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: Making the patient NPO (nothing by mouth) is not an appropriate intervention for CHF. NPO status may be indicated for other reasons, such as before surgery or certain tests, but it does not address the fluid overload or poor cardiac function that causes CHF.
Choice B reason: Administering diuretics is a common and effective intervention for CHF. Diuretics help reduce the excess fluid in the body and lungs, which improves breathing and lowers blood pressure. Diuretics also decrease the workload of the heart and prevent further damage to the cardiac muscles.
Choice C reason: Administering antipyretics is not a specific intervention for CHF. Antipyretics are used to lower fever, which may or may not be present in CHF. Fever may indicate an infection, which can worsen CHF, but antipyretics alone do not treat the underlying cause of the infection or the CHF.
Choice D reason: Providing IV bolus is not a recommended intervention for CHF. IV bolus is a rapid infusion of fluid or medication into the bloodstream. This may increase the fluid volume and pressure in the body and lungs, which can exacerbate CHF and cause pulmonary edema. IV bolus may be used for other conditions, such as hypovolemic shock or dehydration, but not for CHF.
Correct Answer is C
Explanation
Choice A reason: Clear liquids are not the best intervention for acute diarrhea and dehydration in children. Clear liquids are fluids that are transparent or translucent, such as water, broth, tea, or juice. They may provide some hydration, but they do not contain enough electrolytes (sodium, potassium, chloride) to replace the losses from diarrhea. They may also worsen diarrhea by increasing the osmotic load in the gut.
Choice B reason: Absorbents such as kaolin and pectin are not recommended for acute diarrhea and dehydration in children. Absorbents are substances that bind to toxins, bacteria, or water in the gut, and are supposed to reduce the frequency and volume of stools. However, there is no evidence that they are effective or safe for children with diarrhea. They may also interfere with the absorption of other medications or nutrients.
Choice C reason: Oral rehydration solution (ORS) is the preferred intervention for acute diarrhea and dehydration in children. ORS is a specially formulated solution that contains water, glucose, and electrolytes in the right proportions to replenish the losses from diarrhea. ORS can prevent or treat dehydration, and can also reduce the duration and severity of diarrhea. ORS is widely available, inexpensive, and easy to use. It should be given to children with diarrhea as soon as possible, and continued until the diarrhea stops.
Choice D reason: Antidiarrheal medications are not advised for acute diarrhea and dehydration in children. Antidiarrheal medications are drugs that slow down the movement of the gut, reduce the secretion of fluids, or kill the bacteria that cause diarrhea. However, they are not effective for viral diarrhea, which is the most common cause of diarrhea in children. They may also have serious side effects, such as constipation, abdominal pain, drowsiness, or allergic reactions. They may also mask the symptoms of more serious conditions, such as appendicitis or bowel obstruction.
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