A nurse is teaching the mother of a child who has cystic fibrosis and has a prescription for pancreatic enzymes three times per day. Which of the following statements indicates that the mother understands the teaching?

Hirschsprung disease is a condition where nerve cells are missing from parts of the intestine, leading to problems with bowel movements. The treatment for Hirschsprung disease often involves surgery to remove the affected portion of the bowel and create a temporary ostomy (stoma). An ostomy is an opening in the abdominal wall through which waste material can pass into an external pouch, bypassing the affected section of the intestine.
The correct statement by the parent that indicates an understanding of the teaching is C. The parent is expressing relief that the ostomy is temporary, meaning it is not a permanent situation. This response indicates that the parent has been informed about the nature of the ostomy and its planned duration, which is an essential aspect of preoperative teaching.
Let's go through the other options and explain why they are not the best choices:
A. "I'm glad my child will have normal bowel movements now." This statement is not accurate because, after the initial surgery with the creation of a temporary ostomy, the child will not have normal bowel movements. The ostomy is created to bypass the affected part of the intestine, and the child's bowel movements will be directed through the ostomy until further surgery is performed to reconnect the intestine.
B. "I want to learn how to use my child's feeding tube as soon as possible." While learning how to use a feeding tube may be relevant for certain medical conditions, it is not specifically related to Hirschsprung disease or the planned initial surgery. Hirschsprung disease primarily affects the bowel and its function, not the child's ability to eat.
D. "I want to learn how to empty my child's urinary catheter bag." Hirschsprung disease does not directly impact the urinary system, so there is no specific reason for the parent to learn how to empty a urinary catheter bag in the context of this condition or the planned surgery.

To calculate the daily fluid requirements for a child, you typically use the Holliday-Segar method, which provides guidelines based on the child's weight:

1. For the first 10 kg of body weight, you give 100 ml per kg.
2. For the second 10 kg of body weight, you give 50 ml per kg.
3. For any weight above 20 kg, you give 20 ml per kg.

First, convert the child's weight from pounds to kilograms. To do this, divide the weight in pounds by 2.2.

For a child weighing 33 pounds:

• The weight in kilograms is approximately 15 kg (33 divided by 2.2).

Now, calculate the fluid requirement:

• For the first 10 kg of the child's weight, you need 1000 ml (10 kg multiplied by 100 ml).
• For the remaining 5 kg, you need 250 ml (5 kg multiplied by 50 ml).

Adding these together, the total daily fluid requirement is 1250 ml.

So, the daily fluid requirement for a child weighing 33 pounds is 1250 ml.