ATI RN
Gastrointestinal Assessment in Pediatrics Questions
Question 1 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 2 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 3 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.
Question 4 of 5
The nurse knows that Nissen fundoplication involves which of the following?
Correct Answer: B
Rationale: Nissen fundoplication involves wrapping the fundus of the stomach around the inferior esophagus, mimicking a cardiac sphincter. This procedure is commonly performed to treat gastroesophageal reflux disease (GERD) in pediatric patients. By creating a new "valve" at the gastroesophageal junction, it helps prevent stomach acid from backing up into the esophagus. Option A is incorrect because wrapping the fundus around the inferior stomach would not address the issue of reflux effectively. Option C is incorrect as wrapping the fundus around the middle portion of the stomach would not impact reflux. Option D is incorrect as dilating the fundus would not treat reflux but might exacerbate it. Understanding Nissen fundoplication is essential for pediatric nurses caring for patients with GERD. By grasping the rationale behind this surgical procedure, nurses can provide better pre- and post-operative care, educate families effectively, and recognize and manage complications promptly.
Question 5 of 5
The parent of a child being evaluated for celiac disease asks the nurse why it is important to make dietary changes. Select the nurse's best response.
Correct Answer: A
Rationale: The correct answer is A) The body's response to gluten damages the intestinal mucosa and villi, leading to malabsorption of nutrients. This response is correct because in celiac disease, an autoimmune reaction to gluten damages the lining of the small intestine, specifically the villi responsible for nutrient absorption. This damage impairs the intestine's ability to absorb essential nutrients like vitamins, minerals, and other macronutrients, leading to malabsorption and potential nutrient deficiencies in children. Option B is incorrect as it inaccurately states that consuming gluten creates special cells called villi, which is not true. Villi are already present in the intestine and are damaged due to the autoimmune response in celiac disease. Option C is incorrect because gluten does not cause the intestine to become more porous but instead damages the mucosa and villi. Retaining fat-soluble vitamins and leading to toxicity is not a direct consequence of celiac disease. Option D is incorrect as it describes a different condition where mucosal cells are damaged, leading to issues with water absorption and constipation, which is not characteristic of celiac disease. In an educational context, it is crucial for healthcare providers to understand the pathophysiology of celiac disease to effectively educate parents and patients on the importance of dietary changes. By explaining the direct impact of gluten on the intestinal mucosa and villi, nurses can emphasize the necessity of adhering to a strict gluten-free diet to manage celiac disease and prevent long-term complications associated with malabsorption.