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 A
Explanation
A. Administering an antiemetic at least 30 minutes before chemotherapy begins is correct because prevention is more effective than treatment after symptoms appear. Administering antiemetics prophylactically helps reduce the severity and incidence of chemotherapy-induced nausea and vomiting, improving patient comfort and adherence to treatment.
B. Encouraging the child to remain NPO until nausea subsides is incorrect because prolonged fasting does not prevent chemotherapy-induced nausea and may contribute to dehydration and nutritional deficits, especially important in children undergoing cancer treatment.
C. Encouraging drinking large amounts of fluids is incorrect because forcing large volumes may worsen nausea or vomiting. Fluid intake should be adequate but balanced to prevent discomfort.
D. Administering an antiemetic after the child has nausea is incorrect because reactive treatment is less effective than prophylactic administration. Once severe nausea and vomiting have occurred, they are harder to control and can impact hydration, nutrition, and overall treatment tolerance.
Correct Answer is D
Explanation
A. Instruct the child to avoid weight-bearing activities indefinitely is incorrect because prolonged immobilization is unnecessary and can lead to muscle atrophy and delayed functional recovery. Weight-bearing should be restricted only as medically indicated during the initial healing phase.
B. Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb is incorrect because growth plate (physeal) fractures can lead to limb length discrepancies or angular deformities if not properly monitored. Providing false reassurance could delay necessary interventions.
C. Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement is incorrect because pediatric fractures involving the growth plate may have unique healing patterns and potential complications, including growth disturbances.
D. Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies is correct because distal femoral physeal fractures carry a high risk for growth disturbances, including limb shortening or angular deformities. Regular follow-up with imaging and growth monitoring allows early identification and intervention, minimizing long-term functional and cosmetic complications.
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