Peds Exam 3

The mother of an infant with suspected Hirschsprung disease asks the nurse about the disease because she was too upset to ask the physician. Which explanation by the nurse is best? a. The colon has an aganglionic segment b. It results in frequent evacuation of solids, liquid, and gas c. There is a part of the colon that doesn't have the nerves to function d. It results in excessive peristaltic movements within the GI tract.

c. There is a part of the colon that doesn't have the nerves to function Hirschsprung disease is a mechanical obstruction caused by a lack of motility of a segment of the intestine resulting from the lack of innervation by ganglion cells. This is too technical to use as an explanation to the mother. There is a LACK of peristalsis in the affected segment, which INTERFERES with the evacuation of solid waste.

The nurse is caring for a child with probable intussusception. The child had diarrhea before admission, but while waiting for administration of air pressure to reduce the intussusception, the child passes a normal brown stool. What is the priority nursing action? a. Notify the physician b. Measure abdominal girth c. Auscultate for bowel sounds d. Check vital signs, including BP

a. Notify the physician Passage of normal stool indicates intussusception has resolved. Priority action is notify provider before doing all other options.

Management of a peptic ulcer in a child often includes which component? a. Taking PPIs b. Drinking milk at frequent intervals c. Coping with stress of a chronic illness d. Taking an antacid an hour before meals and at bedtime

a. Taking PPIs PPIs block production of acid, well tolerated, and have infrequent SEs. Milk is not beneficial. PUD is not a chronic illness/it is treatable. PPIs more effective than antacids.

The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What should the nurse include in the teaching plan? a. Teach infection control measures to family members b. Bed rest is important until 1 week after the icteric phase c. The child should not return to school until 3 weeks after the icteric phase d. Give reassurance that hepatitis A cannot be transmitted to other family members

a. Teach infection control measures to family members Hep A contagious via fecal-oral route. Does not have icteric phase. Period of communicability from later half of incubation period, 1 week after onset.

A child with lactose intolerance is learning what foods to eliminate from her diet. Patient education by the nurse has been successful if the teenager chooses which foods to eliminate? a. Spaghetti with meat sauce b. Ice cream sundae c. Yogurt with fruit d. Chocolate milkshake e. Hamburger on a bun with mustard

b. Ice cream sundae c. Yogurt with fruit d. Chocolate milkshake These options contain lactose (dairy).

A teenager who has been recently diagnosed with celiac disease is learning to pick correct food choices. Education by the nurse is successful if which menu is picked by the teenager? a. Macaroni and cheese, baked beans, lemonade b. A turkey sandwich, applesauce, milk c. Cottage cheese, sliced peaches, ice tea d. Spaghetti with meatballs, garlic bread, cola drink

c. Cottage cheese, sliced peaches, ice tea Only totally gluten free option

A neonate has been just diagnosed with biliary atresia. What should the nurse consider when providing support to a family whose infant has just been diagnosed? a. Death usually occurs by 6 mos of age b. Prognosis for full recovery is excellent c. Liver transplantation may be needed eventually d. Children with surgical correction live normal lives

c. Liver transplantation may be needed eventually 80-90% will require liver transplantation. If untreated, death will occur by 2 years. Long-term survival possible with surgical intervention.

The nurse is caring for an infant immediately after returning from having a pyloromyotomy. What actions would the nurse to expecting to perform in the immediate postoperative period? Select all that apply. a. Maintain the infant's head in an elevated position. b. Keep the infant on his left side with the head slight elevated. c. Irrigate the nasogastric tube with sterile water. d. Provide oral care frequently until the infant begins drinking. e. Assure bowel sounds are present before feeding the infant. f. Weigh diapers after oral feedings have been started.

a. Maintain the infant's head in an elevated position. d. Provide oral care frequently until the infant begins drinking. e. Assure bowel sounds are present before feeding the infant. Laying on left side is not appropriate postoperatively. NGT is removed immediately after surgery and irrigated with NS. Diapers weighed whether infant is eating or only on IV infusions.

An adolescent has just been diagnosed with Crohn's disease and is receiving extensive patient education. Nursing care has been appropriate if which topic is explored with the patient? a. Adjusting to chronic illness and preventing spread of illness to others b. Preventing spread of illness to others and nutritional guidance c. Coping with stress and adjusting to chronic illness d. Nutritional guidance and preventing constipation

c. Coping with stress and adjusting to chronic illness Nutritional guidance necessary, but constipation not issue. Adjustment to chronic illness necessary, but inflammatory not infectious.

The mother of a child with a nasogastric tube (NG) after surgery for acute appendicitis asks about the purpose of the tube. Which explanation by the nurse is most appropriate? a. The tube helps to maintain electrolyte balance b. The tube prevents the spread of infection c. The tube helps empty the stomach until bowel activity resumes d. The tube maintains an accurate record of output

c. The tube helps empty the stomach until bowel activity resumes NGT for gastric decompression until return of intestinal activity. NG drainage one part of output. NGT may AE electrolyte balance. No relationship with spread of infection.

The nurse is working with children with inflammatory bowel disease (IBD). What should the nurse include as essential in the dietary regimen? a. Eating a high-protein, low-calorie diet b. Including a low-protein but high-caloric intake c. Ingesting a high-fiber diet d. Taking daily vitamin supplements

d. Taking daily vitamin supplements Multivitamins, iron, and folic acid are recommended. High-protein and high-calorie diet needed. High-fiber worsens IBD.

The nurse assesses a neonate immediately after birth and suspects a tracheoesophageal fistula. Which assessment data would cause the nurse to suspect this defect? a. sneezing clear fluid b. flat anterior and posterior fontanels c. absence of sucking and swallowing d. an excessive amount of frothy saliva in the mouth

d. an excessive amount of frothy saliva in the mouth Excessive frothy saliva and drooling indicative of tracheoesophageal fistulas. Sneezing and flat fontanels are expected findings. Infant able to suck but cannot manage secretions oral intake.