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A nurse in a pediatrician's office is caring for an infant.

Exhibits

Drag words from the choices below to fill in each blank in the following sentence.

The infant is at risk for developing

and.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

1. Failure to thrive: The infant has poor weight gain despite being hungry after vomiting. Projectile vomiting, as described, often leads to insufficient caloric intake, putting the infant at risk for failure to thrive.

2. Dehydration: Repeated vomiting results in fluid loss, putting the infant at high risk of dehydration, which is common in conditions like pyloric stenosis, suspected here due to the symptoms and palpable abdominal mass.

3. Intussusception typically presents with intermittent, severe abdominal pain, "currant jelly" stools, and sometimes a sausage-shaped mass, which are not noted in this scenario.

4. Meckel diverticulum can cause painless rectal bleeding or obstruction symptoms but is not associated with projectile vomiting or a palpable mass.

5. Hirschsprung disease presents with failure to pass meconium, abdominal distension, and chronic constipation rather than the projectile vomiting seen here.


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Related Questions

Correct Answer is ["A","B","C","D"]

Explanation

Findings that require immediate follow-up:

  • Generalized muscle weakness noted in bilateral lower extremities: This could indicate a neurological or muscular issue, such as Guillain-Barré Syndrome (GBS), which is a concern after a viral infection or vaccination. This requires further investigation and close monitoring for any signs of progression, such as worsening weakness or respiratory involvement.
  • Child reports pain in legs on palpation, rates pain as 5 on a scale of 0 to 10: This pain could be indicative of muscle cramping or weakness, which may be associated with GBS or another neurological condition. Pain in combination with muscle weakness should be followed up closely.
  • Abdomen slightly firm, bowel sounds hypoactive, and reports last bowel movement was 3 days ago: This could suggest constipation or a gastrointestinal issue. However, the gastrointestinal symptoms may be secondary to the muscle weakness (if part of a systemic condition like GBS), and should be monitored, but it’s not as urgent as the neurological findings.

Findings that do not require immediate follow-up:

  • Patellar deep tendon reflexes 1+ bilaterally: A 1+ reflex is on the lower end of normal and does not indicate a severe problem by itself.
  • Child is awake and alert, responds appropriately to questions: This is a reassuring sign and does not require immediate follow-up.

Correct Answer is C

Explanation

A. Koplik spots: These are small, white lesions on the buccal mucosa associated with measles, not meningitis.
B. Decreased protein in cerebrospinal fluid (CSF): Viral meningitis typically causes normal or slightly elevated protein levels in CSF.
C. Nuchal rigidity. Nuchal rigidity (stiff neck) is a classic sign of meningitis due to inflammation of the meninges.
D. Decreased glucose in cerebrospinal fluid: Decreased glucose in CSF is associated with bacterial meningitis, not viral.

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