Pediatric GI
The day after undergoing abdominal appendectomy, a school-aged child is prepared for ambulation. Which nursing action would be most effective before the start of ambulation?
Administering the prescribed pain medication
Which manifestation of hypertrophic pyloric stenosis in an infant would the nurse expect when palpating the abdomen?
An olive-sized mass in the right upper quadrant
An infant has had a pyloromyotomy performed after the diagnosis of hypertrophic pyloric stenosis. In which position would the nurse teach the mother to place the infant during and after feeding?
At a 90-degree angle for feedings; on the right side with the upper body elevated afterward
After several episodes of abdominal pain and vomiting, a 5-month-old infant is admitted with a tentative diagnosis of intussusception. Which assessment would the nurse document that will aid confirmation of the diagnosis?
Characteristics of stools
Which clinical finding would the nurse recognize as indicative of moderate dehydration in a 4-month-old infant?
Depressed anterior fontanel
Which assessment would the nurse perform while caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)?
Signs of dehydration
A 3.5-year-old child is admitted to the hospital for an appendectomy. Which strategy would the nurse use to prepare the child for the hospital experience?
Therapeutic play
Which assessment would be the most accurate method of monitoring the hydration status of a 2-month-old infant admitted with diarrhea and dehydration?
obtaining daily weights
List in order of priority the techniques the nurse should use when assessing a child's abdomen with suspected appendicitis.
1.Asking where it hurts 2.Visually examining the abdomen 3.Warming the stethoscope's diaphragm 4.Auscultating for bowel sounds 5.Assessing the abdomen by touch
Which family history would the nurse recognize as a risk factor for an infant developing hypertrophic pyloric stenosis (HPS)?
A first cousin underwent surgery for HPS
A severely dehydrated infant with gastroenteritis is admitted to the hospital and nothing-by-mouth (NPO) status is prescribed. The nurse explains that this order is necessary for which reason?
Allow the intestinal tract to rest
Which nursing assessment indicates dehydration in an infant?
Decreased urine output
Which clinical finding would the nurse expect when assessing a 3-week-old infant with hypertrophic pyloric stenosis who is severely dehydrated?
Depressed anterior fontanel
Which assessment finding would the nurse report to the primary health care provider because it likely indicates pyloric stenosis
Peristaltic waves that traverse the epigastrium
Which parent education would the nurse provide the mother of an infant recently treated for severe dehydration related to diarrhea?
Signs of dehydration
A child is admitted to the pediatric unit for an appendectomy. Which question would the nurse ask to determine what the child thinks is the reason for hospitalization?
"What are you doing at the hospital?"
The nurse is caring for a child who has undergone laparoscopic appendectomy. Which interventions would the nurse document on the child's clinical record? Select all that apply. One, some, or all responses may be correct.
I/O, Measurement of pain, presence or absence of bowel sounds
Which clinical finding would the nurse expect when assessing an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)?
Palpable mass in the epigastric area to the right of the umbilicus
An infant who has been vomiting for 3 days is admitted to the pediatric unit with a diagnosis of hypertrophic pyloric stenosis. Which essential information would the nurse identify during the admission procedure?
Respiratory status, amount and appearance of last voiding
Which parent education would the nurse provide for an infant who is restarting bottle feedings after surgery for hypertrophic pyloric stenosis (HPS)?
Start with small, frequent feedings
A child is diagnosed with dehydration resulting from diarrhea. The child's condition improves and a regular diet is started. Which foods would the nurse suggest that the parents offer their child? Select all that apply. One, some, or all responses may be correct.
Strained bananas, poached eggs, animal crackers.
Which management strategy is the treatment of choice for hypertrophic pyloric stenosis (HPS)?
Surgery
Which assessment finding would the nurse expect for a 2-month-old infant admitted to the pediatric unit with gastroenteritis and dehydration?
Tachycardia
Why is the vomitus of an infant with pyloric stenosis white rather than bile-stained?
There is an obstruction above the opening of the common bile duct
Which education would the nurse provide the parents of an infant with pyloric stenosis?
This is a condition with an excellent prognosis
Which nursing assessments are indicated for an infant being admitted with pyloric stenosis and 3 days of vomiting? Select all that apply. One, some, or all responses may be correct.
Tissue turgor, Neurologic status, Amount of last void
Which clinical sign is the most important indication of an accurate degree of dehydration?
Weight loss
Which explanation would the nurse provide the mother of an infant who vomits the first feeding after corrective surgery for hypertrophic pyloric stenosis?
"This often occurs after the first feeding."
An infant with a 3-day history of decreased fluid intake and diarrhea is admitted with dehydration and lethargy. Which explanation would the nurse give the parent for the infant's rapid deterioration?
The extracellular fluid requirement per unit of body weight is greater in infants than in adults.
Which clinical manifestations would the nurse expect to assess in an infant diagnosed with hypertrophic pyloric stenosis (HPS)? Select all that apply. One, some, or all responses may be correct.
White vomitus, peristaltic waves, insatiable hunger
Which physical assessment finding would the nurse expect in a 9-month-old infant with severe dehydration?
Weak, rapid pulse
