Chapter 22: The Child with GI Dysfunction

The nurse is caring for a 4month old infant with biliary atresia and significant urticaria can anticipate administering

Ursodiol

While gathering admission data on a 16 month old child, the nurse notes all the following abdominal findings. Which finding is related to a diagnosis of Hurschsprung's disease

Weighs less than expected for height and weight

Hep A virus is transmitted by which of the following SATA Breast milk from mother with AHV Ingestion of contaminated food Fecal-oral route Casual contact with infected person Blood transfusion

b, c

Dietary mgmt of a child with inflammatory bowel disease should include

vitamin suppl

The nurse assesses a neonate immediately after birth. Clinical s/s of tracheoesophageal fistula is

Excessive amount of frothy saliva in the mouth

In performing a work up for a school aged child who reports frequent abdominal pain symptoms, what information would be critical to collect in order to make an accurate clinical diagnosis

Find out the duration, onset, and quality of characteristics of the symptoms

What clinical manifestations would the nurse expect to find in a newborn who has developed necrotizing enterocolitis

Gastric residual and melena

A 5 month old infant is seen in the well child clinic for a complaint of vomiting and failure to grow. His birth weight was 7lbs and now he weighs 8lbs, 10oz. The infant's mother reports that he is taking 4-7 ounces of formula every 4-5 hours but he "spits up a lot after eating and then is hungry again". The child is noted to be alert but appears malnourished. The mother reports his stools are brown in color and he has 1-2 bowel movements everyday. Based on these findings, the nurse anticipates the infant has

Hypertrophic pyloric stenosis (HPS)

Which factor predisposes an infant to fluid imbalances

Immature kidney functioning

A child has been diagnosed with Hep A and received treatment. Based on this information the nurse determines that

Immunity has been acquired for this type

A 4 year old child is admitted to the unit with moderate dehydration. Which of the following symptoms led to the physicians to diagnosis of moderate dehydration in this child

Increased thirst and urine spec gravity of 1.038

When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember

Infants have a greater body surface area than adults do

What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia

Liver transplantation may be needed eventually

Which diet is most appropriate for the child with celiac disease

Low-gluten diet

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 intussusception, the child passed a normal brown stool. What is the most appropriate nursing action

Notify the physician

A 16 month old has a history of diarrhea for 3 days with poor oral intake. He received IV fluids, has tolerated some oral fluids in the ED and is being discharged home. Instructions for diet for this children should include

Offer a regular diet as child's appetite warrants

An infant with neurologic impairment and delay is receiving several meds. A PPI is one of the meds the infant is receiving. Which med(s) is/are PPIs SATA Ranitidine (Zantac) Omeprazole (Prilosec) Pantoprazole (Protonix) Glycopyrrolate (Robinul) Bethanechol (Urecholine)

Omeprazole (Prilosec) Pantoprazole (Protonix)

Mgmt of the child with a peptic ulcer often includes

PPIs

A 6 week old is brought to the pediatrician's office with a history of frequent vomiting after feedings and failure to gain weight. The diagnosis is Gastroesophageal reflux is made and discharge instructions are begun. While planning discharge teaching on feeding techniques with the parents, the nurse should include instructions to

Position the infant at a 30-45 degree angle after feedings

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

Prevent abdominal distention

The care of a newborn with a cleft lip and palate before surgical repair includes

Providing non nutritive and nutritive sucking

When considering Crohn's and Ulcerative Colitis (UC) as disease states, which clinical symptoms may appear to be common presentations in both

Rashes and joint pain

A child is exhibiting signs of clinical dehydration. Which lab value would support a diagnosis of hypertonic dehydration

Serum sodium level of 150

When evaluating the extent of an infant's dehydration, the nurse should recognize that the symptoms of severe dehydration (15%) are

Tachycardia, parched mucous membranes, sunken eyes and fontanels

The nurse is discussing home care with the mother of a 6 year old child with Hep A. part of the discharge teaching plan should include

Teach infection control measures to family members

The parents of a child being evaluated for celiac disease ask the nurse why it is important to make dietary changes. Select the nurse's best response

The body's response to gluten causes damage to the mucosal cells in the intestine leading to absorption problems

Which statement best describes Hirschsprung disease

The colon has aganglionic segment

Because many children with celiac disease require parenteral nutrition therapy, they are at risk for which of the following nutritional deficiencies when the PN is discontinued? SATA Iron deficiency anemia Folic acid deficiency Zinc deficiency Vitamin A, D, E and K deficiency Vitamin B12 deficiency

A, B, D

The nurse is caring for a 4 week old infant with biliary atresia. Which of the following manifestations would the nurse expect to see

Abdominal distention, enlarged liver, enlarged spleen, clay-colored stool and tea-colored urine

A 4 year old has ingested a toxic dose of iron. The parent reports that the child vomited and complained of gastric pain an hour ago but "feels fine" now. The parent is not certain when the child ingested the iron tablets. The most appropriate recommendation by the nurse to the parent is to

Bring the child to the hospital immediately

A formerly preterm infant who had surgery for NEC is now 6 months old and has short bowel syndrome. He is unable to absorb most nutrients taken by mouth and is totally dependent on parenteral nutrition, which he receives via a Broviac catheter. The clinic nurse following this infant is aware that this infant should be closely observed for the development of

Cholestasis

A 2 month old breastfed infant is successfully rehydrated with ORS for acute diarrhea. Instructions to the mother about breastfeeding should include to

Continue breastfeeding

A school age child with acute diarrhea and mild dehydration is being given ORS. the child's mother calls the clinic nurse because the child is also occasionally vomiting. What should the nurse recommend

Continue to give ORS frequently in small amounts

What should the nurse include when teaching an adolescent with Crohn disease

Coping with stress and adjusting to chronic illness

You are educating nursing students regarding fluid requirements for pediatric patients who present with comorbidities. Increased need for fluid requirements would be consistent with treatment mgmt for which conditions SATA CHF DKA SIADH Diabetes insipidus Burns

DKA, DI, Burns