A hospitalized child has varicella. The nurse arranges for which type of infection precautions?

Choice A reason: Enterocolitis, an inflammatory bowel condition, causes diarrhea and abdominal pain, typically in premature infants or those with Hirschsprung’s disease. It does not cause coughing or choking during feeding, as it affects the intestines, not the airway or esophagus, making it an incorrect diagnosis for this newborn’s feeding-related symptoms.

Choice B reason: Pyloric stenosis causes projectile vomiting due to pyloric muscle hypertrophy, obstructing gastric emptying. It does not typically cause coughing or choking during feeding, as the issue is distal to the esophagus. Tracheoesophageal atresia directly affects airway and esophageal continuity, making it a more likely cause of these symptoms.

Choice C reason: Tracheoesophageal atresia involves an abnormal connection between the trachea and esophagus, causing aspiration during feeding. In newborns, this leads to coughing and choking as milk enters the airway. This congenital defect disrupts normal swallowing, making it the most likely condition causing these symptoms during the first feeding.

Choice D reason: Celiac disease, a gluten-sensitive enteropathy, causes malabsorption, diarrhea, and failure to thrive, typically after gluten introduction. It does not cause coughing or choking during feeding in newborns, as it affects the small intestine, not the airway or esophagus, making it an incorrect diagnosis for these acute symptoms.

Choice A reason: Ewing sarcoma is a bone or soft tissue malignancy, not primarily a renal or intra-abdominal tumor. It affects bones or soft tissues, causing pain or swelling, not abdominal masses. Wilms’ tumor is the most common renal malignancy in children, making Ewing sarcoma an incorrect choice for this context.

Choice B reason: Osteosarcoma is a bone cancer, typically affecting long bones, not the kidneys or intra-abdominal organs. It presents with bone pain or fractures, not abdominal masses. Wilms’ tumor, a renal malignancy, is the most common in this category, making osteosarcoma irrelevant to renal or intra-abdominal cancers.

Choice C reason: Neuroblastoma, an intra-abdominal malignancy, arises from neural crest cells, often in the adrenal glands, causing abdominal masses. While common, it is less frequent than Wilms’ tumor in the renal/intra-abdominal category. Wilms’ tumor’s higher incidence in children makes neuroblastoma a less accurate choice for the most common tumor.

Choice D reason: Wilms’ tumor is the most common malignant renal and intra-abdominal tumor in children, originating in the kidney and presenting as a painless abdominal mass. Its embryonal origin and high incidence in young children make it the primary focus in teaching about pediatric renal malignancies, distinguishing it from other cancers.