Peds GI

The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply.)

. A. Citrus c. Spicy foods d. Peppermint

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

. B. Passage of red, currant jelly-like stools d. Tender, distended abdomen f. Sudden acute abdominal pain

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Assessing bowel function

The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include? (Select all that apply.)

B. Hold the infant in the prone position after a feeding. E. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.

An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for ?

Central venous catheter infection, electrolyte losses, and hyperglycemia

The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

Covering the intact bowel with a nonadherent dressing to prevent injury

What intervention is contraindicated in a suspected case of appendicitis?

Enemas

The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula?

Excessive frothy saliva

What immunization is recommended for all newborns?

Hepatitis B vaccine

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?

Hirschsprung disease

The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include?

Leave the tube open to gravity drainage.

What therapeutic intervention provides the best chance of survival for a child with cirrhosis?

Liver transplantation

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.

. A child is being admitted to the hospital with acute gastroenteritis. The health care provider prescribes an antiemetic. What antiemetic does the nurse anticipate being prescribed?

Ondansetron (Zofran)

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include?

Raise the patient's head and give nothing by mouth.

One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?

Rectal bleeding

A toddler's mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse's response should be based on which premise?

The location needs to be confirmed by radiographic examination.

What is the purpose in using cimetidine (Tagamet) for gastroesophageal reflux?

The medication reduces gastric acid secretion.

The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?

The object may be lodged in the esophagus.

An infant had a gastrostomy tube placed for feedings after a Nissen fundoplication and bolus feedings are initiated. Between feedings while the tube is clamped, the infant becomes irritable, and there is evidence of cramping. What action should the nurse implement?

Vent the gastrostomy tube.

The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Fever b. Vomiting c. Tachycardia

The nurse is preparing to admit a 6-year-old child with irritable bowel syndrome (IBS). What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Flatulence b. Constipation e. Feeling of incomplete evacuation of the bowel

The school nurse is teaching a group of adolescents about avoiding contaminated water during a mission trip. What should the nurse include in the teaching? (Select all that apply.)

a. Ice b. Meats c. Raw vegetables d. Unpeeled fruits

The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Steatorrhea c. Malnutrition e. Foul-smelling stools

The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize? (Select all that apply.)

a. The onset is rapid. b. Fever occurs early. d. Nausea and vomiting are common.

The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Weight loss d. Projectile vomiting e. The infant is hungry after vomiting

The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a.Pain is common. b. Weight loss is severe. d. Diarrhea is moderate to severe.

The nurse is caring for a child with celiac disease. The nurse understands that what may precipitate a celiac crisis? (Select all that apply.)

b. Infections d. Electrolyte depletion e. Emotional disturbance

The nurse is preparing to admit a 7-year-old child with hepatitis B. What clinical features of hepatitis B should the nurse recognize? (Select all that apply.)

b. Rash is common. c. Jaundice is present e. The mode of transmission is principally by the parenteral route.

The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching? (Select all that apply.)

c. Lima beans d. Baked beans e. Raisin bran cereal

The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time?

30 minutes before breakfast

What information should the nurse include when teaching an adolescent with Crohn disease (CD)?

How to cope with stress and adjust to chronic illness

A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?

Metabolic alkalosis

What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

Popcorn

A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock?

Restlessness

What test is used to screen for carbohydrate malabsorption?

Stool pH

What clinical manifestation should be the most suggestive of acute appendicitis?

Colicky, cramping, abdominal pain around the umbilicus

The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

Corn on the cob with butter

What statement is most descriptive of Meckel diverticulum?

Intestinal bleeding may be mild or profuse.

An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?

Stress management may be helpful.

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

Bowel cleansing

A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

Changes in stooling patterns to report to the practitioner

An infant is born with a gastroschisis. Care preoperatively should include which priority intervention?

Covering the defect with a sterile bowel bag

The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe

Currant jelly-like

What should preoperative care of a newborn with an anorectal malformation include?

Gastrointestinal decompression

Nutritional management of the child with Crohn disease includes a diet that has which component?

Increased protein

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?

It is essential because it will be an adjustment.

What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction?

Marking the point of measurement with a pen

After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?

Notify the practitioner.

A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?

Popcorn

A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

Prevent abdominal distention.

An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?

Stimulate adaptation of the small intestine

When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

Sudden relief from pain

The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

Teach infection control measures to family members.

What statement best describes Hirschsprung disease?

The colon has an aganglionic segment

The parents of a newborn with an umbilical hernia ask about treatment options. The nurse's response should be based on which knowledge?

The defect usually resolves spontaneously by 3 to 5 years of age.

A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs?

The infant is taking the Pedialyte without vomiting or distention.

The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?

The laboratory reports a negative guaiac.

Melena, the passage of black, tarry stools, suggests bleeding from which source?

The upper gastrointestinal (GI) tract

A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?

Thicken feedings and enlarge the nipple hole.

The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Spitting up c. Failure to thrive d. Excessive crying e. Respiratory problems

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?

Allow the child to assume a position of comfort.

What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis?

Anorexia and malaise