The nurse is caring for an 8-week-old male who has just been diagnosed with Hirschsprung disease. The parents ask what they should expect. Select the nurse's best response.

Correct Answer: D

Rationale: The correct answer is D: Although your child will require surgery, there are different ways to manage the disease depending on how much of the bowel is involved. Rationale: - Correct Answer Explanation: Hirschsprung disease is a congenital condition where nerve cells are missing in the colon, leading to bowel obstruction. Surgery is the primary treatment, and the extent of surgery depends on how much of the bowel is affected. Different surgical approaches may be used to manage the condition effectively. - Incorrect Answers Explanation: A) Option A is incorrect because Hirschsprung disease requires surgical intervention and stool softeners alone will not resolve the condition. B) Option B is incorrect as colostomy is not the first-line treatment for Hirschsprung disease. Surgery aims to remove the affected segment of the bowel and reestablish normal bowel function. C) Option C is incorrect as daily bowel irrigations are not the mainstay of treatment for Hirschsprung disease. Surgery is the definitive treatment. Educational Context: Understanding the management of Hirschsprung disease is crucial for pediatric nurses as they care for children with this condition. By knowing the appropriate interventions, nurses can educate parents effectively and provide optimal care to the child. Highlighting the importance of surgical management and individualized treatment plans based on the extent of bowel involvement helps nurses deliver comprehensive care and support to families facing this diagnosis.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because if the hernia appears more swollen or tender, seeking immediate medical care is crucial to prevent complications like incarceration or strangulation. This is important information for parents to know to ensure timely intervention and prevent potential harm to the infant. Option A is incorrect because surgery for an umbilical hernia is usually not recommended before the age of 4-5 years unless complications arise. Option C is incorrect as placing a pressure dressing can be harmful and is not a recommended treatment for an umbilical hernia. Option D is incorrect because while there is a possibility of hernia recurrence after surgical repair, it is not described as a strong likelihood. Educationally, this question serves to reinforce the importance of parental education and early recognition of signs of complications related to umbilical hernias in infants. It highlights the significance of prompt medical attention in such situations to ensure the well-being of the child. By understanding these key points, nurses can effectively educate parents on appropriate care and response to umbilical hernias in infants.

Correct Answer: D

Rationale: The most appropriate action for the receiving nurse in this scenario is to prepare to get the infant ready for immediate surgical correction (Option D). Intussusception is a medical emergency where a part of the intestine folds into itself, leading to obstruction and compromised blood flow. The infant's presentation with lethargy, high fever, tachycardia, hypotension, and a rigid abdomen indicates a severe case requiring urgent surgical intervention to prevent complications like bowel perforation, sepsis, and even death. Option A (CT scan) is not the immediate priority as the infant's condition is critical and waiting for imaging could delay life-saving treatment. Option B (reducing enema) may be contraindicated if the bowel is perforated or compromised, as in this case. Starting a second IV line for fluids and antibiotics (Option C) is important but secondary to addressing the immediate surgical need to correct the intussusception. In an educational context, understanding the urgency of surgical intervention in cases of intussusception is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms of this condition and knowing the appropriate interventions can help prevent complications and ensure positive outcomes for the child. It highlights the importance of swift clinical judgment and prioritization in emergency situations.

Correct Answer: B

Rationale: The correct answer is B) A positive Rovsing sign means that when the left lower quadrant is palpated, your child feels pain in the right lower quadrant. This is the correct response because the Rovsing sign is a clinical finding associated with appendicitis. The pain felt in the right lower quadrant when pressure is applied to the left side indicates irritation of the peritoneum overlying the appendix. Option A is incorrect because as a nurse, it is essential to provide information and education to patients and their families to promote understanding and involvement in the care process. Option C is incorrect because the statement about pain when the physician removes the hand from the abdomen does not describe the Rovsing sign. Option D is incorrect as it describes a different clinical sign, not the Rovsing sign associated with appendicitis. In an educational context, understanding clinical signs like the Rovsing sign is crucial for nurses caring for pediatric patients with suspected appendicitis. Proper knowledge and interpretation of these signs help in early identification and timely intervention, which can significantly impact patient outcomes. It is important for nurses to be able to explain these signs to families to enhance their understanding and involvement in the child's care.

Correct Answer: B

Rationale: Rationale: The correct answer is B) Clear liquids such as broth and Jell-O. Children with hepatitis often experience reduced appetite, nausea, and digestive issues. Offering clear liquids like broth and Jell-O is gentle on the digestive system, easy to digest, and helps maintain hydration, which is crucial for liver health and overall recovery. Option A) A tuna sandwich on whole wheat bread and a cup of skim milk is not the best choice for a child with hepatitis because fatty and heavy foods can exacerbate digestive symptoms and strain the liver. Option C) A hamburger, French fries, and a diet soda are high in fat, salt, and processed ingredients, which can be difficult for a child with hepatitis to digest and may worsen symptoms. Option D) A peanut butter sandwich and a milkshake are high in fat and may be too heavy for a child with hepatitis, potentially leading to discomfort and further digestive issues. Educational Context: Understanding the dietary needs of children with hepatitis is crucial for nurses and healthcare professionals, especially when preparing meals for pediatric patients. Providing appropriate foods that are easy to digest, gentle on the liver, and support hydration can aid in the child's recovery process and overall well-being. Educating caregivers about the importance of a hepatic-friendly diet for children with hepatitis is essential in promoting optimal health outcomes.