Which assessment finding should the nurse expect in an infant with Hirschsprung disease?
Constipation with passage of foul-smelling, ribbon-like stools
Diarrhea
Foul-smelling, fatty stools
"Currant jelly" stools
The Correct Answer is A
The assessment finding that the nurse should expect in an infant with Hirschsprung disease is option A, constipation with the passage of foul-smelling, ribbon-like stools. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal part of the colon, leading to functional obstruction. The affected segment of the colon lacks the normal peristaltic movements, resulting in an accumulation of faecal matter. The stools passed by infants with Hirschsprung disease are often constipated, and the narrow, ribbon- like appearance is a result of the narrowed segment of the colon.
diarrhea (option B) is incorrect because it, is not typically associated with Hirschsprung disease. Instead, the condition presents with constipation due to the obstructed bowel.
foul-smelling, fatty stools in (option C) is incorrect because it, is not characteristic of Hirschsprung disease. This finding may be associated with malabsorption disorders such as cystic fibrosis or celiac disease, but not specifically with Hirschsprung disease.
"currant jelly" stools in (option D) is incorrect because it, is a term commonly used to describe the stools seen in intussusception, which is a different condition involving the telescoping of one segment of the bowel into another. It is not an expected finding in Hirschsprung disease.
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Correct Answer is A
Explanation
Intussusception is a medical condition where a portion of the intestine telescopes into an adjacent section, causing an obstruction. This obstruction can affect the normal passage of stool through the intestine.
In intussusception, the obstructed intestine can lead to the development of blood and mucus within the stool, giving it a characteristic appearance described as "currant jelly." The stool may contain a combination of blood, mucus, and faecal matter, resembling the colour and consistency of currant jelly.
loose, foul-smelling stools in (option) is incorrect because it, is not specific to intussusception and can be associated with various gastrointestinal conditions.
hard stools positive for guaiac in (option C) is incorrect because it, is not typical of intussusception. Hard stools and positive guaiac test results are more commonly associated with constipation or other conditions affecting the lower gastrointestinal tract.
ribbon-like stools, in (option D) is incorrect because it may be seen in conditions like colorectal cancer or other obstructive disorders. However, it is not a specific characteristic of intussusception.
In the context of intussusception, the presence of "currant jelly" stools is considered a significant sign and should prompt immediate medical attention. Intussusception is a medical emergency and requires prompt diagnosis and treatment.
Correct Answer is B
Explanation
The statement that best describes why infants are at greater risk for dehydration than older children is option B. Infants have an increased extracellular fluid volume compared to older children. This means that a larger proportion of their total body fluid is located outside the cells, in the extracellular compartment. This higher extracellular fluid volume makes infants more susceptible to fluid losses and dehydration if they experience inadequate fluid intake or increased fluid losses.
infants have an increased ability to concentrate urine in (option A), is incorrect. Infants have limited renal function and may have difficulty concentrating urine compared to older children and adults. This can contribute to a higher risk of dehydration in infants.
infants have a greater volume of intracellular fluid in (option C), is incorrect. The volume of intracellular fluid is not the primary factor contributing to the increased risk of dehydration in infants.
infants have a smaller body surface area in (option D) is incorrect because it, is not directly related to the increased risk of dehydration. Body surface area influences heat exchange and fluid loss through sweating but is not the main factor contributing to the higher risk of dehydration in infants.
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