What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Popcorn. Popcorn is a high-fiber food that can aid in relieving constipation in children. Fiber helps to add bulk to the stool, making it easier to pass through the digestive tract. Popcorn, specifically the whole-grain variety, is a good source of dietary fiber, promoting regular bowel movements and preventing constipation. Now, let's discuss why the other options are incorrect: A) White rice: White rice is a low-fiber food that may contribute to constipation rather than alleviate it. C) Fruit juice: While some fruit juices may contain fiber, many are low in fiber content and can even worsen constipation due to their high sugar content and lack of sufficient fiber. D) Ripe bananas: While bananas are a good source of fiber, ripe bananas are lower in fiber content compared to when they are slightly unripe. Therefore, they may not be as effective in treating chronic constipation in children. Educationally, it is crucial for nurses to understand the importance of dietary fiber in managing constipation in children. By recommending high-fiber foods like popcorn, nurses can help promote gastrointestinal health and alleviate constipation issues in pediatric patients. It is also essential to educate caregivers on the significance of a balanced diet rich in fiber for maintaining overall digestive health in children.

Correct Answer: A

Rationale: In understanding Hirschsprung disease, it is crucial to recognize that the correct statement is option A: "The colon has an aganglionic segment." This statement accurately describes the pathophysiology of Hirschsprung disease, where there is a missing ganglion cells in a segment of the colon, leading to a lack of peristalsis and functional obstruction. Option B is incorrect because Hirschsprung disease actually results in a failure to evacuate stool, leading to constipation and potential bowel obstruction rather than frequent evacuation of solids, liquids, and gas. Option C is incorrect because while it is true that Hirschsprung disease is often diagnosed in neonates due to the failure to pass meconium, this is not a defining characteristic of the disease. Option D is incorrect as it describes hypermotility, which is not a feature of Hirschsprung disease. In fact, the affected segment of the colon experiences decreased motility due to the lack of innervation. Educationally, understanding the pathophysiology of Hirschsprung disease is essential for nurses caring for pediatric patients. Recognizing the signs and symptoms, such as chronic constipation, abdominal distension, and failure to pass meconium, can lead to timely diagnosis and appropriate management to prevent complications such as enterocolitis. By grasping the underlying cause of the condition, nurses can provide comprehensive care and support to both the child and their family.

Correct Answer: B

Rationale: The correct answer is B) Marking the point of measurement with a pen. This is the most appropriate procedure for assessing an abdominal circumference related to a bowel obstruction because marking the point of measurement with a pen ensures consistency in measuring the same location each time, allowing for accurate monitoring of changes in abdominal girth. In the context of a bowel obstruction, changes in abdominal circumference can indicate worsening or improvement of the condition, making precise measurements crucial for effective patient care. Option A) Measuring the abdomen after feedings is incorrect because abdominal measurements should ideally be taken before meals to minimize variations due to food intake. Option C) Measuring the circumference at the symphysis pubis is incorrect as it is not the standard location for assessing abdominal circumference related to a bowel obstruction. The point of measurement should be consistent and reproducible, typically around the umbilicus. Option D) Using a new tape measure with each assessment to ensure accuracy is unnecessary as long as the same tape measure is used consistently and the point of measurement is marked accurately. Replacing the tape measure for each assessment may not significantly impact measurement accuracy if the technique is standardized and reliable. In an educational context, understanding the correct procedure for assessing abdominal circumference in conditions like bowel obstruction is essential for nurses caring for pediatric patients. Accurate measurements can provide valuable information about a child's condition, guide treatment decisions, and help in monitoring progress or identifying complications. Nurses must be proficient in proper measurement techniques to deliver high-quality care and ensure patient safety.

Correct Answer: B

Rationale: The correct answer is B) It is essential because it will be an adjustment. When preparing a 3-year-old child with Hirschsprung disease for temporary colostomy surgery, it is crucial to help them understand and adapt to the upcoming changes. Children at this age are developing autonomy and may struggle with changes to their body and routine. Preparing the child emotionally and psychologically for the colostomy can help reduce anxiety, fear, and confusion. By providing age-appropriate information, reassurance, and emotional support, the nurse can help the child cope with the upcoming procedure and the temporary colostomy. Option A is incorrect because the child's age does not negate the need for preparation; all children, regardless of age, benefit from psychological preparation before surgery. Option C is incorrect because the temporary nature of the colostomy does not eliminate the need for emotional preparation. Option D is incorrect because while body image is important, the immediate focus should be on preparing the child for the upcoming surgery and the changes it will bring to their body. In an educational context, nurses must understand the developmental stage of the child and tailor their preparation strategies accordingly. Providing emotional support and age-appropriate information can help children cope with medical procedures and promote better outcomes.

Correct Answer: C

Rationale: The correct answer is C) Prevent abdominal distention. In the context of a child post-surgery for Hirschsprung disease, which is a condition affecting the large intestine, the NG tube serves to decompress the gastrointestinal system and prevent abdominal distention. Hirschsprung disease results in the inability of the colon to push stool toward the rectum, leading to a build-up of stool in the intestines. Option A) Prevent the spread of infection is incorrect as the primary purpose of an NG tube in this scenario is not related to infection control. Option B) Monitor electrolyte balance is also not the primary purpose of an NG tube in this specific situation. While electrolyte balance may be monitored in children with NG tubes for other reasons, it is not the main purpose post-surgery for Hirschsprung disease. Option D) Maintain accurate records of output is not the primary purpose of the NG tube in this case. While output may be measured and recorded, the main goal of the NG tube here is to prevent abdominal distention by removing gas and fluids from the gastrointestinal tract. Educationally, understanding the rationale behind the use of an NG tube in specific conditions like Hirschsprung disease is crucial for providing safe and effective care to pediatric patients. Nurses need to be knowledgeable about the purposes of different interventions to ensure optimal outcomes for their patients.