A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?

The infant has passed several tar-like stools.

The infant has not gained weight and has stooled once.

The infant has not stooled.

The infant has passed hard, pellet-like stools.

Answer and Explanation

The Correct Answer is C

A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.

B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.

C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.

D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.

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Correct Answer is ["23"]

Explanation

To calculate the IV fluid rate, first, convert the infant's weight from pounds and ounces to kilograms. There are 2.2 pounds in one kilogram. The infant weighs 16 pounds and 8 ounces, which is 16.5 pounds or approximately 7.5 kilograms when converted (16.5 pounds ÷ 2.2 pounds per kilogram). Next, multiply the infant's weight in kilograms by the prescribed amount of IV fluid, which is 6 mL/kg. This results in 45 mL (7.5 kg × 6 mL/kg). Since the fluid is to be infused over 2 hours, divide the total volume of 45 mL by 2 hours to find the rate per hour. The IV pump should be set to deliver approximately 22.5 mL/hr. After rounding to the nearest whole number, the IV pump should be set to deliver 23 mL/hr.

A. Decreased urine specific gravity B. Hypotension C. Positive antistreptolysin O titer D. Low blood urea nitrogen and creatinine

Correct Answer is C

Explanation

A. Decreased urine specific gravity is not typical; rather, increased specific gravity may be noted due to concentrated urine.

B. Hypotension is not usually associated with acute glomerulonephritis; hypertension is more common due to fluid retention and renal impairment.

C. A positive antistreptolysin O titer indicates a recent streptococcal infection, which is often the cause of post-streptococcal glomerulonephritis.

D. Elevated blood urea nitrogen (BUN) and creatinine levels are expected due to impaired kidney function, not low levels.

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A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["23"]

Explanation

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Correct Answer is C

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