A 4-year-old child with short bowel syndrome is admitted for nutritional management. The nurse notes the child has poor weight gain, frequent loose stools. and signs of iron deficiency anemia. Considering the child's condition, which nursing intervention should be prioritized to address the nutritional deficits?
Limit fluid intake to reduce bowel movements and prevent dehydration.
Withhold iron supplementation until full bowel recovery is confirmed to prevent irritation.
Administer partially hydrolyzed, high-calorie enteral formulas to improve nutrient absorption.
Encourage a high-fiber diet to promote bowel regularity and reduce diarrhea.
The Correct Answer is C
A. Limit fluid intake to reduce bowel movements is incorrect because children with short bowel syndrome are at high risk for dehydration due to malabsorption and frequent diarrhea. Fluid restriction would worsen hydration status and compromise electrolyte balance.
B. Withhold iron supplementation is incorrect because iron deficiency anemia is already present. Delaying supplementation would exacerbate anemia, impair growth, and delay recovery. Iron should be administered carefully, considering tolerance and absorption.
C. Administer partially hydrolyzed, high-calorie enteral formulas is correct. Children with short bowel syndrome have reduced absorptive surface area, making nutrient absorption difficult. Partially hydrolyzed formulas provide predigested proteins and carbohydrates, which are easier to absorb. High-calorie formulas help meet energy needs, promote weight gain, and address deficiencies, including iron, calcium, and fat-soluble vitamins. This intervention directly targets the nutritional deficits and growth challenges associated with short bowel syndrome.
D. Encourage a high-fiber diet is incorrect because high-fiber foods can worsen diarrhea in children with short bowel syndrome. Fiber increases stool bulk and may reduce nutrient absorption, further contributing to poor weight gain and fluid loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Enlargement of the testes and scrotum with the appearance of pubic hair is characteristic of Tanner stage 2, which marks the early stages of puberty. This is when initial changes in the genitalia and pubic hair begin.
B. Penile enlargement and deepening of the voice is correct because these changes occur during Tanner stage 3, representing continued pubertal development. Stage 3 includes further growth of the penis, continued enlargement of the testes, increased pubic hair that is darker and coarser, and the beginning of voice changes.
C. Increased muscle mass and facial hair growth is incorrect because these changes are more characteristic of Tanner stage 4–5, the later stages of puberty, when secondary sexual characteristics become more pronounced.
D. Full development of genitalia and the growth of axillary hair is incorrect because this represents Tanner stage 5, which indicates full sexual maturity and adult genital development.
Correct Answer is A
Explanation
A. Sweat chloride test is correct because it is the gold standard diagnostic test for cystic fibrosis. In CF, mutations in the CFTR gene lead to abnormal chloride transport in epithelial cells. This results in elevated chloride levels in sweat, typically ≥60 mmol/L in children, which confirms the diagnosis.
B. Genetic testing for CFTR mutations is incorrect as the sole diagnostic tool because not all CF mutations are detectable, and testing may identify carriers or atypical variants. While genetic testing is useful for confirmation or family counseling, it is not the first-line diagnostic test.
C. Chest x-ray is incorrect because, although it may reveal hyperinflation, bronchiectasis, or infiltrates indicative of chronic lung disease in CF, it cannot confirm the diagnosis. Imaging is supportive but not diagnostic.
D. Pulmonary function tests (PFTs) are incorrect because these tests assess lung function and airflow limitation, but they are not diagnostic for CF, especially in young children who may not be able to perform the tests reliably.
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