A child diagnosed with Hirschsprung's disease is scheduled for surgery. Which of the following actions should the nurse include in the preoperative care for this child? (Select All that Apply.)
Measure abdominal girth
Teach the child deep breathing exercises
Assess the child's bowel function with characteristics of stool
Administer isotonic enema to evacuate bowel
Administer an antibiotic as per order
Restrict the child's fluid intake
Assess vomiting
Correct Answer : A,C,E,G
A. Measure abdominal girth – Correct. Measuring abdominal girth helps monitor for signs of obstruction, which is common in Hirschsprung’s disease due to the absence of ganglion cells in the colon.
B. Teach the child deep breathing exercises – Incorrect. Deep breathing exercises are not typically taught to infants or young children undergoing surgery for Hirschsprung’s disease.
C. Assess the child's bowel function with characteristics of stool – Correct. Assessing stool patterns is important since Hirschsprung’s disease is characterized by an absence of peristalsis in the affected bowel.
D. Administer isotonic enema to evacuate bowel – Incorrect. Enemas are contraindicated in Hirschsprung’s disease as they can lead to bowel perforation.
E. Administer an antibiotic as per order – Correct. Preoperative antibiotics are given to prevent infection.
F. Restrict the child's fluid intake – Incorrect. Fluid restriction is not necessary and may worsen dehydration, especially if the child has vomiting or diarrhea.
G. Assess vomiting – Correct. Vomiting can indicate worsening obstruction or enterocolitis, a serious complication of Hirschsprung’s disease.
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Related Questions
Correct Answer is D
Explanation
A. Prevents respiratory infections. – Incorrect. Pamidronate does not affect the risk of infections.
B. Improves joint mobility. – Incorrect. Bisphosphonates do not directly improve joint movement.
C. Decreases pain and inflammation. – Incorrect. While reducing fractures may indirectly decrease pain, the primary goal is to improve bone density.
D. Increases bone density. – Correct. Bisphosphonates like pamidronate inhibit bone resorption and strengthen bones, reducing fractures in osteogenesis imperfecta (brittle bone disease).
Correct Answer is ["A","B","C","D","F"]
Explanation
A. Administer benzodiazepine medication. – Correct. Benzodiazepines (e.g., lorazepam, diazepam) are first-line treatments for prolonged seizures.
B. Perform neurological checks. – Correct. Monitoring postictal status helps assess brain function.
C. Reorient and calm the child. – Correct. After the seizure, the child may be confused and require reassurance.
D. Position the child in a side-lying position. – Correct. This prevents aspiration and maintains a clear airway.
E. Restrict the child's movements during the seizure. – Incorrect. Restraining can cause injury. Instead, protect the child from harm by removing nearby objects.
F. Document the duration and characteristics of the seizure. – Correct. Recording seizure length, activity, and triggers is crucial for medical management.
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