The nurse receives a call from the parent of a 10-month-old who has vomited three times in the past 8 hours. The parent describes the baby as playful and wanting to drink. The parent asks what to give the child. Select the nurse's best response.

Correct Answer: D

Rationale: The correct answer is D: Offer your child 1/2 ounce of Pedialyte every 10 minutes. If vomiting continues, keep the child NPO for a while, then restart fluids slowly. This response is the best choice because it provides a balanced approach to managing the situation. Offering Pedialyte helps prevent dehydration and provides essential electrolytes. The small, frequent amounts help reduce the likelihood of further vomiting. If vomiting persists, the instruction to keep the child NPO (nothing by mouth) allows the stomach to rest before slowly reintroducing fluids. Option A is incorrect because giving plain water can worsen dehydration due to the lack of electrolytes. Option B is incorrect as restricting feeding can lead to further dehydration and inadequate nutrition for the baby. Option C is also incorrect as withholding fluids for 24 hours can lead to dehydration and is not recommended, especially for infants. In an educational context, this question highlights the importance of assessing and managing vomiting in infants to prevent dehydration. It emphasizes the need for proper fluid and electrolyte replacement strategies in pediatric patients, especially in cases of acute gastrointestinal disturbances. Understanding these principles is crucial for nurses caring for pediatric patients to ensure optimal outcomes and prevent complications.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Offer a diet high in protein. In the case of encopresis, which is a condition characterized by chronic constipation leading to involuntary bowel movements, it is essential to provide a diet high in fiber rather than protein. Fiber helps soften the stool and promotes regular bowel movements, which is crucial in managing and preventing further episodes of encopresis. Therefore, offering a diet high in protein would not address the underlying issue of constipation in this child. Option A) Limit the intake of milk is incorrect because milk intake does not directly relate to encopresis. However, excessive dairy consumption can sometimes contribute to constipation in some individuals, so it may be beneficial to monitor dairy intake. Option B) Obtain a complete dietary log is a good practice as it helps identify any dietary factors that may be contributing to constipation. This information can guide interventions and dietary modifications to improve bowel function. Option C) Follow up with a child psychologist is important in cases of encopresis as it is often associated with psychological factors like stress or anxiety. A multidisciplinary approach involving healthcare providers, including psychologists, can address both the physical and emotional aspects of the condition. Educational Context: Understanding the appropriate dietary interventions for pediatric GI disorders like encopresis is crucial for nurses working with children. By providing a rationale for the correct answer and explaining why the other options are incorrect, nurses can develop a comprehensive approach to managing such conditions. It also emphasizes the importance of considering both physical and psychological factors in addressing pediatric GI disorders.

Correct Answer: A

Rationale: The correct answer is A) Abdominal distention, enlarged liver and spleen, clay-colored stool, and tea-colored urine in a 4-week-old infant with biliary atresia. Biliary atresia is a serious pediatric GI disorder where there is a blockage in the bile ducts, leading to bile accumulation in the liver. This results in jaundice, clay-colored stools due to lack of bile in the intestines, and tea-colored urine due to conjugated hyperbilirubinemia. Abdominal distention occurs due to liver enlargement. Option B is incorrect because bruising, bloody stools, and hematuria are not typical manifestations of biliary atresia. Option C is incorrect as the manifestations described are more indicative of a bleeding disorder or liver dysfunction. Option D is incorrect as biliary atresia typically presents with symptoms early in infancy, such as jaundice and liver enlargement. In an educational context, understanding the specific manifestations of pediatric GI disorders like biliary atresia is crucial for early identification and intervention. Nurses caring for infants must be able to recognize these signs to facilitate prompt diagnosis and treatment, improving outcomes for the infant. This knowledge also highlights the importance of early screening and referral to specialists in cases of suspected biliary atresia.

Correct Answer: C

Rationale: Rationale: The correct answer is C) rectal bleeding. In ulcerative colitis, rectal bleeding is a hallmark symptom due to the inflammation and ulceration that typically starts in the rectum and extends proximally through the colon in a continuous manner. In contrast, Crohn's disease is characterized by transmural inflammation that can affect any part of the gastrointestinal tract, leading to a variety of symptoms including abdominal pain, diarrhea, and mouth ulceration. Abdominal pain (option A) is a common symptom in both ulcerative colitis and Crohn's disease, but it is more frequently associated with Crohn's disease due to the nature of the inflammation affecting multiple layers of the intestinal wall. Growth failure (option B) is more commonly seen in Crohn's disease, especially in children, due to malabsorption and chronic inflammation impacting proper growth and development. Mouth ulceration (option D) is also more typical of Crohn's disease rather than ulcerative colitis. Understanding the distinguishing features between ulcerative colitis and Crohn's disease is crucial in diagnosing and managing pediatric patients with gastrointestinal disorders. Recognizing the differences in presentation, location of inflammation, and associated symptoms can guide healthcare providers in providing appropriate treatment strategies and improving patient outcomes.

Correct Answer: D

Rationale: In immunocompromised children, infections can lead to malabsorption due to compromised gut function. In this scenario, the correct answer is D) Giardia. Giardia is a parasite that causes giardiasis, leading to malabsorption by damaging the lining of the small intestine, affecting nutrient absorption. Shigella (option A), Salmonella (option B), and enteropathogenic E. coli (option C) are bacterial infections that can cause gastroenteritis but typically do not lead to malabsorption in the same way as Giardia. These bacterial infections often cause symptoms like diarrhea, abdominal pain, and fever, but they do not primarily result in malabsorption due to damage to the intestinal lining. It is crucial for healthcare providers to be aware of the specific pathogens that can cause malabsorption in immunocompromised children to provide appropriate treatment and management. Understanding the differences in how various infections affect the gastrointestinal tract helps in accurate diagnosis and targeted interventions to improve outcomes for pediatric patients with GI disorders.