Key nursing interventions for all renal disorders include: (Select all that apply)

Choice A reason:

A low protein diet is not a therapeutic treatment for Hirschsprung disease. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal colon, leading to a lack of peristalsis and functional obstruction. Dietary modifications, such as a low protein diet, do not address the underlying issue of the absence of nerve cells in the bowel. Therefore, this choice is incorrect.

Choice B reason:

Surgical removal of the affected section of the bowel is the primary treatment for Hirschsprung disease. This procedure, known as a pull-through surgery, involves removing the aganglionic segment of the colon and connecting the healthy part of the intestine to the anus. This surgery restores normal bowel function by allowing the passage of stool through the healthy, innervated portion of the intestine. The pull-through procedure can be performed using minimally invasive techniques, resulting in shorter recovery times and fewer complications.

Choice C reason:

A permanent colostomy is not typically the first-line treatment for Hirschsprung disease. While a temporary colostomy may be performed in some cases to allow the bowel to heal before a pull-through surgery, a permanent colostomy is usually reserved for more severe cases or when other surgical options are not feasible. The goal of treatment is to restore normal bowel function, and a permanent colostomy is generally considered a last resort.

Choice D reason:

Daily enemas are not a definitive treatment for Hirschsprung disease. While enemas may be used temporarily to relieve symptoms and manage bowel movements, they do not address the underlying cause of the condition. The absence of ganglion cells in the bowel requires surgical intervention to restore normal bowel function. Therefore, daily enemas are not a long-term solution for Hirschsprung disease.

Calculation Steps

Step 1: Determine the total urine output in mL.

• Total urine output = 360 mL

Step 2: Determine the child’s weight in kg.

• Weight = 15 kg

Step 3: Determine the time period in hours.

• Time = 12 hours

Step 4: Calculate the urine output in mL/kg/hour.

• Urine output (mL/kg/hour) = Total urine output ÷ (Weight × Time)

Step 5: Perform the multiplication inside the parentheses first.

• Weight × Time = 15 kg × 12 hours = 180 kg·hours

Step 6: Perform the division.

• Urine output (mL/kg/hour) = 360 mL ÷ 180 kg·hours = 2 mL/kg/hour

Result

The child’s urine output is 2 mL/kg/hour.