

slight sour smell occurs after a feeding runs out of the mouth with no force

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration

sunken fontantels (fontanelles)