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 C
Explanation
Choice A reason: This is not a correct statement, as delaying dental visits until the child's heart defect is fully repaired is not advisable. Dental visits are important for maintaining oral hygiene and preventing dental caries, which can increase the risk of infective endocarditis. The child should have regular dental check-ups and follow the dentist's recommendations for oral care¹.
Choice B reason: This is not a correct statement, as administration of daily prophylactic antibiotics is not recommended for prevention of infective endocarditis. Daily antibiotics can cause adverse effects, such as allergic reactions, diarrhea, or yeast infections. They can also lead to antibiotic resistance, which can make the treatment of infective endocarditis more difficult².
Choice C reason: This is the correct statement, as administration of antibiotics one hour prior to any dental procedure is recommended for prevention of infective endocarditis. Dental procedures can cause bleeding and release bacteria into the bloodstream, which can infect the damaged heart valves or tissues. Antibiotics can help prevent or reduce the bacterial growth and prevent infective endocarditis¹².
Choice D reason: This is not a correct statement, as high dose IV antibiotics for 29 weeks is not a preventive measure, but a treatment option for infective endocarditis. IV antibiotics are given to eradicate the infection and prevent complications, such as heart failure or stroke. The duration of treatment depends on the type and severity of the infection, but it usually ranges from 4 to 6 weeks²³.
Correct Answer is D
Explanation
Choice A reason: Unfamiliar equipment should be shown to the child and the family before the surgery, as part of the preoperative education and preparation. This can help reduce the child's fear and anxiety, as well as increase the child's understanding and cooperation during the surgery¹.
Choice B reason: Explain that an endotracheal tube will be needed for the surgery, regardless of how well it goes. The endotracheal tube is inserted through the mouth or nose into the trachea to provide mechanical ventilation during the surgery and the immediate postoperative period. The child and the family should be informed about the purpose, duration, and possible complications of the endotracheal tube, as well as the methods of communication and comfort measures².
Choice C reason: Mention the postoperative discomfort and interventions that the child may experience after the surgery, such as pain, nausea, chest tubes, drains, dressings, and monitors. The child and the family should be reassured that these are normal and expected, and that the nurse will provide adequate pain relief and care. The child and the family should also be taught about the postoperative activities and exercises, such as deep breathing, coughing, turning, and leg movements, to promote recovery and prevent complications³.
Choice D reason: Let the child hear the sounds of an ECG monitor, as well as other equipment that will be used during the surgery, such as a blood pressure cuff, an oxygen mask, and an IV pump. This can help familiarize the child with the sounds and sensations that he or she will encounter during the surgery, and reduce the fear of the unknown. The child should also be encouraged to ask questions and express feelings about the surgery⁴.
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