Chapter 45 Nursing care child with a GI disorder

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

The nurse is caring for a pediatric client with idiopathic celiac disease. Which meal will the nurse select for this client? A. Baked salmon, potato slices, vanilla ice cream, and apple juice B. Ham and cheese sandwich, orange slices, chips, and whole milk C. Whole wheat pasta, meatballs, carrot sticks, apple, and water D. Meatloaf, green beans, peanut butter cookie, and fat-free milk

A. Baked salmon, potato slices, vanilla ice cream, and apple juice

A parent brings the 2-week-old newborn to the office because the infant has been experiencing gastroesophageal reflux over the past week. Which intervention(s) should the nurse recommend to the parent at this point? Select all that apply. A. Feed the infant a formula thickened with rice cereal. B. Consult the heath care provider regarding having botulinum toxin injected into the lower esophageal sphincter. C. If breastfeeding, switch to feeding the infant formula. D. Consult a pediatric surgeon regarding having a myotomy procedure performed. E. Feed the infant while holding the infant in an upright position. F. Keep the infant upright in an infant chair/car seat for 30 minutes after feeding.

A. Feed the infant a formula thickened with rice cereal. E. Feed the infant while holding the infant in an upright position. F. Keep the infant upright in an infant chair/car seat for 30 minutes after feeding.

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? A. Hard, moveable, olive-shaped mass in the right upper quadrant B. Sausage-shaped mass in the upper mid-abdomen C. Abdominal pain in the epigastric or umbilical region D. Tenderness over the McBurney point in the right lower quadrant

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

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. Projectile vomiting B. Explosive diarrhea C. Frequent urination D. Severe abdominal pain

A. Projectile vomiting

A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described? A. Vomiting immediately after feeding B. Refusal to eat C. Vomiting about 2 hours after feeding D. Chronic diarrhea

A. Vomiting immediately after feeding

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor? A. "The cause of this disease can be treated very simply." B. "It is important to increase the intake of protein for these children." C. "The highest incidence of this disease is seen in children who are adolescents." D. "These children have a severe deficiency of vitamin D."

B. "It is important to increase the intake of protein for these children."

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 gastroesophageal reflux? A. There are recurrent paroxysmal bouts of abdominal pain. B. In this disorder the sphincter that leads into the stomach is relaxed. C. A thickened, elongated muscle causes an obstruction at the end of the stomach. D. A partial or complete intestinal obstruction occurs.

B. In this disorder the sphincter that leads into the stomach is relaxed.

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? A. Encouraging consumption of fruit juice B. Maintaining the intravenous (IV) fluid rate as ordered C. Offering Kool-Aid or popsicles as tolerated D. Encouraging milk products to boost caloric intake

B. Maintaining the intravenous (IV) fluid rate as ordered

What occurs in the gastrointestinal system of the child with Hirschsprung disease? A. There is an invagination or telescoping of one portion of the bowel into a distal portion. B. There is a partial or complete mechanical obstruction in the intestine. C. There is a relaxed sphincter in the lower portion of the esophagus. D. There is a severe narrowing of the lumen of the pylorus.

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

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

C. Effortless vomiting just after the child has eaten

A preschooler has celiac disease. The parent is preparing a gluten-free diet. The nurse knows that the parent understands the diet when the parent prepares which breakfast foods? A. Rye toast and peanut butter B. Cheerios (oat cereal) and skim milk C. Eggs and orange juice D. Wheat toast and grape jelly

C. Eggs and orange juice

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. Short-bowel/short-gut syndrome B. Necrotizing enterocolitis C. Intussusception D. Volvulus with malrotation

C. Intussusception

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality? A. Greasy B. Clay-colored C. Bloody D. Currant jelly-like

D. Currant jelly-like

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. Gastroenteritis B. Ulcerative colitis (UC) C. Short bowel syndrome (SBS) D. Hirschsprung disease

D. Hirschsprung disease

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

D. Persistent, right lower quadrant pain with rebound tenderness

A 7-year-old boy has experienced severe diarrhea resulting from an intestinal virus. The nurse is concerned that the child will develop an acid-base imbalance. Which of the following blood test results would indicate that the boy is experiencing metabolic acidosis A. pH of 7.35, HCO3 of 24 mEq/L B. pH of 7.4, HCO3 of 26 mEq/L C. pH of 7.5, HCO3 of 29 mEq/L D. pH of 7.25, HCO3 of 20 mEq/L

D. pH of 7.25, HCO3 of 20 mEq/L

A young child has presented to the pediatric unit with a swollen abdomen, edema, thin patchy hair, and irritability with growth retardation and muscle wasting. The nurse suspects a malnutrition disorder. The nurse identifies this child to most likely have which condition? A. Vitamin D deficiency B. Vitamin C deficiency C. Marasmus D. Thiamine deficiency E. Kwashiorkor

E. Kwashiorkor

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. hypotonic C. hypertonic D. acidotic

A. isotonic

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is: A. steatorrhea. B. severe diarrhea. C. currant jelly stools. D. projectile stools.

A. steatorrhea.

The nurse is caring for a 3-year-old with repeated diarrhea. The client is listless and clings to the parent. The nurse reviews the lab work, which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented? A. normal serum pH B. metabolic acidosis C. metabolic alkalosis D. high serum pH

B. metabolic acidosis

Which congenital condition leads to the infant being hungry, irritable, losing weight and rapidly becoming dehydrated with the potential of metabolic alkalosis? A. Aganglionic megacolon B. Colic C. Pyloric stenosis D. Intussusception

C. Pyloric stenosis

In understanding the disease of marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following? A. excess of protein and calories B. deficiency of vitamin C and iron C. deficiency of protein and calories D. excess of vitamin C and iron

C. deficiency of protein and calories