Peds 5 chapters Prep U
A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding." "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing." "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."
"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."
A nurse is caring for a 6-year-old boy with a history of encopresis. What is the best way to approach the parents to assess for proper laxative use? "Tell me about his daily stool patterns." "Are the laxatives working?" "Describe his bowel movements for the past week." "Are you giving him the laxatives properly?"
"Describe his bowel movements for the past week."
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? "I should offer milk after each episode of diarrhea." "I should take the baby's temperature and call my physician." "I could give Kaopectate as long as I follow the directions on the bottle." "I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."
"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."
The nurse is caring for a 3-year-old girl with short bowel syndrome as a result of trauma to the small intestine. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. How should the nurse respond? "I will help you become an expert on your daughter's care." "You must learn how to care for your daughter at home." "You really need the support of your husband." "There is a lot to learn and you need a positive attitude."
"I will help you become an expert on your daughter's care."
The parent of a 3-week-old infant brings the infant in for an evaluation. During the visit, the parent tells the nurse that the infant is spitting up after feedings. Which response by the nurse would be most appropriate? "Thicken the formula by adding rice cereal." "Infants this age commonly spit up." "Your child might have an allergy." "Do not worry; you are just feeding your infant too much."
"Infants this age commonly spit up."
After teaching nursing students about pyloric stenosis, the instructor determines that the session was successful when the students state which of the following? Select all that apply. "This condition occurs immediately after birth." "The infant experiences vomiting immediately after each feeding." "Breastfed infants are affected more often than formula-fed infants." "The vomitus is sour smelling and contains bile." "The infant doesn't seem to be ill otherwise."
"The infant experiences vomiting immediately after each feeding." "The infant doesn't seem to be ill otherwise."
The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? "The treatment for the disorder will be a surgical procedure." "Your child will be treated with oral iron preparations to correct the anemia." "We will give enemas until clear and then teach you how to do these at home." "Your child will receive counseling so the underlying concerns will be addressed."
"The treatment for the disorder will be a surgical procedure."
A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? "We should not stop this medication abruptly." "We might notice some of the medication in her stool." "She might lose some weight initially." "This drug helps to control the abdominal cramping."
"We should not stop this medication abruptly."
The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond? "You will most likely have a blood test to check for certain antibodies." "You will most likely have viral studies." "You will most likely be tested for ammonia levels." "You will most likely have an ultrasound evaluation."
"You will most likely have a blood test to check for certain antibodies."
When providing diaper care to an infant after pyloric stenosis surgery, which approach is indicated? Diapers should be folded so that the incision line is well covered to prevent infection. Diapers should be folded so that the incision line does not become contaminated. Diapers should not be used. Sterile diapers should be used.
Diapers should be folded so that the incision line does not become contaminated.
The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? Effortless vomiting just after the child has eaten Forceful vomiting followed by the child being eager to eat again Severe constipation with occasional ribbon-like stools Bouts of diarrhea with failure to gain weight
Effortless vomiting just after the child has eaten
Hepatitis A is spread by which mode of transmission? Respiratory droplets Blood Body fluids Fecal-oral
Fecal-oral
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents? Explaining to them about the diagnosis and surgery. Having a wound, ostomy, and continence nurse meet with them. Reinforcing that the ostomy will be temporary. Teaching them about the medications used to slow stool output.
Having a wound, ostomy, and continence nurse meet with them.
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? Short bowel syndrome (SBS) Hirschsprung disease Ulcerative colitis (UC) Gastroenteritis
Hirschsprung disease
An infant brought to the emergency department has been vomiting for 2 days. The nurse assesses the infant and finds sunken fontanels (fontanelles), tenting skin, dry mucus membranes and no urine output for 12 hours. Which intervention(s) will the nurse complete as first-line care for this infant? Select all that apply. Start oral rehydration. Administer a prescribed IV fluid bolus. Administer an antiemetic. Insert a peripheral IV. Begin maintenance IV fluids.
Insert a peripheral IV. Administer a prescribed IV fluid bolus. Administer an antiemetic.
A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? Intussusception Short-bowel/short-gut syndrome Necrotizing enterocolitis Volvulus with malrotation
Intussusception
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? Medicate the infant with analgesics. Prepare the infant for surgery. Assist in doing a barium enema procedure on the infant. Change the infant's diet to one that is lactose-free.
Prepare the infant for surgery.
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? Prepare the infant for surgery. Medicate the infant with analgesics. Change the infant's diet to one that is lactose-free. Assist in doing a barium enema procedure on the infant.
Prepare the infant for surgery.
A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client? Hold all medications until the vomiting stops. Give an antiemetic prior to giving oral medications. Place the child on NPO status. Request an intravenous form of the medication.
Request an intravenous form of the medication.
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? Tenting of skin Soft and flat fontanels (fontanelles) Blood pressure of 80/42 mm Hg Pale and slightly dry mucosa
Tenting of skin
The nurse is providing care for a child who has been diagnosed with rickets. What is the nurse's priority intervention? administration of thiamine supplements administration of adequate vitamin D administration of a high-calorie diet increased protein intake
administration of adequate vitamin D
The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: respiratory distress. painless rectal bleeding. dehydration. ischemia.
painless rectal bleeding.
A neonatal nurse examines an infant born with a congenital diaphragmatic hernia (CDH). The nurse is prepared for what condition associated with CDH that generally occurs at birth or within the first few hours of life? intussusception malrotation anemia respiratory distress
respiratory distress
The nurse should monitor which laboratory values for the child who has had a nasogastric (NG) tube placed for decompression of the gastrointestinal tract with suction? hematocrit urine ketones blood glucose serum sodium and potassium
serum sodium and potassium
The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is: steatorrhea. severe diarrhea. currant jelly stools. projectile stools.
steatorrhea.
The nurse has performed client education for a 15-year-old boy with Crohn disease and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning has occurred? "It's unusual for someone my age to get Crohn disease." "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." "I have a lot of diarrhea every day because of how my small intestine is damaged." "I have to be careful because I am prone to not absorbing nutrients."
"I have to be careful because I am prone to not absorbing nutrients."
The nurse is determining maintenance fluid requirements for a child who weighs 25 kg (55 lb). How much fluid would the child need per day? 1,560 ml 1,600 ml 1,650 ml 1,700 ml
1,600 ml
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of pyloric stenosis? In this disorder the sphincter that leads into the stomach is relaxed. There are recurrent paroxysmal bouts of abdominal pain. A thickened, elongated muscle causes an obstruction at the end of the stomach. A partial or complete intestinal obstruction occurs.
A thickened, elongated muscle causes an obstruction at the end of the stomach.
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality? Greasy Clay-colored Currant jelly-like Bloody
Currant jelly-like
A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect? Pancreatitis Appendicitis Hirschsprung disease Gastroenteritis
Gastroenteritis
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? A partial or complete intestinal obstruction occurs. A thickened, elongated muscle causes an obstruction at the end of the stomach. There are recurrent paroxysmal bouts of abdominal pain. In this disorder the sphincter that leads into the stomach is relaxed.
In this disorder the sphincter that leads into the stomach is relaxed.
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? Anxiety related to new feeding method used postoperatively Ineffective tissue perfusion related to pressure on heart chambers Excess fluid volume related to increased fluid intake prescribed postoperatively Risk for infection of incision line, related to disruption of skin barrier during surgery
Risk for infection of incision line, related to disruption of skin barrier during surgery
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of colic? A partial or complete intestinal obstruction occurs. In this disorder the sphincter that leads into the stomach is relaxed. There are recurrent paroxysmal bouts of abdominal pain. A thickened, elongated muscle causes an obstruction at the end of the stomach.
There are recurrent paroxysmal bouts of abdominal pain.
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? Refusal to eat Vomiting about 2 hours after feeding Chronic diarrhea Vomiting immediately after feeding
Vomiting immediately after feeding
A mother is told that her child will receive total parenteral nutrition. She asks the nurse what this means. The nurse bases her response on knowledge that total parenteral nutrition is: daily IM injections of vitamins. nutrition through a nasogastric tube. administration of Ringer's lactate through a peripheral IV line. administration of fluids, electrolytes, amino acids, lipids, dextrose, and minerals through an IV.
administration of fluids, electrolytes, amino acids, lipids, dextrose, and minerals through an IV.
A nurse is caring for a 4-year-old child who has undergone surgery to repair a hernia. Which of the following is a priority nursing intervention for this client? using nonpharmacologic interventions for pain management to prevent constipation encouraging shallow breathing to protect the incision restricting fluids to prevent fluid and electrolyte imbalance assisting with early ambulation to facilitate peristalsis
assisting with early ambulation to facilitate peristalsis
The nurse recognizes that in the disorder referred to as rickets, the child has a lack of vitamin D. Because of the lack of vitamin D, the absorption of which of the following is decreased? calcium and phosphorus riboflavin and niacin iron and potassium vitamin C and thiamine
calcium and phosphorus
The nurse is caring for a child with gastroenteritis. Which nursing actions would the nurse include in the plan of care? Select all that apply. maintaining reverse isolation precautions following standard precautions monitoring the child's fluid balance documenting the number and characteristics of stools auscultating the child's lungs frequently
documenting the number and characteristics of stools following standard precautions monitoring the child's fluid balance
Which assessment findings suggest that an infant with diarrhea is severely dehydrated? elevated hematocrit and depressed eye globes moist and flushed skin, fontanels (fontanelles) depressed salty saliva and tears with crying low specific gravity of urine, moist skin
elevated hematocrit and depressed eye globes
A nurse is teaching a group of parents about hepatitis A viral infection. The nurse would describe which of the following as the route of transmission? fecal-oral direct contact airborne transplacental
fecal-oral
The nurse is preparing an intravenous infusion for a 3-month-old client with dehydration secondary to gastroenteritis. Which condition or scenario puts this infant at greatest risk for a higher volume of fluid loss? greater fluid exchange caused by increased metabolic activity experiencing bouts of nausea throughout the day the decreased body surface area (BSA) to the body fluid volume only taking sips of fluids when the infant does not feel well
greater fluid exchange caused by increased metabolic activity
The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? sausage-shaped mass in the upper mid abdomen perianal fissures and skin tags abdominal pain and irritability hard, moveable "olive-like mass" in the upper right quadrant
hard, moveable "olive-like mass" in the upper right quadrant
Parents ask the nurse to explain why they should encourage their reluctant child to eat when the youngster is receiving total parenteral nutrition (TPN). What is the reason the nurse will provide? for prevention of liver damage so that nausea can be avoided to prevent electrolyte imbalance to keep the digestive system healthy and functioning
maintaining NPO status while restoring hydration and electrolyte balance.
Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is: providing adequate pain control. assessing the abdomen hourly for distention and bowel sounds. maintaining NPO status while restoring hydration and electrolyte balance. reducing vomiting by feeding small amounts of clear liquids or breast milk frequently.
maintaining NPO status while restoring hydration and electrolyte balance.
The nurse teaches a parent to differentiate between regurgitation and vomiting in the infant. The parent correctly states which characteristic of regurgitation? Select all that apply. timing unrelated to feeding no appearance of distress followed by dry retching occurs with feeding forceful expulsion of stomach contents
occurs with feeding no appearance of distress
