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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","H"]
Explanation
Signs: "increasingly confused and irritable", "tremors in the client's hands when arms are extended", "The client with cirrhosis appears disoriented and has difficulty answering simple asks", "The nurse observes asterixis when the client extends their arms", "The nurse monitors the client closely for worsening neurologic functions.”. Causes: "cirrhosis", "elevated mental status" (This phrase is likely a typo and should refer to elevated ammonia levels, which is the primary cause of hepatic encephalopathy). Treatments: "The provider prescribes lactulose to lower ammonia levels.”.
Correct Answer is ["1.9"]
Explanation
Step 1 is to determine the concentration of the reconstituted medication. The vial contains 4g and is reconstituted with 12mL for a final concentration of 2g per 2.5mL.
Step 2 is to calculate how many mL are needed for the 1.5g dose. The desired dose is 1.5g. The concentration is 2g in 2.5mL.
Step 3 is to set up a proportion: (2g ÷ 2.5mL) = (1.5g ÷ X mL).
Step 4 is to solve for X: X mL = (1.5g × 2.5mL) ÷ 2g.
Step 5 is to calculate the value: X = 3.75 ÷ 2.
Step 6 is to calculate the final answer: X = 1.875 mL.
Step 7 is to round to the nearest tenth: 1.9 mL. The final calculated answer is 1.9 mL.
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