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 A
Explanation
Choice A reason: Semi-Fowler's position is a position in which the head of the bed is elevated to 30 to 45 degrees, and the knees may be slightly bent. This position can help relieve pain and facilitate drainage after an appendectomy, as it reduces the tension on the abdominal muscles and incision, and promotes the flow of blood and fluids away from the surgical site. It can also improve breathing and prevent pulmonary complications.
Choice B reason: Supine position is a position in which the person lies flat on their back, with the head and shoulders slightly elevated. This position is not recommended after an appendectomy, as it can increase the pressure on the abdominal muscles and incision, and cause pain and discomfort. It can also impair breathing and increase the risk of pneumonia.
Choice C reason: Trendelenburg position is a position in which the person lies flat on their back, with the head of the bed lowered and the feet elevated. This position is not advised after an appendectomy, as it can increase the pressure on the abdominal organs and incision, and cause pain and bleeding. It can also reduce the blood flow to the brain and cause dizziness, nausea, or fainting.
Choice D reason: Prone position is a position in which the person lies flat on their stomach, with the head turned to one side. This position is not suitable after an appendectomy, as it can stretch and irritate the abdominal muscles and incision, and cause pain and inflammation. It can also hinder breathing and drainage, and increase the risk of infection.
Correct Answer is B
Explanation
Choice A reason: This is not a correct statement, as the American Academy of Pediatrics does not recommend avoiding breastfeeding for children with congenital heart disease. On the contrary, it supports breastfeeding as the optimal source of nutrition for infants, including those with special health care needs¹.
Choice B reason: This is the correct statement, as the American Academy of Pediatrics does not recommend avoiding breastfeeding for children with congenital heart disease. Breastfeeding may have several benefits for these infants, such as enhancing their immune system, reducing their risk of infection, and promoting their growth and development¹². However, breastfeeding may also pose some challenges for these infants, such as increased energy expenditure, poor weight gain, and difficulty coordinating sucking, swallowing, and breathing²³. Therefore, breastfeeding should be individualized and monitored for each infant with congenital heart disease, and supplemented with formula or fortified breast milk if needed²³.
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