Which assessment finding would cause the nurse to notify the MD immediately when assessing a 10-month-old child who had emergency reduction for intussusception 10 hours previously?

Choice A reason: This statement is correct, as hydrostatic reduction of telescoped bowel with an air or saline enema is the preferred treatment for intussusception, which is a condition where a segment of the intestine slides into another segment, causing obstruction, inflammation, and ischemia. The enema can help to push the invaginated bowel back to its normal position, relieve the obstruction, and restore the blood flow. The procedure is safe, effective, and minimally invasive, and can avoid the need for surgery.

Choice B reason: This statement is incorrect, as hydrostatic reduction of telescoped bowel with an air or saline enema is not a false statement, but a true one. The nurse should be aware of the indications, contraindications, and complications of this procedure, and monitor the child's vital signs, abdominal distension, bowel sounds, and stool output before, during, and after the enema. The nurse should also educate the parents about the signs and symptoms of recurrence, such as abdominal pain, vomiting, or bloody stools.

Choice A reason: Starting bolus feedings to stretch the stomach is not recommended for a child with Nissen fundoplication as it can cause increased pressure on the surgical site and lead to complications such as bleeding, perforation, or slippage of the wrap.

Choice B reason: Venting gastrostomy tube is a correct answer as it allows for the release of gas and fluids from the stomach and prevents gastric distension and discomfort. A gastrostomy tube is often placed during Nissen fundoplication to facilitate feeding and venting.

Choice C reason: Keeping child flat in bed to increase absorption of food is not advised for a child with Nissen fundoplication as it can increase the risk of aspiration and pneumonia. The child should be positioned at a 30-degree angle or higher after feeding to prevent reflux.

Choice D reason: Observing for abdominal distension, flushing and hypotension which may indicate dumping syndrome is a correct answer as it is a potential complication of Nissen fundoplication. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms such as abdominal cramps, nausea, diarrhea, sweating, and dizziness.