A nurse is teaching a parent of an infant who has heart failure about meeting the infant's nutritional needs. Which of the following statements by the parent indicates an understanding of the teaching?

Choice A reason: A child with Hirschsprung disease may require a temporary or permanent ostomy, depending on the extent of the bowel affected. The parent should be prepared for either outcome and not assume that the ostomy is only temporary.

Choice B reason: A child with Hirschsprung disease will not have normal bowel movements immediately after the surgery, as the bowel needs time to heal and adapt. The parent should be aware of the possible complications and follow-up care that the child will need.

Choice C reason: A child with Hirschsprung disease may need a feeding tube after the surgery to provide adequate nutrition and hydration while the bowel recovers. The parent should express interest in learning how to use and care for the feeding tube, as this indicates an understanding of the teaching.

Choice D reason: A child with Hirschsprung disease will not need a urinary catheter after the surgery, unless there is a specific indication for it. The parent should not confuse the feeding tube with the urinary catheter, as this indicates a lack of understanding of the teaching.

Choice A reason: Acidic odors are not a sign of a perforated appendix, but rather a possible indication of gastroesophageal reflux disease (GERD), which is a condition that causes stomach acid to flow back into the esophagus¹.

Choice B reason: Sudden decrease in abdominal pain is a sign of a perforated appendix, which is a serious complication of acute appendicitis. When the appendix ruptures, the pressure inside the abdomen is released, causing a temporary relief of pain. However, this is followed by severe inflammation and infection of the peritoneum, which is the membrane that lines the abdominal cavity². This can lead to sepsis, shock, and death if not treated promptly.

Choice C reason: Narrow fever is not a term that is commonly used in medicine. Fever is a general sign of infection or inflammation, and it can be present in both acute appendicitis and perforated appendix. However, fever alone is not a reliable indicator of the severity or location of the problem³.

Choice D reason: Rigid abdomen is a sign of peritonitis, which is a possible consequence of a perforated appendix. Peritonitis causes the abdominal muscles to contract and become stiff, making the abdomen hard and tender to touch². However, rigidity can also occur in other conditions that cause intra-abdominal inflammation, such as pancreatitis or cholecystitis⁴.

Choice E reason: Nausea is a common symptom of acute appendicitis, but it is not specific to a perforated appendix. Nausea can be caused by irritation of the stomach or the nerves that control vomiting. It can also occur in other gastrointestinal disorders, such as gastritis or gastroenteritis⁵.