Ch. 28 The Child with a GI disorder

The nurse explains that the treatment of choice for a child with intussusception is:

A Barium Enema

A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. An acid-base imbalance that the nurse would expect to occur from this persistent vomiting is:

Alkalosis

The finding in a newborn suggestive of tracheoesophageal fistula is:

Choking on the first feeding

An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO2 40, HCO3- 21. The nurse interprets these values as:

Metabolic Acidosis

A mother reports that her child has been scratching the anal area and complaining of itching. Based on this information, the nurse might suspect this child has:

Pinworms

The nurse interviewing parents of an infant with pyloric stenosis would expect the parents to report if the infant has had:

Projectile Vomiting

After reviewing dietary restrictions for celiac disease, the nurse determines that a parent understands the information when she states that a grain that can be eaten by a child with celiac disease is:

Rice

FORMULA

• (100 mL for each of the first 10 kg) + ( 50 mL for each kg 11-20) + (20 mL for each additional kg)/24hour • Example: • Calculate the hourly maintenance fluid rate for a child who weighs 25 kg • (100 mL x 10 kg) + (50 mL x 10 kg) + (20 mL x 5 kg)/24hrs • (1000 mL) + (500 mL) + (100 mL) = 1600 mL/24hrs = 66.7ml/hr • Using this formula the hourly fluid maintenance for this child is 67mL/hr

FORMULA

• 4 / 2 / 1 Method • (4 mL/kg for the first 10 kg) + (2 mL/kg for kg 11-20) + (1 mL/kg for every kg above 20) = hourly rate • Example: • Calculate the hourly maintenance fluid rate for a child who weighs 25 kg • (4 mL x 10 kg) + (2 mL x 10 kg) + (1 mL x 5 kg) = hourly rate • 40 mL + 20 mL + 5 mL = 65 mL/hr Using the 4/2/1 method, this child's hourly maintenance fluid rate is 65 mL/hr

The nurse would expect the stools of a child with celiac disease to have which appearance?

• Bulky, Frothy

When feeding a child with pyloric stenosis, what interventions will the nurse perform? Select all that apply.

• Burp the infant before and during feeding. • Give the feeding slowly. • Refeed if the infant vomits.

Intussusception would be suspected when parents describe the child's stools as:

• Currant Jelly

A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). After gastric lavage is completed, the nurse might expect this child to receive:

• N-acetylcysteine.

What assessment(s) would lead a nurse to suspect Hirschsprung's disease in a 1-month-old infant? Select all that apply.

• Ribbon-like stools • Fever • Failure to thrive • Vomiting • Diminished peristalsis

On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?

• Weight loss of 4 ounces

Following surgery for pyloric stenosis an infant awoke from anesthesia hungry and crying. The nurse should:

• allow one ounce of glucose water at frequent intervals.

A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. The priority goal of the infant's care is to prevent:

• fluid and electrolyte imbalance.

The nurse instructing a mother how to administer oral nystatin suspension prescribed to treat thrush would teach her to:

• use a sterile applicator to swab the medication on the oral mucosa.