mother/baby chapter 41

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis?

Coping with stress and avoiding triggers

What is used to treat moderate-to-severe inflammatory bowel disease?

Corticosteroids

Which vaccine is now recommended for the immunization of all newborns?

Hepatitis B vaccine

First priority

Promptly administer an intramuscular (IM) dose of epinephrine.

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by

Antihistamines.

A high-fiber food that the nurse could recommend for a child with chronic constipation is:

Popcorn

A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux?

Thicken formula with rice cereal.

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss

A nurse is conducting dietary teaching on high-fiber foods for parents of a child with constipation. Which foods should the nurse include as being high in fiber (Select all that apply)?

Whole grain breads Bran pancakes Raw carrots

Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings?

Hepatitis A

Which description of a stool is characteristic of intussusception?

"Currant jelly" stools

Acute diarrhea is often caused by:

Antibiotic therapy.

Fourth priority

Call Jason's parents and notify them of the situation.

Nurses must be alert for increased fluid requirements when a child has:

Fever

Which statement is most descriptive of Meckel's diverticulum?

Intestinal bleeding may be mild or profuse.

A young child is brought to the ER with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with:

Intravenous fluids.

A child has a nasogastric (NG) tube to continuous low intermittent suction. The physician's prescription is to replace the previous 4-hour NG output with a normal saline piggyback over a 2-hour period. The NG output for the previous 4 hours totaled 50 mL. What milliliter/hour rate should the nurse administer to replace with a normal saline piggyback? _____ Record your answer as a whole number.

25 The previous total 4-hour output was 50 mL. To run the 50 mL over a 2-hour period, the nurse would divide 50 by 2 = 25. The normal saline replacement fluid would be run at 25 mL/hr.

Which clinical manifestation would most suggest acute appendicitis?

Abdominal pain that is most intense at McBurney's point

Second priority

Call 911 and wait for the emergency response personnel to arrive.

A parasite that causes acute diarrhea is

Giardia lamblia.

Which intervention should be included in the nurse's plan of care for a 7-year-old child with encopresis who has cleared the initial impaction?

Give the child a choice of beverage to mix with a laxative.

What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux?

Teach the parents how to do infant cardiopulmonary resuscitation (CPR).

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include

Teaching the family signs of central venous catheter infection.

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition?

Bacterial gastroenteritis

The earliest clinical manifestation of biliary atresia is:

Jaundice

The best chance of survival for a child with cirrhosis is:

Liver transplantation.

An infant with pyloric stenosis experiences excessive vomiting that can result in:

Metabolic alkalosis.

A 3-year-old child with Hirschsprung's disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:

Necessary because it will be an adjustment.

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurse's response should be based on knowledge that this drug is:

Not indicated.

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to:

Notify the practitioner.

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching?

Oatmeal

Which statement best characterizes hepatitis A?

Onset is usually rapid and acute

Therapeutic management of the child with acute diarrhea and dehydration usually begins with:

Oral rehydration solution (ORS).

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be to:

Recognize that negative feelings toward the child continue throughout childhood.

A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to:

Reduce gastric acid production.

During the first few days after surgery for cleft lip, which intervention should the nurse do?

Remove restraints periodically to cuddle infant.

The viral pathogen that frequently causes acute diarrhea in young children is:

Rotavirus

Which type of hernia has an impaired blood supply to the herniated organ?

Strangulated hernia

What is the major focus of the therapeutic management for a child with lactose intolerance?

Teaching dietary modifications

For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia?

A nasogastric tube fails to pass at birth.

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

Elevating the head but giving nothing by mouth.

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply):

Encouraging and helping mother to breastfeed. Recommending use of a breast pump to maintain lactation until infant can suck.

Bismuth subsalicylate, clarithromycin, and metronidazole are prescribed for a child with a peptic ulcer to:

Eradicate Helicobacter pylori.

The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing (Select all that apply)?

Administration of analgesics for pain Intravenous (IV) fluids continued until tolerating fluids by mouth Clear liquids as the first feeding

Which statements regarding hepatitis B are correct (Select all that apply)?

Hepatitis B can be prevented by hepatitis B virus vaccine. Hepatitis B can be transferred to an infant of a breastfeeding mother. The onset of hepatitis B is insidious. Immunity to hepatitis B occurs after one attack.

An important nursing consideration in the care of a child with celiac disease is to:

Refer to a nutritionist for detailed dietary instructions and education.

Therapeutic management of most children with Hirschsprung's disease is primarily:

Surgical removal of affected section of bowel.

Third priority

Call Jason's family practitioner to obtain further orders for medication.

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant's postoperative care include:

Cleansing of suture line, supine and side-lying positions, and arm restraints

Which type of dehydration results from water loss in excess of electrolyte loss?

Hypertonic dehydration

Caring for the newborn with a cleft lip and palate before surgical repair includes:

Providing satisfaction of sucking needs.

What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus?

Crohn's disease

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include:

Brushing teeth or rinsing mouth after vomiting.

An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of:

Dehydration

Which interventions should a nurse implement when caring for a child with hepatitis (Select all that apply)?

Provide a well-balanced, low-fat diet. Teach parents not to administer any over-the-counter medications. Instruct parents on the importance of good hand washing.

When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is

Sudden relief from pain.