A nurse is collecting data from an infant who has Hirschsprung's disease. Which of the following manifestations should the nurse expect?
Abdominal distention.
Steatorrhea.
Blood-tinged emesis.
Dysphagia.
The Correct Answer is A
Abdominal distention. Choice A reason:
Abdominal distention is a common manifestation of Hirschsprung's disease in infants. This condition is characterized by the absence of ganglion cells in the distal segment of the colon, leading to a functional obstruction. The absence of ganglion cells causes the affected part of the colon to become narrow and unable to relax, resulting in a buildup of stool and gas, leading to abdominal distention.
Choice B reason:
Steatorrhea, which is the presence of fatty, bulky, and foul-smelling stools, is not typically associated with Hirschsprung's disease. This manifestation is more commonly seen in conditions affecting the pancreas, liver, or small intestine, where the digestion and absorption of fats are impaired.
Choice C reason:
Blood-tinged emesis (vomiting) is not a typical manifestation of Hirschsprung's disease. This symptom is more commonly associated with gastrointestinal bleeding, which can be caused by various factors such as ulcers, esophageal varices, or gastritis.
Choice D reason:
Dysphagia, which refers to difficulty swallowing, is also not a characteristic manifestation of Hirschsprung's disease. Dysphagia is more commonly seen in conditions affecting the esophagus or throat, such as esophageal strictures or neurological disorders affecting swallowing reflexes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
The nurse should prioritize Choice B over Choice A as it is essential to first confirm the correct placement of the NG tube before proceeding with any other actions. If the tube is not correctly positioned, administering the enteral feeding can lead to potential complications, such as aspiration, which can be life-threatening. Therefore, it is crucial to ensure the NG tube's proper placement before moving forward with the feeding
Choice B reason:
This option takes precedence as verifying the NG tube's position is a fundamental step in the enteral feeding process. The nurse must use appropriate methods, such as X-ray or pH testing, to confirm that the tube is in the stomach and not in the respiratory tract or elsewhere. This verification ensures the safety and effectiveness of the feeding procedure and prevents potential harm to the child.
Choice C reason:
While checking the gastric residual volume (GRV) is an important step in some cases, it should be done after confirming the NG tube's proper placement (Choice B). GRV provides information about the amount of feeding left in the stomach and helps in assessing tolerance to the feeding. However, if the NG tube is misplaced, determining GRV becomes irrelevant as the feeding would not be going to the intended location.
Choice D reason:
Flushing the child's NG tube with sterile water is an appropriate step during the enteral feeding process but should be done after verifying the tube's position (Choice B). Flushing ensures that the tube is patent and free from any obstructions, allowing the feeding to pass through smoothly. However, again, if the NG tube is incorrectly positioned, flushing it would not address the underlying issue.
Correct Answer is B
Explanation
Choice A reason:
Ibuprofen - Ibuprofen belongs to the nonsteroidal anti-inflammatory drugs (NSAIDs) class, which includes aspirin. Since the client reports an allergy to aspirin, there is a risk of cross- reactivity, leading to a potential allergic reaction. Therefore, Ibuprofen should be avoided.
Choice B reason:
Acetaminophen - Acetaminophen is not an NSAID, and it works differently from aspirin. It is a safe option for the client in the postpartum period to manage pain without causing a cross- reaction with their aspirin allergy. Acetaminophen primarily acts on the central nervous system to reduce pain and fever, making it suitable for the client.
Choice C reason:
Naproxen - Naproxen is also an NSAID, and like Ibuprofen, it carries the risk of cross-reactivity in someone allergic to aspirin. Therefore, Naproxen should be avoided in this client.
Choice D reason:
Celecoxib - Celecoxib is a type of NSAID known as a selective cyclooxygenase-2 (COX-2) inhibitor. Although it is a bit more selective and generally considered to have a lower risk of causing cross-reactions, it is still an NSAID and not recommended for someone with a known aspirin allergy. Hence, Celecoxib should not be administered to the client in this scenario.
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