Chapter 45: Nursing Care of a Family When a Child Has a Gastrointestinal Disorder
A school-aged girl with Crohn disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan? A. Help her ambulate with the bottles. B. Provide some time to talk to her several times a day. C. Help her give the bottles nicknames and personalities. D. Explain that TPN substitutes for normal food.
B
Which assessment findings suggest that an infant with diarrhea is severely dehydrated? A. moist and flushed skin, fontanels (fontanelles) depressed B. salty saliva and tears with crying C. elevated hematocrit and depressed eye globes D. low specific gravity of urine, moist skin
C
A 1-month-old infant is diagnosed with gastroesophageal reflux. Which intervention should the nurse teach the mother to help with the symptoms of this disorder? A. Hold in a horizontal position while feeding. B. Place on the back immediately after feeding. C. Feed with formula thickened with rice cereal. D. Administer prescribed medications before each feeding.
C
A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described? A. Refusal to eat B. Vomiting about 2 hours after feeding C. Chronic diarrhea D. Vomiting immediately after feeding
D
A 2-month-old infant experiencing severe diarrhea is prescribed intravenous fluid replacement. Before adding potassium to this solution, which assessment should the nurse make? A. Ensure that the child is voiding. B. Ensure that the child is sleeping. C. Ensure that the child is crying with tears. D. Ensure that the child's hands are restrained.
A
A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has: A. severe dehydration. B. failure to thrive. C. malabsorption syndrome. D. risk for fluid volume deficit.
A
A preschooler has celiac disease. The parent is preparing a gluten-free diet. The nurse knows that the parent understands the diet when the parent prepares which breakfast foods? A. Eggs and orange juice B. Wheat toast and grape jelly C. Cheerios (oat cereal) and skim milk D. Rye toast and peanut butter
A
An adolescent is diagnosed with hepatitis A. Which problem should be considered when planning care? A. The adolescent will become fatigued easily. B. The adolescent will be very irritable and perhaps require sedation. C. Hypothermia is common. D. The adolescent's urine will be dark and infectious.
A
During the assessment of a preschooler, the nurse notes that the child has abnormal dryness and thickening of the conjunctiva and dry and scaly skin. Which vitamin deficiency does the nurse suspect this child is experiencing?A. vitamin A B. vitamin B C. vitamin D D. vitamin E
A
Following surgery for pyloric stenosis, an infant should be burped well following feedings primarily to prevent: A. pressure on the incision line. B. abdominal discomfort. C. contaminating flatulence. D. intestinal obstruction.
A
The nurse is caring for a 3-year-old with repeated diarrhea. The client is listless and clings to the parent. The nurse reviews the lab work, which reports a pH- 7.33, HCO3- 21, PaCO2- 42. Which would be documented? A. metabolic acidosis B. metabolic alkalosis C. high serum pH D. normal serum pH
A
The nurse is working with a school district to ensure students do not develop food-borne illnesses. Which intervention should the nurse emphasize that supports the 2030 National Health Goals regarding food preparation? A. Refrigerate foods promptly. B. Provide fresh fruits and vegetables. C. Ensure all students are appropriately immunized. D. Examine the number of students who contract food-borne illnesses.
A
The mother of a 3-month-old infant is distraught because the child vomits after every feeding. After an assessment, the nurse determines that the infant is experiencing regurgitation and not vomiting. What did the nurse assess in the infant? Select all that apply. A. slight sour smell B. occurs after a feeding C. accompanied by prolonged crying D. runs out of the mouth with no force E. volume amount similar to entire stomach contents
A,B,D
The nurse suspects that an infant is experiencing intussusception. What did the nurse assess in this infant? Select all that apply. A. crying as if in severe pain B. pulse rate of 78 beats/min and irregular C. sudden drawing up of the legs D. stool that looks like currant jelly E. leg drawing up, and the infant's crying repeats every 15 minutes
A,C,D,E
A school-aged child with Crohn disease will receive enteral nutrition for the next 6 weeks. What parental teaching is needed to support this child's needs? A. Provide feedings during regular meal times. B. Encourage the child to be with the family during meals. C. Provide diversional activities during routine family meal times. D. Explain to the child that this may be a permanent way to eat.
B
The nurse is caring for a 12-year-old child with Crohn disease. What assessment finding will the nurse report to the health care provider when caring for the child? A. clear lung sounds B. fever C. no joint swelling D. report of a headache
B
When providing diaper care to an infant after pyloric stenosis surgery,which approach is indicated? A. Diapers should be folded so that the incision line is well covered to prevent infection. B. Diapers should be folded so that the incision line does not become contaminated. C. Diapers should not be used. D. Sterile diapers should be used.
B
Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed? A. Flatulence B. Vomiting C. Semi formed bowel movements D. Falling asleep at each feeding
B
A 14-year-old child is brought into the emergency room with manifestations consistent with a ruptured appendix. What is the first action that the nurse should take in the care of this child? A. Apply oxygen. B. Position flat in bed. C. Place in the semi-Fowler position. D. Insert an indwelling urinary catheter.
C
A preschool-age child has been experiencing severe vomiting for over 24 hours. The child's respiratory rate is currently 10 breaths/min. On which health problem will the nurse focus when caring for this child? A. overhydration B. metabolic acidosis C. metabolic alkalosis D. hypertonic dehydration
C
An adolescent has hepatitis B. What would be the most important nursing action? A. Conscientious collection of stool for ova and parasites B. Strict calculation of caloric and vitamin B intake C. Strict enforcement of standard precautions D. Close observation to detect cerebral hallucinations
C
The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective? A. "I should offer milk after each episode of diarrhea." B. "I should take the baby's temperature and call my physician." C. "I could give Kaopectate as long as I follow the directions on the bottle." D. "I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."
D
The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period? A. Anxiety related to new feeding method used postoperatively B. Ineffective tissue perfusion related to pressure on heart chambers C. Excess fluid volume related to increased fluid intake prescribed postoperatively D. Risk for infection of incision line, related to disruption of skin barrier during surgery
D
The nurse is demonstrating to the parent how to feed her neonate following pyloromyotomy. Which position is best? A. supine with feet elevated B. Fowler's C. prone D. right side
D
The nurse is instructing new parents on caring for their infant if gastroenteritis symptoms should occur. Which parental statement indicates understanding of appropriate care? A. "I should offer foods and fluid frequently to prevent dehydration." B. "I could give Kaopectate as long as I follow the directions on the bottle." C. "I should offer milk after each episode of diarrhea." D. "I should take the baby's temperature and call my health care provider."
D
