Pediatrics Chapter 20

A nurse prepares a menu for a patient with Crohn Disease. What is the focus of dietary management for this disease?

High carbohydrate, high protein

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. Which of the following conditions should the nurse suspect in this case?

Intussusception

The nurse is caring for a neonate who has undergone an intestinal pull-through procedure for an imperforate anus. Which of the following would be most important for the nurse to do postoperatively?

Listening for bowel sounds

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:

Painless rectal bleeding

Which of the following assessments would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed?

Vomiting

A nurse is caring for a 6-year-old boy with a history of encopresis. What is the best way to approach the parents to assess for proper laxative use?

"Describe his bowel movements for the past week."

The nurse is collecting data on a 2 ½ year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask?

"Tell me about the types of stools you child has been having."

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?

"We should not stop this medication abruptly."

Which client most likely has ulcerative colitis rather than Crohn disease?

16-year-old female with continuous distribution of disease in the colon, distal to proximal

The infant is listless with sunken fontanels and has been diagnosed with dehydration. The infant is still producing at least 1 mL/kg each hour of urine. The infant weighs 13.2 lb (6 kg). At the minimum, how many milliliters of urine will the infant produce during the next 8-hour shift? Record your answer using a whole number.

48

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for which time frame?

7 to 14 days

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 congenital aganglionic megacolon?

A partial or complete intestinal obstruction occurs.

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which of the following findings would the nurse identify as the hallmark of this condition?

A sausage-shaped mass in the upper midabdomen

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 pyloric stenosis?

A thickened, elongated muscle causes an obstruction at the end of the stomach.

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family?

Ask the parents if they have any questions regarding the care of their child.

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet?

Bananas

A child is diagnosed with intussusception. The nurse anticipates that which of the following would be attempted first to reduce this condition?

Barium enema

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis?

Hard, moveable "olive-like mass" in the upper right quadrant

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. Which of the following goal has the highest priority at this time?

Improving hydration

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?

Isotonic

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, which of the following would the nurse identify as a risk factor for this condition?

Mother age 42 with pregnancy

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which of the following conditions should the nurse suspect in this child?

Pyloric stenosis

The nurse is caring for a 6-month-old infant who was admitted to the emergency room 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104° F (40° C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which of the following is the priority nursing intervention?

Take a stool culture

The nurse is caring for a 6-month-old girl with diarrhea and dehydration. The mother is concerned because the girl has some patches on her tongue. Which of the following features indicates a geographic tongue rather than thrush?

The patches are light in color on the tongue.

Which of the following occurs in the gastrointestinal system of the child with Hirschsprung disease?

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

You care for a 12-year-old girl with Crohn's disease. A primary assessment you would want to make when caring for her would be to note if

she has a temperature.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which of the following foods would be permitted in the diet of the child with celiac syndrome?

• Bananas • Skim milk • Applesauce

Which of the following is most correct regarding the gastrointestinal system of the child?

The child cannot break down and use complex carbohydrates in the same way the adult can.

A mother brings her 10-year-old son to the ER with complaints of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which of the following diseases would the nurse consider as a diagnosis?

Pancreatitis