Exam 4, Peds GI

When obtaining the nursing history from the mother of an infant with suspected intussusception, which question would be most helpful? 1. what do the stools look like 2. when was the last time your child urinated 3. is your child eating normally 4. has your child had any episodes of vomiting

1

A child with Hirschsprung disease is to be discharge 1-2 days after a colostomy takedown surgery. After teaching the infants parents about the overall effects of their infants surgery, the nurse determines that the teaching has been effective when the parents make what statement? 1. his abdomen will be large for a while 2. toilet training may be difficult 3. we need to limit his intake of dairy products 4. we will give him vitamin supplements until he is an adolescent

2

After teaching the parents of a neonate diagnosed with TEF about this anomaly, the nurse determines that the teaching was successful when the parents describe the condition in which way? 1. the muscle below the stomach is too tight, causing the baby to vomit forcefully 2. there is a blind upper pouch and an opening from the esophagus into the airway 3. the lower bowel is lacking certain nerves to allow normal function 4. a part of the bowel is outside without anything covering it

2

When assessing a 4 month old diagnosed with possible intussusception, the nurse should expect the parent to relate what info about the infant crying and episodes of pain? 1. constant accompanied by leg extension 2. intermittent with knees drawn to chest 3. shrill during ingestion of solids 4. intermittent while being held

2

When teaching the mother of than infant who has received temporary colostomy for treatment of Hirschsprung disease about how the stoma should normally appear, the nurse should include which description about the stoma appearance in the teaching? 1. becoming dark brown in 2 months 2. staying deep red in color 3. changing to several shades of pink 4. turning almost purple in color

2

Which assessment should be priority for an infant who has had surgery to correct an intussusception and is now at risk for development of paralytic ileus post op? 1. measurement of urine specific gravity 2. auscultation of bowel sounds 3. inspection of first stool passed 4. measurement of gastric output

2

Which behavior exhibited by the parents of an infant with pyloric stenosis should the nurse correctly interpret as a positive indication of parental coping? 1. telling the nurse they have to get away for a while 2. discussing the infant care realistically 3. repeatedly asking if their child is normal 4. exhibiting fear that they will disturb the infant

2

A 4 week old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse should anticipate that the infants vomitus would contain gastric contents and which other body substances? 1. bile and streaks of blood 2. mucus and stool 3. mucus and streaks of blood 4. stool and bile

3

A parent of a 7 year old with Hirschsprung disease and chronic constipation asks about increasing dietary fiber in the childs diet. Which food would the nurse recommend? 1. fruit juice 2. white bread 3. popcorn 4. pancakes

3

After teaching the parents of an infant diagnosed with Hirschsprung disease, the nurse determines that the parents understand the diagnosis when the parent makes which statement? 1. there are congenital polyps obstructing the colon 2. a section of the colon is constricted 3. the nerves at the end of the large colon are missing 4. there is a weakened area in the colon that is inflamed

3

An infant diagnosed with Hirschsprung disease is scheduled to receive a temporary colostomy. When the nurse is initially discussing the diagnosis and treatment with the parents, which action by the nurse would be most appropriate? 1. assess the adequacy of their coping skills 2. reassuring them that their child will be fine 3. encourage them to ask questions 4. giving them printed material on the procedure

3

The parents report that their 1 day old is drooling and have choking episodes with excessive amounts of mucus and color changes, especially during feedings. The nurse should contact the HCP to further assess the baby and request which prescription? 1. a lactation consultation 2. an arterial blood gas 3. x-ray for gastric tube placement 4. serum blood glucose

3

When developing a pre op plan of care for an infant with Hirschsprung disease, the nurse should include with intervention? 1. administering a tap water enema 2. inserting a gastrostomy tube 3. restricting oral intake to clear liquids 4. using povidone-iodine solution to prepare the perineum

3

A newborn is admitted with pyloric stenosis is lethargic and has poor skin turgor. The HCP has prescribed IV fluids of dextrose water with sodium and potassium. The baby admission potassium is 3.4. What should the nurse do first? 1. notify HCP 2. administer prescribed fluids 3. verify that the infant is urinating 4. have the potassium level redrawn

3 the nurse must verify baby has the ability to pass potassium through urination before administering

A newborn who had a surgical repair of a TEF is started on oral feedings. What should the nurse include in the teaching plan for the parent about oral feedings? 1. they are better tolerated when larger but less frequent feedings are offered 2. they should be offered on a feeding schedule to help the infant accept the feedings more readily 3. they are best accepted by the infant when offered by the same nurse or the infant parents 4. they are best planned in conjunction with the observations of the infants behavioral cues

4

After surgery to repair a tracheoesophageal fistula, an infant receives gastrostomy tube feedings. The nurse continues holding the infant for about 15 min after the feeding primarily to help accomplish what need? 1. promote intestinal peristalsis 2. preventing regurgitation of formula 3. relieve pressure on the surgical site 4. associate eating with a pleasurable experience

4

A NG tube inserted during surgical correction of intussusception is no longer freely removing gastric secretions. What should the nurse do next? 1. verify tube placement 2. irrigate tube 3. increase level of suction 4. rotate tube

1

After surgery to correct pyloric stenosis, the nurse instructs the parents about the postop feeding schedule. The parent exhibit understanding of these instructions when they state that they can start feeding the child within what time frame? 1. 6 hours 2. 8 hours 3. 10 hours 4. 12 hours

1

After the nurse teaches the parent of an infant with pyloric stenosis about the condition, which cause, if stated by the parent, indicated effective teaching? 1. an enlarge muscle below the stomach 2. a telescoping of the large bowel into the smaller bowel 3. a result of giving the baby more formula than is necessary 4. a genetically smaller stomach than normal

1

An infant is to be discharged after surgery for intussusception. What info should the nurse include in the discharge teaching plan? 1. the infant will experience a change in the normal home routine 2. the infant can return to the prehospital routine immediately 3. the infant needs to ingest more calories at home than what was consumed in the hospital 4. the infant will continue to experience abdominal cramping for a few days

1

The parents of a child with a tracheoesophageal fistula express feelings of guilt about their baby's anomaly. Which approach by the nurse would best support the parents? 1. helping the parents accept their feelings as a normal response 2. explaining that the parents did nothing to cause the newborns defect 3. encouraging the parents to concentrate on planning their baby's care 4. urging the parents to visit their newborn as often as possible

1

When an infant with pyloric stenosis is admitted to the hospital, which aspect of the plan of care should the nurse implement first? 1. weigh the infant 2. begin IV infusion 3. switch the infant to an oral electrolyte solution 4. orient the mother to the hospital unit

1

An infant diagnosed with Hirschsprung disease undergoes surgery with the creation of a temporary colostomy. Which statement by the parents regarding the colostomy indicates the need for further teaching? 1. the colostomy is only temporary 2. the colostomy will give time for the nerves to return to normal 3. the colostomy may include 2 separate abdominal openings .4. right after the procedure, the stoma may appear purple

2

During the physical assessment of a 4 month old with Hirschsprung disease, the nurse would most likely note which finding? 1. scaphoid-shaped abdomen 2. weight less than expected 3. cyanosis of the fingers and toes 4. hyperactive deep tendon reflexes

2

Which finding would indicate that an infant with a TEF most needs suctioning? 1. barking cough 2. substernal retractions 3. decreased activity level 4. increased respiratory rate

2

After undergoing surgical correction of pyloric stenosis, an infant is returned to the room in stable condition. While standing by the crib, the mother says, "Perhaps if I had brought my baby to the hospital sooner, the surgery could have been avoided." What is the nurses best response? 1. surgery is the most effective treatment for pyloric stenosis 2. try not to worry, your baby will be fine 3. do you feel that this problem indicates that you are not a good mother 4. do you think that earlier hospitalization could have avoided surgery

4

Immediately after the first oral feeding after corrective pyloric stenosis surgery, a 4 week old is fussy and restless. Which action would be most appropriate at this time? 1. encourage parents to hold infant 2. hang a mobile in infants crib 3. give the infant more to eat 4. give the infant a pacifier to suck on

4

When teaching the parents of an infant with Hirschsprung disease who received a temporary colostomy about the types of food the infant will be able to eat, which diet would the nurse recommend? 1. high-fiber diet 2. low-fat diet 3. high-residue diet 4. regular diet

4