Pediatric GI

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? 1. Maternal polyhydramnios. 2. Pregnancy lasting more than 38 weeks. 3. Poor nutrition during pregnancy. 4. Alcohol consumption during pregnancy

1. Maternal polyhydramnios is present because the infant cannot swallow andabsorb the amniotic fluid in utero. 2. Many mothers of infants with esophageal atresia deliver early because of the pressure of the unabsorbed amniotic fluid. 3. Although good nutrition is important in every pregnancy, there is not a direct relationship between diet and esophageal atresia. 4. Although alcohol should not be consumed in any pregnancy, there is not a direct link between alcohol and esophageal atresia.

8. Which manifestations should the nurse expect to find in a child in the early stages of acute hepatitis? 1. Nausea, vomiting, and generalized malaise. 2. Nausea, vomiting, and pain in the left upper quadrant. 3. Generalized malaise and yellowing of the skin and sclera. 4. Yellowing of the skin and sclera without any other generalized complaints.

The early stage of acute hepatitis is referred to as the anicteric phase, during which the child usually complains of nausea, vomiting, and generalized malaise. 2. A tender enlarged liver is noted in the right upper quadrant. 3. The child does not appear jaundiced until the icteric phase. 4. The child does not appear jaundiced until the icteric phase. The child usually does not feel well during the early stages of acute hepatitis.

he nurse is interviewing the parents of a 6-year-old who has been experiencing constipation. Which could be a causative factor? Select all that apply. 1. Hypothyroidism. 2. Muscular dystrophy. 3. Myelomeningocele. 4. Drinks a lot of milk. 5. Active in sports

1-4 1. Hypothyroidism can be a causative factor in constipation. 2. Weakened abdominal muscles can be seen in muscular dystrophy and can lead to constipation. 3. Myelomeningocele affects the innervation of the rectum and can lead to constipation. 4. Excessive milk consumption can lead to constipation. 5. Activity tends to decrease constipation and increase regularity

The nurse is caring for a 14-year-old with celiac disease. The nurse knows that the patient understands the diet instructions by ordering which of the following meals? 1. Eggs, bacon, rye toast, and lactose-free milk. 2. Pancakes, orange juice, and sausage links. 3. Oat cereal, breakfast pastry, and nonfat skim milk. 4. Cheese, banana slices, rice cakes, and whole milk.

4. Cheese, banana slices, rice cakes, and whole milk do not contain gluten

The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant 's condition? Select all that apply. 1. There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention. 2. There is excessive peristalsis throughout the intestine, resulting in abdominal distention. 3. There is a small-bowel obstruction, leading to ribbon-like stools. 4. There is inflammation throughout the large intestine, leading to accumulation of intestinal contents and abdominal distention. 5. There is an accumulation of bowel contents, leading to non-passage of stools.

1, 5. Hirschsprung does present with ribbon-like stools, but it does not occur in the small-bowel It is not due to inflammation but a mechanical obstruction, caused by reduced peristalsis from lack of ganglion cells (loss of recto-sphinteric reflex)

The nurse is caring for a 3-year-old who had an appendectomy 2 days ago. The child has a fever of 101.8°F (38.8°C) and breath sounds are slightly diminished in the right lower lobe. Which action is most appropriate? 1. Teach the child how to use an incentive spirometer. 2. Encourage the child to blow bubbles. 3. Obtain an order for intravenous antibiotics. 4. Obtain an order for acetaminophen (Tylenol)

1. Many 3-year-olds have difficulty understanding how to use an incentive spirometer. 2. Blowing bubbles is a developmentally appropriate way to help the preschooler take deep breaths and cough. 3. In the early postoperative period, a fever is likely a respiratory issue and not a result of infection of the incision. 4. Although acetaminophen (Tylenol) maybe administered, encouraging the child to breathe deeply and cough will help prevent the fever from returning.

The nurse receives a call from the mother of a 6-month-old who describes her child as alternately sleepy and fussy. She states that her infant vomited once this morning and had two episodes of diarrhea. The last episode contained mucus and a small amount of blood. She asks the nurse what she should do. Which is the nurse 's best response? 1. "Your infant will need to have some tests in the emergency department to determine whether anything serious is going on." 2. "Try feeding your infant in about 30 minutes; in the event of repeat vomiting,bring the infant to the emergency department for some tests and intravenous re-hydration." 3. "Many infants display these symptoms when they develop an allergy to the formula they are receiving; try switching to a soy-based formula." 4. "Do not worry about the blood and mucus in the stool; it is not unusual for infants to have blood in their stools because their intestines are

1. The infant is displaying signs of intussusception. This is an emergency that needs to be evaluated to prevent ischemia and perforation. 2. The mother should be told not to give the infant anything by mouth and bring the infant immediately to the emergency department. 3. Although similar symptoms may be seen among infants with allergies, a more serious illness must first be ruled out. It is uncommon to see lethargy as a response to an allergy. 4. All bloody stools should be evaluated.

Which manifestation would the nurse expect to see in a 4-week-old infant with biliary atresia? 1. Abdominal distention, enlarged liver, enlarged spleen, clay-colored stool, and tea-colored urine. 2. Abdominal distention, multiple bruises, bloody stools, and hematuria. 3. Yellow sclera and skin tones, excessively oily skin, and prolonged bleeding times. 4. No manifestations until the disease has progressed to the advanced stage.

1.The infant with biliary atresia usuallyhas an enlarged liver and spleen. The stools appear clay-colored because of the absence of bile pigments. The urine is tea-colored because of the excretion of bile salts. 2. The urine typically contains bile salts, not blood. There is usually no blood noted in the stool. 3. The skin is usually dry and itchy, not oily. 4. Manifestations of biliary atresia usually appear by 3 weeks of life

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse 's next action? 1. Cancel the ultrasound and obtain an order for oral ondansetron (Zofran). 2. Cancel the ultrasound and prepare to administer an intravenous bolus. 3. Prepare for the probable discharge of the patient. 4. Immediately notify the health-care provider of the child 's status.

4. the appendicitis is perforated and need to notify PCP to prevent sepsis

Which is the best position for an 8-year-old who has just returned to the pediatric unit after an appendectomy for a ruptured appendix? 1. Semi-Fowler. 2. Prone. 3. Right side-lying. 4. Left side-lying.

3 The right side-lying position promotes comfort and allows the peritoneal cavity to drain.

The nurse is caring for a 7-week-old scheduled for a pyloromyotomy in 24 hours. Which would the nurse expect to find in the plan of care? 1. Keep infant NPO; begin intravenous fluids at maintenance. 2. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube(NGT) to low wall suction. 3. Obtain serum electrolytes; keep infant NPO; do not attempt to pass NGT due toobstruction. 4. Offer infant small frequent feedings; keep NPO 6 to 8 hours before surgery.

2

The nurse is caring for an 8-week-old infant being evaluated for pyloric stenosis.Which statement by the parent would be typical for a child with this diagnosis? 1. "The baby is a very fussy eater and just does not want to eat." 2. "The baby tends to have a very forceful vomiting episode about 30 minutes after most feedings." 3. "The baby is always hungry after vomiting, so I feed her again." 4. "The baby is happy in spite of getting really upset after spitting up."

3

Which should be included in the plan of care for a 14-month-old whose cleft palate was repaired 12 hours ago? Select all that apply. 1. Allow the infant to have familiar items of comfort such as a favorite stuffed animal and a "sippy" cup. 2. Once liquids have been tolerated, encourage a bland diet such as soup, Jell-O,and saltine crackers. 3. Administer pain medication on a regular schedule, as opposed to an as-needed schedule. 4. Use a Yankauer suction catheter on the infant 's mouth to decrease the risk of aspiration of oral secretions. 5. When discharged, remove elbow restraints.

1, 3 1. The child should not be allowed touse anything that creates suction inthe mouth, such as pacifiers or straws."Sippy" cups are acceptable. 2. The child should not have anything hard in the mouth, such as crackers, cookies, or a spoon. 3. Pain medication should be administered regularly to avoid crying, which places stress on the suture line.

Which child may need extra fluids to prevent dehydration? Select all that apply. 1. A 7-day-old receiving phototherapy. 2. A 6-month-old with newly diagnosed pyloric stenosis. 3. A 2-year-old with pneumonia. 4. A 2-year-old with full-thickness burns to the chest, back, and abdomen. 5. A 13-year-old who has just started her menses.

1-4 The lights in phototherapy increase insensible fluid loss, requiring the nurse to monitor fluid status closely. 2. The infant with pyloric stenosis is likely to be dehydrated as a result of persistent vomiting. 3. A 2-year-old with pneumonia may have increased insensible fluid loss as a result of tachypnea associated with respiratory illness. The nurse needs to monitor fluid status cautiously because fluid overload can result in increased respiratory distress. 4. The child with a burn experiences extensive extracellular fluid loss and is at great risk for dehydration. The younger child is at greater risk because of greater proportionate body surface area. 5. An adolescent starting her menses is not at risk for dehydration.

The nurse is to receive a 4-year-old from the recovery room after an appendectomy.The parents have not seen the child since surgery and ask what to expect. Which isthe nurse's best response? 1. "Your child will be very sleepy, have an intravenous line in the hand, and have a nasal tube to help drain the stomach. If your child needs pain medication, it will be given intravenously." 2. "Your child will be very sleepy, have an intravenous line in the hand, and have white stockings to help prevent blood clots. If your child needs pain medication,we will give it intravenously or provide a liquid to swallow." 3. "Your child will be wide awake and will have an intravenous line in the hand. If your child needs pain medication, we will give it intravenously or provide a liquid to swallow." 4. "Your child will be very sleepy and have an intravenous line in the hand. If your child needs pain medication, we will give it intr

1. An NGT is not needed when an appendixhas not ruptured. 2. Anti-embolic stockings are not used in children this young, who will likely be moving the lower extremities and ambulating. 3. The child in the immediate post operative period is usually not wide awake. 4. In the immediate postoperative period,the child is usually sleepy but can be roused. The child usually has an intravenous line for hydration and pain medication.

The nurse is caring for a 3-month-old being evaluated for possible Hirschsprung disease. His parents call the nurse and show her his diaper containing a large amount of mucus and bloody diarrhea. The nurse notes that the infant is irritable and his abdomen appears very distended. Which should be the nurse 's next action? 1. Reassure the parents that this is an expected finding and not uncommon. 2. Call a code for a potential cardiac arrest and stay with the infant. 3. Immediately obtain all vital signs with a quick head-to-toe assessment. 4. Obtain a stool sample for occult blood.

3. want to monitor for signs of enterocolitis: shock F/E balance