A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?

A. Ribbon Like, foul-smelling stools: Hirschsprung disease is characterized by a lack of nerve cells in parts of the colon, leading to obstruction and resulting in narrow, ribbon-like stools due to the passage through a narrowed section of bowel.

B. Chronic hunger: This is not typical for Hirschsprung disease. Children may actually have a poor appetite due to discomfort and constipation.

C. Projectile vomiting: Projectile vomiting is more commonly associated with pyloric stenosis, not Hirschsprung disease.

D. Rigid abdomen: While abdominal distention can occur due to severe constipation and fecal impaction, a rigid abdomen is more indicative of a more acute or severe abdominal condition, such as peritonitis or severe bowel obstruction.

A. "You should give your child's last daily dose of the medication before 6 o'clock in the evening." Methylphenidate is a stimulant, and giving it too late in the day can cause insomnia. Administering the last dose before 6 PM helps minimize sleep disturbances.

B. "You will need to give your child the medication after meals." Methylphenidate is typically given before meals to enhance its absorption and effectiveness. Taking it after meals is not recommended as it can delay absorption.

C. "You will need to have your child's blood glucose level checked monthly." There is no need for regular blood glucose monitoring unless the child has other conditions like diabetes. Methylphenidate does not typically affect blood glucose levels.

D. "You should not give your child the medication on weekends." Continuous use of methylphenidate is generally recommended to provide consistent symptom control, including on weekends. “Drug holidays” may be considered in specific cases but should be discussed with a healthcare provider.