ATI RN
Gastrointestinal Assessment in Pediatrics Questions
Question 1 of 5
The nurse is caring for a 1-month-old term infant who experienced an anoxic episode at birth. The health-care team suspects that the infant is developing necrotizing enterocolitis (NEC). Which would the nurse expect to be included in the plan of care?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Prepare to administer antibiotics intravenously. Necrotizing enterocolitis (NEC) is a serious condition that involves inflammation and damage to the intestinal tissue, often seen in premature infants or those with perinatal stress like an anoxic episode. Antibiotics are a crucial part of the treatment for NEC to address the bacterial overgrowth and prevent further complications. Option A is incorrect because removing the feeding nasogastric tube (NGT) without addressing the underlying issue of NEC would not be beneficial. Option B, obtaining vital signs every 4 hours, is important but not the priority in a suspected case of NEC where prompt treatment is crucial. Option D, changing feedings to half-strength and administering slowly, is not the immediate intervention needed for NEC. From an educational standpoint, understanding the importance of early recognition and intervention in NEC is vital for pediatric nurses. Recognizing the signs and symptoms of NEC, such as abdominal distention, bloody stools, and feeding intolerance, and knowing the appropriate actions to take, including initiating antibiotic therapy, can significantly impact patient outcomes in infants at risk for this condition.
Question 2 of 5
The nurse is caring for a 7-week-old scheduled for a pyloromyotomy in 24 hours. Which would the nurse expect to find in the plan of care?
Correct Answer: B
Rationale: The correct answer is B) Keep infant NPO; begin intravenous fluids at maintenance; place a nasogastric tube (NGT) to low wall suction. Rationale: - Keeping the infant NPO (nothing by mouth) is crucial to prevent aspiration and reduce the risk of complications during the surgery. - Beginning intravenous fluids at maintenance helps maintain hydration and electrolyte balance in preparation for the procedure. - Placing a nasogastric tube (NGT) to low wall suction helps decompress the stomach, reducing the risk of vomiting and aspiration during and after the surgery. Why the other options are wrong: - Option A is incorrect because it does not address the need for gastric decompression, which is essential in this situation. - Option C is incorrect as obtaining serum electrolytes alone does not address the immediate preoperative management required for a pyloromyotomy. - Option D is incorrect as offering small frequent feedings to an infant scheduled for pyloromyotomy increases the risk of aspiration and complications during surgery. Educational context: Understanding the preoperative care required for infants undergoing pyloromyotomy is essential for pediatric nurses. This scenario highlights the importance of maintaining NPO status, providing intravenous fluids, and using NGT for gastric decompression to ensure a safe surgical outcome for the infant.
Question 3 of 5
The nurse is caring for a newborn with an anorectal malformation and a colostomy. The nurse knows that more education is needed when the infant's parent states which of the following?
Correct Answer: D
Rationale: The correct answer is D) As my baby grows, a pattern will develop over time, and there should be predictable bowel movements. This statement is inaccurate because infants with anorectal malformations and colostomies typically do not have predictable bowel movements due to the nature of their condition. It is important for parents to understand that bowel patterns may vary, and they should not expect a consistent schedule. Option A is incorrect because the stoma should be pink or red, indicating good blood flow. Option B is incorrect as some discharge and irritation around the stoma can be normal and should be managed appropriately. Option C is incorrect as it is important to allow some air exposure to the stoma to promote healing and prevent skin breakdown. In an educational context, it is crucial for nurses to provide accurate information to parents of infants with anorectal malformations and colostomies to ensure proper care and management of the stoma. Understanding the nuances of stoma care and bowel patterns can help parents effectively care for their child and prevent complications.
Question 4 of 5
The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant's condition?
Correct Answer: A
Rationale: In caring for an infant with Hirschsprung disease, the nurse must understand the pathophysiology of the condition to provide appropriate care. The correct answer is A) There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention. In Hirschsprung disease, there is a lack of ganglion cells in the distal colon, causing a segment of the bowel to have no peristalsis, leading to the accumulation of stool, distention, and potential complications like enterocolitis. Option B) There is excessive peristalsis throughout the intestine, resulting in abdominal distention is incorrect as Hirschsprung disease is characterized by a lack of peristalsis, not excessive peristalsis. Option C) There is a small-bowel obstruction leading to ribbon-like stools is incorrect because Hirschsprung disease primarily affects the large intestine, not the small bowel. Option D) There is inflammation throughout the large intestine, leading to accumulation of intestinal contents and abdominal distention is incorrect because while there can be complications like enterocolitis, the primary issue in Hirschsprung disease is the lack of peristalsis due to missing ganglion cells. Understanding the specific manifestations of Hirschsprung disease is crucial for nurses caring for affected infants to provide appropriate interventions, monitor for complications, and educate families on managing the condition.
Question 5 of 5
The nurse is interviewing the parents of a 6-year-old who has been experiencing constipation. Which could be a causative factor? (Select all that apply.)
Correct Answer: D
Rationale: In pediatric gastrointestinal assessment, constipation is a common concern that requires a comprehensive understanding of potential causative factors. In this scenario, selecting all the options (A, B, and C) as causative factors for constipation in a 6-year-old child is the correct choice. - A) Hypothyroidism: Hypothyroidism can lead to decreased metabolic rate and affect gastrointestinal motility, potentially causing constipation in children. - B) Muscular dystrophy: Muscular weakness and impaired coordination of bowel movements associated with muscular dystrophy can contribute to constipation. - C) Myelomeningocele: Children with myelomeningocele often have neurological issues affecting bowel function, leading to constipation. Educationally, understanding these causative factors helps nurses in conducting thorough assessments, formulating appropriate care plans, and providing necessary interventions to manage constipation effectively in pediatric patients. By grasping the relationship between underlying conditions and gastrointestinal symptoms, nurses can promote optimal health outcomes for children experiencing constipation.