Chapter 22 GI EAQ

The nurse is teaching a 2-year-old's parent about necessary dietary restrictions needed to manage celiac disease. Which statement made by the parent indicates effective learning?

"I should provide a bowl of rice in my child's lunch and dinner."

Which factors would the nurse attribute to insensible fluid loss in an infant? Select all that apply.

1. Heat and humidity 2. Body temperature 5. Respiratory rate

What factors contribute to infants' having a greater and more rapid water loss than adults? Select all that apply.

1. Infants lose a large amount of fluid at birth. 3. Infants maintain more extracellular fluid than do adults.

The nurse is aware of the need to maintain water balance in infants. Which infants would the nurse expect to have an increased need for water replacement? Select all that apply.

1. The infant in the radiant warmer 4. An infant receiving phototherapy 5. The febrile infant who is vomiting

An infant with neurologic impairment and delay is receiving several medications, including a proton pump inhibitor. Which of these medications are proton pump inhibitors? Select all that apply.

2. Omeprazole 3. Pantoprazole

What are some clinical manifestations of gastroesophageal reflux in infants? Select all that apply.

2. Spitting up 4. Failure to thrive 5. Excessive crying and arching of the back

What does the care of a newborn with a cleft lip and palate before surgical repair include?

Alternative feeding systems

The nurse assesses a neonate immediately after birth. What is one clinical sign/symptom of tracheoesophageal fistula?

An excessive amount of frothy saliva in the mouth Excessive salivation and drooling are indicative of tracheoesophageal fistulas. The child with a fistula has difficulty managing the secretions, which may cause choking, coughing, and cyanosis.

What should the nurse teach the parents about caring for the infant with gastroesophageal reflux (GER)?

Avoid vigorous play after feedings.

An 8-week-old infant is brought to the clinic. The infant's parents tell the nurse that the baby was thriving and doing well with only a mild amount of jaundice at birth but report that over the past several days the baby has become increasingly irritable and has started passing dark yellow urine and is having difficulty gaining weight. The nurse notices jaundice in the baby's sclerae. With what condition are these clinical manifestations associated?

Biliary atresia

A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution (ORS). The child's mother calls the clinic nurse because the child is also occasionally vomiting. What should the nurse recommend?

Continuing to give ORS frequently in small amounts.

Constipation has recently become a problem for a school-age boy who just started attending a new school. What is the most likely cause of his constipation?

Fear of using bathrooms at school

The nurse is caring for a 6-year-old child who has been brought to the clinic with constipation. The nurse recognizes that constipation may arise as a result of a variety of conditions. Which condition is most commonly associated with constipation?

Hirschsprung disease (HD)

What information should the nurse include when teaching an adolescent with Crohn's disease?

How to cope with stress and adjust to chronic illness

An adolescent who has been consuming a low-sodium diet for a long period is at risk for:

Hyponatremia

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

Hypotonic

The nurse is caring for a child with Crohn disease (CD). What is a distinctive characteristic of CD?

Inflammation results in stiffening of the bowel wall. CD is a form of inflammatory bowel disease. The inflammation may result in the stiffening of the bowel wall. Other manifestations include ulcerations, fibrosis, adhesions, stricture formation, and fistulas to other loops of bowel, bladder, vagina, or skin. Inflammation occurs in any part of the gastrointestinal tract from the mouth to the anus but most often affects the terminal ileum.

Which factor does the nurse associate with chronic diarrhea in a child?

Lactose intolerance

What should the nurse consider when providing support to a family whose infant has just been found to have biliary atresia?

Liver transplantation may be needed eventually. Approximately 80% to 90% of children with biliary atresia will require liver transplantation. When the condition is untreated, death usually occurs by 2 years of age. Long-term survival is possible with surgical intervention; liver transplantation is usually required for long-term survival. Even with surgical intervention most children progress to liver failure and require transplantation.

Which diet is most appropriate for the child with celiac disease?

Low-gluten

The nurse is caring for a child who had an appendectomy following a ruptured appendix and peritonitis. Which intervention does the nurse perform first for the child with risk for infection?

Monitor wound status, integrity, and type of dressing.

A stool specimen from a child with diarrhea shows the presence of eosinophils. With what condition is this finding associated?

Parasitic infection

A patient with gastrointestinal Helicobacter pylori is prescribed triple-drug therapy of bismuth, clarithromycin, and metronidazole as first-line treatment. Which condition does the nurse expect to be present in the patient?

Peptic ulcer disease The triple-drug therapy bismuth, clarithromycin, and metronidazole should be given as a first-line treatment for the patient with gastrointestinal H. pylori infection. This infection of H. pylori results in peptic ulcer disease.

A child has a nasogastric (NG) tube after surgery for acute appendicitis. What is the purpose of the NG tube?

Prevent abdominal distention

What does management of the child with a peptic ulcer often include?

Proton pump inhibitors

What should the nurse teach the parents of an infant with cleft lip (CL) about feeding?

Provide cheek support when feeding. The CL may interfere with an infant's ability to achieve an adequate anterior lip seal. The parent must provide support by squeezing the cheeks together to decrease the width of the cleft. This may be useful in improving the lip seal during feeding.

Infection with which bacterial pathogen that results in acute diarrhea has the highest incidence in infants?

Salmonella Salmonella infection has the highest occurrence in infants; Giardia and Shigella infections have the highest incidence among toddlers. Campylobacter infection has a bimodal presentation that is highest in children younger than 12 months of age, with a second rise in incidence between the ages of 15 and 19 years.

An infant is found to have malrotation of the intestine. What is the therapeutic management to reverse this condition?

Surgery to remove the affected area

When evaluating the extent of an infant's dehydration, the nurse should recognize which symptoms of severe dehydration?

Tachycardia, parched mucous membranes, sunken eyes and fontanels

The nurse reviews the medical record of a child with a cleft palate scheduled for surgery. Which finding suggests possible complications?

The child's hemoglobin content is 8 mg/dL. The rule of tens is followed before a child can undergo a cleft palate surgical repair. The hemoglobin level of the child at the time of surgery should be 10 mg/dL, so a low hemoglobin level may cause complications for the child. Following the rule of tens, the child should be at least 10 weeks old at the time of surgery, and the minimum weight of the child should be 10 pounds to reduce complications. The normal platelet count is 150,000 to 400,000 cells/mcL; this child has normal platelets and is not at risk for bleeding

Which statement best describes Hirschsprung disease?

The colon has an aganglionic segment.

A 2-month-old breastfed infant is receiving oral rehydration solution for acute diarrhea. What instructions should the nurse give the mother about breastfeeding?

To continue breastfeeding

The nurse is caring for an infant with celiac disease. Why does the nurse expect the child to be prescribed a wheat-free diet at all times?

To prevent villous atrophy

A nurse caring for a neonate immediately after birth notices an excessive amount of frothy mucus coming from the child's nose and mouth. What condition does the nurse suspect?

Tracheoesophageal fistula

What should dietary management of a child with inflammatory bowel disease include?

Vitamin supplements

What complication can result when a child ingests an excessive volume of electrolyte-free water?

Water intoxication