Therapeutic management of children with Hirschsprung's disease includes:
a low-fiber diet.
surgical removal of aganglionic bowel segment(s).
a permanent colostomy.
medical management with nasogastric decompression until the issue resolves.
The Correct Answer is B
Rationale:
A. A low-fiber diet is not a definitive treatment; dietary modifications may help manage symptoms but do not correct the underlying problem.
B. Surgical removal of the aganglionic segment of the bowel is the primary treatment for Hirschsprung’s disease, as the affected segment lacks nerve cells needed for normal peristalsis. Postoperative care may include temporary ostomy in some cases, but definitive management requires excision of the affected bowel.
C. A permanent colostomy is rarely needed; most children undergo a primary pull-through procedure.
D. Nasogastric decompression and supportive medical management do not resolve the underlying defect, though they may be used temporarily preoperatively to relieve obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. In severe hypernatremic dehydration, an infant typically presents with tachycardia, decreased urine output, poor skin turgor, and lethargy. Hypernatremia leads to intracellular dehydration, causing compensatory cardiovascular responses such as tachycardia.
B. Bulging anterior fontanel is more suggestive of increased intracranial pressure, not routine hypernatremic dehydration. Weight loss may be present but is nonspecific.
C. A sodium level of 140 mEq/L is normal, not indicative of hypernatremia. Parched mucous membranes may occur in dehydration, but hypernatremic dehydration usually presents with sodium >150 mEq/L.
D. Potassium of 5.2 is mildly elevated but bradycardia is not typical; tachycardia is the expected cardiovascular response in hypernatremic dehydration.
Correct Answer is A
Explanation
Rationale:
A. Intercostal retractions occur when the skin between the ribs is pulled inward during inspiration, indicating increased work of breathing and possible respiratory distress.
B. Subcostal retractions are seen when the skin just below the ribcage is drawn inward.
C. Substernal retractions involve inward movement below the sternum.
D. Supraclavicular retractions involve inward movement above the clavicles, often indicating severe respiratory distress.
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