A child has been diagnosed with Hirschsprung's disease. Which of the following findings would the nurse expect the parents to report in the child's history? Select all that apply.
Ribbon-like stools.
Distended abdomen.
Chronic constipation.
Black and tarry stools.
Correct Answer : A,B,C
Choice A rationale:
Ribbon-like stools are a classic sign of Hirschsprung's disease, indicating narrowed or obstructed bowel segments due to the absence of ganglion cells in the intestine's muscular layers.
Choice B rationale:
A distended abdomen is common in Hirschsprung's disease due to the accumulation of stool and gas in the narrowed segments of the intestine.
Choice C rationale:
Chronic constipation is a result of the dysfunctional intestinal motility caused by Hirschsprung's disease. The absence of ganglion cells leads to a lack of peristalsis and difficulty passing stools.
Choice D rationale:
Black and tarry stools are indicative of upper gastrointestinal bleeding, often caused by conditions like peptic ulcers. This finding is not directly related to Hirschsprung's disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Giving the patient a soft tissue is not the initial action to take when dealing with clear liquid drainage from the nose. Assessing the content of the drainage is more crucial for appropriate management.
Choice B rationale:
Checking the drainage for glucose content is essential because the presence of glucose indicates that the drainage is cerebrospinal fluid (CSF), which can occur with a skull fracture that involves the base of the skull.
Choice C rationale:
Obtaining a specimen of the drainage for culture and sensitivity is important, but it is not the initial action. Confirming the nature of the drainage takes precedence.
Choice D rationale:
Asking the father about nasal drainage before the injury is not as relevant as assessing the current drainage, which could be indicative of a CSF leak.
Correct Answer is D
Explanation
Choice A rationale:
Instructing the mother in palpation of bladder distention might not effectively address the issue of incomplete bladder emptying. Clean intermittent catheterization is a more appropriate technique to ensure complete emptying.
Choice B rationale:
Informing the mother that life-long antibiotic administration will be necessary is not the primary approach. Antibiotics may be required in specific situations, but addressing incomplete emptying is the key focus.
Choice C rationale:
Preparing the mother for the need for urinary diversion surgery is premature. Clean intermittent catheterization is a conservative measure that should be attempted before considering surgical options.
Choice D rationale:
Instructing the mother in the technique of clean intermittent catheterization helps manage the neurogenic bladder's incomplete emptying. This technique reduces the risk of urinary tract infections and promotes bladder health.
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