A child with severe gastroesophageal reflux disease (GERD) is scheduled for Nissen fundoplication. Postoperative nursing management should include (select all that apply):
Starting bolus feedings to stretch the stomach
Venting gastrostomy tube
Keeping child flat in bed to increase absorption of food
Observing for abdominal distension, flushing and hypotension which may indicate dumping syndrome
Correct Answer : B,D
Choice A reason: Starting bolus feedings to stretch the stomach is not recommended for a child with Nissen fundoplication as it can cause increased pressure on the surgical site and lead to complications such as bleeding, perforation, or slippage of the wrap.
Choice B reason: Venting gastrostomy tube is a correct answer as it allows for the release of gas and fluids from the stomach and prevents gastric distension and discomfort. A gastrostomy tube is often placed during Nissen fundoplication to facilitate feeding and venting.
Choice C reason: Keeping child flat in bed to increase absorption of food is not advised for a child with Nissen fundoplication as it can increase the risk of aspiration and pneumonia. The child should be positioned at a 30-degree angle or higher after feeding to prevent reflux.
Choice D reason: Observing for abdominal distension, flushing and hypotension which may indicate dumping syndrome is a correct answer as it is a potential complication of Nissen fundoplication. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms such as abdominal cramps, nausea, diarrhea, sweating, and dizziness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This statement is correct, as breastfeeding is the best source of nutrition and hydration for infants with diarrhea, as it provides antibodies, electrolytes, and fluids. The nurse should encourage the mother to continue breastfeeding per routine, or to offer expressed breast milk if the infant is too weak or fussy to nurse.
Choice B reason: This statement is incorrect, as Imodium is not recommended for infants with diarrhea, as it can cause serious side effects, such as ileus, toxic megacolon, or central nervous system depression. The nurse should advise the parents to avoid giving any anti-diarrheal medications to the infant, unless prescribed by the doctor.
Choice C reason: This statement is incorrect, as Kaopectate is not recommended for infants with diarrhea, as it contains bismuth subsalicylate, which can cause Reye syndrome, a rare but serious condition that affects the liver and brain. The nurse should advise the parents to avoid giving any anti-diarrheal medications to the infant, unless prescribed by the doctor.
Choice D reason: This statement is incorrect, as returning to daycare 24 hours after antibiotics have been started is not appropriate for infants with diarrhea secondary to rotavirus, as antibiotics are not effective against viral infections, and the infant may still be contagious and infect other children. The nurse should instruct the parents to keep the infant at home until the diarrhea has resolved, and to practice good hand hygiene and sanitation to prevent the spread of the infection.
Correct Answer is A
Explanation
Choice A reason: This statement is correct, as standard precautions are the minimum level of infection control practices that should be applied to all patients, regardless of their diagnosis or presumed infection status. Standard precautions include hand hygiene, use of personal protective equipment (PPE), safe handling of sharps and contaminated items, and environmental cleaning. Standard precautions are sufficient for most patients with HIV, unless they have other infections that require additional precautions.
Choice B reason: This statement is incorrect, as droplet precautions are not required for patients with HIV, unless they have other infections that are transmitted by respiratory droplets, such as influenza, pertussis, or meningitis. Droplet precautions include wearing a surgical mask when within 3 feet of the patient, placing the patient in a private room or cohorting with other patients with the same infection, and limiting the movement of the patient outside the room.
Choice C reason: This statement is incorrect, as contact precautions are not required for patients with HIV, unless they have other infections that are transmitted by direct or indirect contact, such as Clostridioides difficile, scabies, or herpes simplex virus. Contact precautions include wearing gloves and gowns when entering the patient's room, placing the patient in a private room or cohorting with other patients with the same infection, and dedicating patient-care equipment to the patient or disinfecting it before use on another patient.
Choice D reason: This statement is incorrect, as airborne precautions are not required for patients with HIV, unless they have other infections that are transmitted by airborne particles, such as tuberculosis, measles, or chickenpox. Airborne precautions include wearing a respirator or N95 mask when entering the patient's room, placing the patient in a negative-pressure isolation room with the door closed, and limiting the movement of the patient outside the room.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.