Which therapeutic treatment is commonly implemented for children with Hirschsprung disease?
Low protein diet
Surgical removal of the affected section of the bowel
Permanent colostomy
Daily enemas
The Correct Answer is B
Choice A reason:
A low protein diet is not a therapeutic treatment for Hirschsprung disease. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal colon, leading to a lack of peristalsis and functional obstruction. Dietary modifications, such as a low protein diet, do not address the underlying issue of the absence of nerve cells in the bowel. Therefore, this choice is incorrect.
Choice B reason:
Surgical removal of the affected section of the bowel is the primary treatment for Hirschsprung disease. This procedure, known as a pull-through surgery, involves removing the aganglionic segment of the colon and connecting the healthy part of the intestine to the anus. This surgery restores normal bowel function by allowing the passage of stool through the healthy, innervated portion of the intestine. The pull-through procedure can be performed using minimally invasive techniques, resulting in shorter recovery times and fewer complications.
Choice C reason:
A permanent colostomy is not typically the first-line treatment for Hirschsprung disease. While a temporary colostomy may be performed in some cases to allow the bowel to heal before a pull-through surgery, a permanent colostomy is usually reserved for more severe cases or when other surgical options are not feasible. The goal of treatment is to restore normal bowel function, and a permanent colostomy is generally considered a last resort.
Choice D reason:
Daily enemas are not a definitive treatment for Hirschsprung disease. While enemas may be used temporarily to relieve symptoms and manage bowel movements, they do not address the underlying cause of the condition. The absence of ganglion cells in the bowel requires surgical intervention to restore normal bowel function. Therefore, daily enemas are not a long-term solution for Hirschsprung disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
A 7-year-old child with diabetes insipidus and a urine specific gravity of 1.016 is not in immediate danger. Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of severely diluted urine. A urine specific gravity of 1.016 is within the normal range (1.005 to 1.030). Therefore, this child does not require immediate assessment.
Choice B reason:
A 4-year-old child with asthma and a PCO2 of 37 mm Hg is also not in immediate danger. Asthma is a chronic condition that can cause difficulty breathing, but a PCO2 level of 37 mm Hg is within the normal range (35-45 mm Hg). This indicates that the child’s respiratory status is currently stable, and immediate assessment is not required.
Choice C reason:
A 1-year-old toddler with roseola and a temperature of 39°C (102.2°F) is experiencing a common viral infection that typically causes a high fever followed by a rash. While the fever is high, it is not uncommon for roseola and can be managed with antipyretics and supportive care. This child does not require immediate assessment.
Choice D reason:
A 10-year-old child with sickle cell anemia reporting 8 out of 10 chest pain is in immediate danger and requires urgent assessment. Chest pain in a child with sickle cell anemia can indicate acute chest syndrome, a severe and potentially life-threatening complication. Acute chest syndrome is characterized by chest pain, fever, and respiratory distress, and it requires prompt medical intervention. Therefore, this child should be assessed first.
Correct Answer is C
Explanation
Choice A reason:
Performing an ultrasound to determine if there is urinary retention is not the immediate priority action. While an ultrasound can help assess urinary retention, the presence of edema, redness, and the foreskin being behind the glans penis suggests a condition known as paraphimosis. Paraphimosis is a medical emergency that requires prompt attention to prevent complications such as tissue damage. Therefore, alerting the ER physician is the priority action.
Choice B reason:
Asking the parents specifically how long the infant has not voided is important for gathering information, but it is not the immediate priority action. The clinical signs of edema, redness, and the foreskin being behind the glans penis indicate a potential emergency that requires immediate medical intervention. While obtaining a detailed history is important, the nurse should first alert the ER physician to ensure timely management.
Choice C reason:
Alerting the ER physician to the patient’s condition is the correct priority action. The presence of edema, redness, and the foreskin being behind the glans penis suggests paraphimosis, which is a urological emergency. Prompt intervention is necessary to reduce the foreskin and restore normal blood flow to prevent tissue damage3. The ER physician can provide the necessary treatment and management for this condition.
Choice D reason:
Continuing to monitor the patient in the ER setting is not appropriate without first addressing the potential emergency. The signs of edema, redness, and the foreskin being behind the glans penis indicate a condition that requires immediate medical attention. Monitoring alone is insufficient; the nurse must alert the ER physician to ensure prompt intervention.
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