A pediatric client is admitted to the unit with failure to thrive. The mother states that the child has been "spitting up" and excessively crying immediately after every bottle. What diagnostic test will the nurse anticipate to confirm a diagnosis?
Upper gastrointestinal series to determine structural abnormalities from gastroesophageal reflux
Biopsy of small intestine mucosa to rule out celiac disease
Ultrasound to assess for presence of pyloric stenosis
Lower gastrointestinal series to assess for an intestinal blockage
The Correct Answer is A
A. An upper gastrointestinal series is commonly used to diagnose gastroesophageal reflux (GER), which can cause symptoms like spitting up and crying after feedings, leading to failure to thrive. This test helps visualize the esophagus, stomach, and duodenum for abnormalities.
B. A biopsy of the small intestine is typically done to diagnose celiac disease, which is less likely in this clinical scenario.
C. An ultrasound is used to diagnose pyloric stenosis, which presents with projectile vomiting and is less consistent with the described symptoms.
D. A lower gastrointestinal series is used to detect intestinal blockages, which are not suggested by the symptoms of spitting up and crying immediately after feeding.
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Related Questions
Correct Answer is A
Explanation
A. Projectile vomiting is a classic sign of pyloric stenosis, where the thickened pylorus muscle obstructs the passage of food from the stomach to the small intestine, causing forceful vomiting.
B. Large amounts of bilious emesis would suggest an obstruction beyond the pylorus, which is not characteristic of pyloric stenosis.
C. Watery diarrhea is not associated with pyloric stenosis, which typically causes dehydration and constipation.
D. Steatorrhea, or fatty stools, is not a feature of pyloric stenosis but rather is associated with malabsorption syndromes.
Correct Answer is D
Explanation
A. Prone positioning is not recommended post-operatively for abdominal surgery and could exacerbate respiratory issues.
B. While monitoring white blood cell count is important, encouraging lung expansion and preventing complications such as atelectasis is a more immediate priority.
C. The client's pain rating is low and does not necessitate immediate administration of acetaminophen.
D. Encouraging the use of an incentive spirometer helps improve lung expansion, which is crucial to prevent atelectasis and promote proper oxygenation, particularly when breath sounds are diminished.
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