The nurse caring for a 22-pound 1-year-old child who has had open heart surgery is aware that the minimum acceptable urine output for the child

A. A fontanelle that bulges with crying.

Myelomeningocele is a congenital neural tube defect that involves the spinal cord. It is associated with an increased risk of hydrocephalus, which can lead to increased intracranial pressure (ICP). The fontanelle (soft spot) on an infant's head can provide insight into ICP. When an infant with myelomeningocele has an increase in intracranial pressure, the fontanelle may bulge, especially when the infant cries. This is due to the buildup of cerebrospinal fluid within the skull.

B. Increased respiratory rate: While increased intracranial pressure can affect various body systems, an increased respiratory rate is not a specific sign of ICP associated with myelomeningocele.

C. A high-pitched cry: A high-pitched cry is not typically associated with increased intracranial pressure in the context of myelomeningocele. Signs of ICP in infants may include irritability, lethargy, vomiting, and changes in head circumference.

D. Tachycardia: Tachycardia can be a response to stress or discomfort in an infant, but it is not a specific indicator of increased intracranial pressure related to myelomeningocele.

A. "The body's response to gluten causes the intestine to become more porous and hang on to more of the fat-soluble vitamins, leading to vitamin toxicity." This answer is not accurate. The issue in celiac disease is malabsorption, not vitamin toxicity.

B. "The body's response to gluten causes damage to the mucosal cells in the intestines leading to absorption problems."

Celiac disease is an autoimmune disorder in which the ingestion of gluten (a protein found in wheat, barley, and rye) leads to damage of the mucosal cells in the small intestine. This damage, in turn, can lead to malabsorption of essential nutrients, including vitamins, minerals, and other important components of the diet. It is important for individuals with celiac disease to avoid gluten-containing foods to prevent ongoing damage to the intestinal mucosa and improve nutrient absorption.

C. "The body's response to consumption of anything containing gluten is to create special cells called villi, which leads to more diarrhea." This statement is not accurate. Celiac disease leads to damage to the villi (finger-like projections) in the small intestine, not the creation of special cells. It can lead to diarrhea but is not the primary cause.

D. "The body's response to gluten causes damage to the mucosal cells, leading to malabsorption of water and hard, constipated stools." This response is not accurate. Celiac disease is more commonly associated with diarrhea and malabsorption, not constipation and malabsorption of water.