Ch. 26

How soon in development is the esophagus and stomach considered identifiable?

4 weeks gestation

The nurse explains to the nursing student the various causes and conditions associated with acute diarrhea. What is included in this discussion? Select all that apply.

Antibiotics, otitis media, and overfeeding

A young teen with a fever and a history of constipation who has been experiencing 10/10 right-sided abdominal pain, suddenly stops crying because "I feel better." What is the nurse's best action?

Assess abdomen

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

Bacterial gastroenteritis

What is necessary for absorption of vitamins A, D, E, and K?

Bile

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. Which of the following should the nurse include?

Brush teeth or rinse mouth after vomiting.

Which agent is associated with alteration of normal intestinal flora by antibiotics?

C-difficile

Which child should the nurse see first?

Child with stridor who appears anxious

Infant who had surgery for necrotizing enterocolitis is now 6 months and has short bowel syndrome. Unable to absorb most nutrients taken by mouth and is dependent on parenteral nutrition, received through broviac catheter. Should be observed for the development of

Cholestasis

Which of the following types of diarrhea is commonly seen in malabsorption syndromes because the intestine cannot absorb nutrients or electrolytes?

Chronic: Chronic diarrhea is commonly seen in malabsorption syndromes. In disorders such as lactose intolerance, the intestine cannot absorb nutrients or electrolytes. Secretory diarrhea is usually caused by bacterial enterotoxins that stimulate fluid and electrolyte secretion. Acute diarrhea is caused by infectious agent in the gastrointestinal tract. Intractable diarrhea of infancy is a syndrome that occurs in the first few months of life and persists longer than 2 weeks with no recognized pathogens.

A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. Instructions to the mother about breastfeeding should include which of the following?

Continue breastfeeding

A nursing student receives report that a child has the diagnosis of failure to thrive. The nurse explains what failure to thrive means. What is included in this explanation? Select all that apply.

Deceleration from growth patterns, A condition that is sometimes accompanied by developmental delays, Consistently remaining below the fifth percentile for height and weight on standard growth charts

Classic signs and symptoms of intussusception are

Diarrhea, anorexia, weight loss, occasional vomiting, and periodic pain. Older child may have pain without other signs and symptoms.

Encouraging intake of fluids by mouth like fruit juices, carbonated soft drinks, and gelatin, does or does not help diarrhea?

Doesnt help with diarrhea. These fluids have a high carbohydrate content, a very low electrolye content, and a high osmolality. Have patients avoid caffeinated beverages because caffeine is a mild diuretic and may lead to increased loss of water and sodium. Chicken or beef broth is not given because it contains excessive sodium and inadequate carbohydrates. BRAT diet (banana, rice, applesauce, and toast/tea) is contraindicated for the child and especially for the infant with acute diarrhea, since this diet has little nutritional value, is high in carbohydrates, and low in electrolytes.

Frothy saliva, apnea, cyanosis, and oxygen desaturation are sigsn of what

EA and TEF Esophageal atresia and tracheoesophageal fistula

Which is most associated with a child with a fecal impaction?

Encopresis

Mineral oil instructions

Given to one year or older, be careful when administering so that aspiration doesnt occur.

The nursing student reviews the many causes of chronic diarrhea. Which are included in this review? Select all that apply.

HIV/AIDS, celiac disease, malabsorption causes

The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. The nurse should do which of the following first?

Have someone call for an ambulance or paramedic rescue squad

A child has constipation, abdominal distension, and ribbon-like stools. What does the nurse suspect?

Hirschsprung disease

5 mos is seen in the well-child clinic for complaint of vomiting and failure to grow. Birth weight was 7 pounds, and he now weighs 8 pounds, 10 ounces. Mother reports hes taking 4-7 ounces of formula every 4-5 hours but spits up a lot after eating then is hungry again. Patient is alert but looks malnourished. Stools are brown in color and he has 1-2 bowel movements every day. Infant has what?

Hypertrophic pyloric stenosis

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child begins with

IV fluid

Hepatitis A virus is transmitted by which of the following

Ingestion of contaminated food and fecal-oral route

Because child with celia disease must limit intake of products containing gluten in wheat, rye, oats, and barley, they are at risk for which of the following nutritional deficiencies?

Iron deficiency anemia, folic acid deficiency, and vit. ADEK deficiency

Which drug therapy is the most effective for a 5-year-old child who has hepatitis B viral (HBV) infection?

Lamivudine

Administration of what stimulate motility and increase risk of perforation with appendix rupture?

Laxatives and enemas

Which specific findings indicate severe dehydration in a child with acute diarrhea? Select all that apply.

Lethargy, sunken eyes, loss of skin turgor, and Dry buccal mucous membranes

Which are true statements associated with pica? Select all that apply.

Nonfood pica example is hair, pica is an eating disorder, and food pica example is coffee grounds

16 mos. has hx of diarrhea for three days with poor oral intake. Received IV fluids, has tolerated some oral fluids in ED, and is being discharged home. Instructions for diet for this child should include:

Offer regular diet as child's appetite warrants

Therapeutic management of the child with acute diarrhea and dehydration usually begins with which of the following?

Oral rehydration solution

The nursing student asks the nursing instructor about intussusception. Which statements are true about intussusception? Select all that apply.

Passage of red, currant jelly-like stools Associated with sudden acute abdominal pain

Parents reported to the nurse that their child is passing less than three hard stools per week for the past month. After performing oral clean out for 3 days, the child has been put on maintenance therapy. Which oral laxative is the best treatment choice for maintenance therapy?

Polyethylene glycol

The nursing instructor explains the concerns about gastrointestinal disease and its effects on children. What are the most common consequences of gastrointestinal disease in children? Select all that apply.

Poor growth Malnutrition Malabsorption Electrolyte disturbances

Which factors predispose a child to diarrhea? Select all that apply.

Poor sanitation, age of child, lack of clean water, nutritional deficiencies

Which of the following is the viral pathogen that frequently causes acute diarrhea in young children?

Rotavirus: Rotavirus is the viral pathogen that most frequently causes diarrhea in young children. Giardia is a bacterial pathogen that causes diarrhea. Shigella is a bacterial pathogen that is uncommon in the United States. Salmonella is a bacterial pathogen that causes diarrhea.

A child has been experiencing acute diarrhea for the past couple days. The practitioner suggests to first treat with oral rehydration therapy (ORT). What are the advantages of ORT? Select all that apply.

Safer Less painful More effective Less costly than IV fluids

Peritonitis signs aside from fever are

Sudden relief from pain after perforation, subsequent increase in pain which is usually diffuse and accompanied by rigid guarding of the abdomen. Progressive abdominal distention, tachycardia, rapid/shallow breathing as the child refrains from using abdominal muscles, pallor, chills, irritability, and restlessness

Which is the most effective diagnostic test to diagnose Meckel diverticulum in a child?

Technetium-99 pertechnetate scan

Why does a nurse administer antipyretics to a child with acute diarrhea?

To reduce high temperature

4 mos old with biliary atresis and significant urticaria can anticipate administering

Ursodiol (ursodeoxycholic acid)

A young child is experiencing chronic constipation. Which interventions does the nurse recommend to promote regular bowel elimination? Select all that apply.

Use of polyethylene glycol Establish bathroom use routine Increase dietary fiber and fluid

A child is experiencing a fever, rigid abdomen, and is bending over, holding his right lower abdomen. What does the nurse suspect is the likely cause of this?

appendicitis

Which conditions are associated with acute, severe pain? Select all that apply.

appendicitis, intussusception

Which findings are most associated with ulcerative colitis? Select all that apply.

bloody diarrhea, abdominal pain

What is the similarity between an umbilical hernia and an inguinal hernia?

both more prominent when infant is crying

Which drug may be prescribed for a critically ill infant in an intensive care unit and is a histamine receptor antagonist that suppresses gastric acid production?

cimetidine

Which processes are necessary for the body to convert nutrients into forms it can use? Select all that apply.

digestion, absorption, metabolism

After digestion is complete, what are the simplified nutrient end products? Select all that apply.

fatty acids and amino acids

A child has swallowed a couple of magnets that are partially obstructing the airway. What is the priority intervention for this emergency?

flexible endoscopy removal

A teen has a sigmoid colon bleed. He describes his stool as bright red. The nurse documents this stool as what?

hematoschezia

When reviewing the endocrine causes of chronic diarrhea, the nursing instructor includes which medical problems? Select all that apply.

hyperthyroidism, addison disease, and congenital adrenal hyperplasia

Which are causes of chronic diarrhea? Select all that apply.

immunodeficiency, malabsorption syndromes, inflammatory bowel diseases

Which condition in the child brought to the emergency department is the likely cause of the symptoms of vomiting, fever, and diarrhea?

infection

Which are causes of acute diarrhea? Select all that apply.

laxatives, antibiotic therapy, URI

An 8-year-old child with a stomach ulcer passes a dark-colored, tarry stool. As what does the nurse document this?

melena

Which nursing actions are important in the care of a patient with cirrhosis after a liver biopsy?

monitoring hemoglobin and hematocrit

Which signs might prompt the nurse to call for immediate assistance while monitoring a child admitted with acute gastrointestinal bleeding? Select all that apply.

pallor, poor cap. refill, and increased HR

Which symptom does the nurse identify as the most common clinical manifestation of gastroesophageal reflux (GER) in an infant

passive regurgitation

The nurse is assessing newborn male and female twins for the presence of anorectal malformations. Which is an anorectal malformation that the nurse may identify only in the female twin?

persisten cloaca

Enteral feedings are ordered for a young child with burns covering 40% of total body surface area. The nurse should know that

presence of a paralytic ileus does not preclude use of enteral feedings.

The nursing student asks the nursing instructor to clarify the various functions of the gastrointestinal tract. Which functions are included in his explanation? Select all that apply.

secretory, endocrine, absorption, immunologic

A nursing student is trying to determine if a patient has ulcerative colitis or Crohn disease. Which symptoms are most associated with Crohn disease? Select all that apply.

skip lesions and inflammation involves any part of GI tract

Which stage of liver disease does the patient with chronic active hepatitis have if the pathology report of the patient shows fibrosis or scarring?

stage three

Which diagnostic test does the nurse choose to detect carbohydrate malabsorption in a child?

stool pH

Which are common causes of functional constipation among school-age children? Select all that apply.

stresses, environmental changes, and change in toiletting pattern

Which clinical manifestation in a child should be considered as the first sign suggestive of an obstruction in the pylorus?

vomiting of gastric contents