A nurse is caring for a child diagnosed with Hirschsprung's disease.
Which of the following should the nurse include in the education of the child's parents? (Select All that Apply.)
The need for frequent enemas to stimulate bowel movements.
The importance of avoiding medications that can cause constipation.
The importance of maintaining a high-fiber diet.
Strict adherence to a low-protein diet.
The need for daily laxative use to promote bowel movements.
The need for surgical intervention to correct the condition.
The need for frequent visits to the emergency department for bowel management.
Correct Answer : B,F
Choice A rationale
Frequent enemas are sometimes used in the management of Hirschsprung's disease, but their primary purpose is to empty the bowel of accumulated stool, not to stimulate bowel movements. The disease is characterized by an absence of ganglion cells, which prevents normal peristalsis, making stimulation ineffective.
Choice B rationale
Avoiding medications that can cause constipation is crucial for children with Hirschsprung's disease. Since their colon lacks the necessary ganglion cells for normal peristalsis, any further slowing of bowel transit due to medication can exacerbate fecal impaction and increase the risk of enterocolitis.
Choice C rationale
Maintaining a high-fiber diet is generally contraindicated in Hirschsprung's disease. High-fiber diets increase stool bulk, which can worsen constipation and impaction in a colon that is unable to propel stool effectively due to the absence of ganglion cells in the affected segment.
Choice D rationale
There is no specific evidence or recommendation for strict adherence to a low-protein diet in the management of Hirschsprung's disease. Dietary interventions primarily focus on managing constipation and preventing enterocolitis, rather than protein restriction, which can impact growth and development.
Choice E rationale
Daily laxative use is generally not recommended as a primary long-term management strategy for Hirschsprung's disease. While laxatives might provide temporary relief, they do not address the underlying physiological defect and can lead to dependency or electrolyte imbalances. Surgical correction is the definitive treatment.
Choice F rationale
Surgical intervention is the definitive treatment for Hirschsprung's disease. This involves removing the aganglionic segment of the bowel, allowing for normal peristalsis to be restored. Without surgery, the child will continue to experience severe constipation, impaction, and potential life-threatening complications like enterocolitis.
Choice G rationale
While complications like enterocolitis in Hirschsprung's disease may necessitate emergency department visits, the goal of management is to minimize these occurrences through appropriate medical and surgical interventions. Frequent visits for routine bowel management indicate suboptimal long-term care, not a planned approach.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A rationale
Local funeral home morgues would be quickly overwhelmed and inadequate for mass casualties resulting from a nuclear detonation. The sheer volume of bodies would exceed their capacity, and they may lack the specialized facilities required for handling contaminated remains, posing significant public health and safety risks. Normal morgue capacity is designed for typical mortality rates.
Choice B rationale
Refrigerated trucks provide a temporary, scalable solution for storing a large number of bodies, helping to prevent decomposition and the spread of pathogens in a mass casualty event. This method allows for organized collection and identification processes to be established while awaiting more permanent arrangements, crucial in disaster response. Proper refrigeration maintains body integrity.
Choice C rationale
Hospital morgues, like local funeral home morgues, have limited capacity and are primarily designed for routine patient deaths. In a large-scale disaster, they would be rapidly overfilled, compromising their ability to manage current hospital fatalities and posing logistical challenges for body management and identification. Normal hospital morgues are equipped for standard operations.
Choice D rationale
Mass graves are a last resort in extreme mass casualty events when conventional methods of body disposal are overwhelmed or impractical due to scale, contamination, or resource limitations. While a somber decision, they can be a necessary measure to manage large numbers of deceased individuals safely and efficiently, preventing widespread public health crises. Proper procedures minimize environmental impact.
Correct Answer is ["112"]
Explanation
Step 1: Calculate the minimum daily dose based on the safe dose range. Minimum safe dose per kg = 8 mg/kg/day. Child's weight = 14 kg. Minimum daily dose = 8 mg/kg/day × 14 kg = 112 mg/day. The minimum dose the child should receive per day is 112 mg.
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