Which one of the following statements by a parent would reflect the presenting history for gastroesophageal reflux in a 12-month-old?
She has green, loose stools with cow's milk
She coughs and spits up while eating foods
She has projectile vomiting after feeding
Her stools are hard and black in color
The Correct Answer is B
Choice A reason: She has green, loose stools with cow's milk is not a typical sign of gastroesophageal reflux in a 12-month-old. Green, loose stools may indicate an infection, an allergy, or a malabsorption problem. Cow's milk may cause an allergic reaction or intolerance in some infants, but it does not cause reflux. Reflux is when stomach contents flow back up into the esophagus, causing vomiting, regurgitation, or heartburn.
Choice B reason: She coughs and spits up while eating foods is a common symptom of gastroesophageal reflux in a 12-month-old. Coughing and spitting up may occur because the food or liquid irritates the throat or the airway, or because the infant swallows air while feeding. Reflux may be more frequent or severe when the infant eats solid foods, as they may be harder to digest or may trigger the lower esophageal sphincter to relax. Reflux may also be worse when the infant lies down, as gravity does not help to keep the food in the stomach.
Choice C reason: She has projectile vomiting after feeding is not a usual sign of gastroesophageal reflux in a 12-month-old. Projectile vomiting is when the vomit is ejected forcefully and travels a distance. It may indicate a serious condition such as pyloric stenosis, which is a narrowing of the outlet of the stomach that prevents food from passing into the small intestine. Projectile vomiting may also be caused by a bowel obstruction, a brain tumor, or a metabolic disorder.
Choice D reason: Her stools are hard and black in color is not a normal sign of gastroesophageal reflux in a 12-month-old. Hard and black stools may indicate constipation, bleeding in the upper gastrointestinal tract, or ingestion of iron supplements or certain foods. Reflux does not affect the color or consistency of the stools, unless there is an underlying condition such as an infection, an allergy, or a malabsorption problem.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is a correct statement, as assessing the affected extremity for temperature and color can help detect any signs of vascular injury or thrombosis after the cardiac catheterization. The extremity should be warm and pink, indicating adequate blood flow. If the extremity is cold, pale, or cyanotic, it may indicate ischemia or occlusion¹.
Choice B reason: This is not a correct statement, as managing hydration with IV fluids until able to tolerate oral fluids is not a necessary intervention after the cardiac catheterization. The child may be able to resume oral fluids as soon as they are awake and alert, unless there are contraindications such as nausea or vomiting. IV fluids may be given to prevent dehydration or hypotension, but they should be monitored carefully to avoid fluid overload or pulmonary edema¹².
Choice C reason: This is a correct statement, as checking pulses above the catheterization site for equality and symmetry can help detect any signs of arterial injury or spasm after the cardiac catheterization. The pulses should be strong and equal on both sides, indicating normal blood flow. If the pulses are weak, absent, or unequal, it may indicate arterial occlusion or narrowing¹.
Choice D reason: This is a correct statement, as monitoring vital signs frequently can help detect any signs of bleeding, infection, or cardiac complications after the cardiac catheterization. The vital signs should be stable and within normal limits, indicating normal hemodynamic status. If the vital signs are abnormal, such as hypotension, tachycardia, fever, or dysrhythmia, it may indicate hemorrhage, sepsis, or cardiac tamponade¹².
Correct Answer is B
Explanation
Choice A reason: Placing the infant in Trendelenburg position (head lower than feet) after eating is not a good suggestion to minimize reflux. This position may increase the abdominal pressure and the risk of aspiration. The infant should be placed in an upright or semi-upright position (30 to 45 degrees) for at least 30 minutes after feeding to reduce reflux and prevent regurgitation¹.
Choice B reason: Thickening the formula with rice cereal is a common and effective suggestion to minimize reflux. The rice cereal increases the viscosity and weight of the formula, making it less likely to flow back into the esophagus. The amount of rice cereal added should be about 1 teaspoon per ounce of formula, unless otherwise instructed by the health care provider².
Choice C reason: Giving continuous nasogastric tube feedings is not a necessary or desirable suggestion to minimize reflux. Nasogastric tube feedings are used for infants who have severe reflux and cannot tolerate oral feedings, or who have other medical conditions that require tube feeding. Nasogastric tube feedings may have complications such as infection, irritation, displacement, or obstruction of the tube. They may also interfere with the infant's oral development and bonding with the caregiver³.
Choice D reason: Giving larger, less frequent feedings is not a helpful suggestion to minimize reflux. Larger feedings may overfill the stomach and increase the pressure on the lower esophageal sphincter, which is the muscle that prevents reflux. Less frequent feedings may also make the infant more hungry and irritable, and cause more crying and swallowing of air. The infant should be given smaller, more frequent feedings to reduce reflux and promote digestion.
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