NURS 3900 Final Exam Guide With
Complete Solution
Failure to thrive: What it is - ANSWER Failure to grow related to an inability
to obtain or use calories required for growth
Failure to thrive: classifications - ANSWER Organic (25%): disease process or
congenital or genetic disorders that inhibit feeding, digestion, absortion or
transport of nutrients to tissues; includes CHD, GI disorders, neuro problems,
CF, etc
Nonorganic (50%): may be due to complex set of interactive patterns
between the infant and caregiver (picky eater)
FTT: manifestations - ANSWER -weight below 5th percentile
-sudden decerlation in growth
-delay in developmental milestones
-muscle hypotonia, decreased muscle mass
-generalized weakness, ab distension
FTT: nursing interventions - ANSWER 1. Note feeding patterns, assess
tolerance to approriate foods, schedule mealtimes
2. Initiate correct diet
3. Monitor intake and weight gain
4. Teach good mealtime behaviors
,5. Organic: address underlying health condition
GERD: what it is - ANSWER Transfer of gastric contents into esophagus
GERD: nursing interventions - ANSWER 1. Positioning: hold infant in upright
position after feeding, prone ok but not while asleep; older kids stand after
eating, elevate HOB
2. Meds: PPI
3. Comfort measures
4. Education: most kids grow out of it
Pyloric stenosis: what it is - ANSWER constriction of pyloric sphincter with
obstruction of the gastric outlet
Pyloric stenosis: treatment - ANSWER -preoperative care
-surgical intervention: pyloromytomy
-postop care
Intussusception: what it is - ANSWER Intestine folds in on itself with cause
unknown
Intussusception: manifestations - ANSWER -occurs suddenly
-episodic, severe abdominal pain (very cyclic)
-abdominal distension
-vomiting
-"currant jelly" stools
Intussusception: nursing interventions - ANSWER Barium enema: can
,diagnose or treat
-bowel prep preoperatively
-stools may be light colored for a few days
What is rebound tenderness? - ANSWER pain upon releasing the palpating
hand pushing on the abdomen (think appendicitis)
Hirschsprung disease: what it is - ANSWER *dilating colon*
mechanical obstruction of intestine from inadequate motility of intestine due
to absence of ganglion cells in colon; aganglionic segment usually includes
rectum and proximal colon
Hirschsprung disease: treatment - ANSWER Surgery: pull through operation
which is surgical resection of aganglionic bowel and anastomosis of
ganglionic bowel to distal rectum
GI obstruction: symptoms - ANSWER abdominal pain and vomiting
When do you no longer need NG tube to suction? - ANSWER when there are
bowel sounds and passing gas
Should someone vomit if patient has NG tube to suction? - ANSWER No;
check patency of suction
Signs of dehydration - ANSWER -dry oral mucosa
-tenting skin
-alert to comatose
-sunken fontanels
-deeply sunken orbits
, -increased HR
-hypotension
-cool, mottled skin with delayed cap refill
-UO <1 ml/kg/hr
What is gastroenteritis? - ANSWER *inflamed stomach*
Intestinal infection marked by watery diarrhea, abdominal cramps, N/V and
vomiting. Usually caused by the rotavirus
Urinalysis: lab values - ANSWER -pH: 5-9
-*Specific gravity: 1.001-1.030*
-*Protein: <20 mg/dL*
-urobilinogen: up to 1 mg/dL
-no: glucose, ketones, RBCs, HgB, WBCs, casts, nitrates
-*production 1-2 cc/kg/hour*
UTI: Etiology - ANSWER -alteration of defense mechanisms increases risk of
UTI
-female anatomy is predisposing factor
-organisms usually introduced via ascending route from urethra from
urologic instrumentation, sex, or other
-E. coli, streptococci, staphylococcus saprophysticus
-fungal and paristic pathogens
UTI: manifestations - ANSWER -no sx or nonspecific sx: fatigue,
Complete Solution
Failure to thrive: What it is - ANSWER Failure to grow related to an inability
to obtain or use calories required for growth
Failure to thrive: classifications - ANSWER Organic (25%): disease process or
congenital or genetic disorders that inhibit feeding, digestion, absortion or
transport of nutrients to tissues; includes CHD, GI disorders, neuro problems,
CF, etc
Nonorganic (50%): may be due to complex set of interactive patterns
between the infant and caregiver (picky eater)
FTT: manifestations - ANSWER -weight below 5th percentile
-sudden decerlation in growth
-delay in developmental milestones
-muscle hypotonia, decreased muscle mass
-generalized weakness, ab distension
FTT: nursing interventions - ANSWER 1. Note feeding patterns, assess
tolerance to approriate foods, schedule mealtimes
2. Initiate correct diet
3. Monitor intake and weight gain
4. Teach good mealtime behaviors
,5. Organic: address underlying health condition
GERD: what it is - ANSWER Transfer of gastric contents into esophagus
GERD: nursing interventions - ANSWER 1. Positioning: hold infant in upright
position after feeding, prone ok but not while asleep; older kids stand after
eating, elevate HOB
2. Meds: PPI
3. Comfort measures
4. Education: most kids grow out of it
Pyloric stenosis: what it is - ANSWER constriction of pyloric sphincter with
obstruction of the gastric outlet
Pyloric stenosis: treatment - ANSWER -preoperative care
-surgical intervention: pyloromytomy
-postop care
Intussusception: what it is - ANSWER Intestine folds in on itself with cause
unknown
Intussusception: manifestations - ANSWER -occurs suddenly
-episodic, severe abdominal pain (very cyclic)
-abdominal distension
-vomiting
-"currant jelly" stools
Intussusception: nursing interventions - ANSWER Barium enema: can
,diagnose or treat
-bowel prep preoperatively
-stools may be light colored for a few days
What is rebound tenderness? - ANSWER pain upon releasing the palpating
hand pushing on the abdomen (think appendicitis)
Hirschsprung disease: what it is - ANSWER *dilating colon*
mechanical obstruction of intestine from inadequate motility of intestine due
to absence of ganglion cells in colon; aganglionic segment usually includes
rectum and proximal colon
Hirschsprung disease: treatment - ANSWER Surgery: pull through operation
which is surgical resection of aganglionic bowel and anastomosis of
ganglionic bowel to distal rectum
GI obstruction: symptoms - ANSWER abdominal pain and vomiting
When do you no longer need NG tube to suction? - ANSWER when there are
bowel sounds and passing gas
Should someone vomit if patient has NG tube to suction? - ANSWER No;
check patency of suction
Signs of dehydration - ANSWER -dry oral mucosa
-tenting skin
-alert to comatose
-sunken fontanels
-deeply sunken orbits
, -increased HR
-hypotension
-cool, mottled skin with delayed cap refill
-UO <1 ml/kg/hr
What is gastroenteritis? - ANSWER *inflamed stomach*
Intestinal infection marked by watery diarrhea, abdominal cramps, N/V and
vomiting. Usually caused by the rotavirus
Urinalysis: lab values - ANSWER -pH: 5-9
-*Specific gravity: 1.001-1.030*
-*Protein: <20 mg/dL*
-urobilinogen: up to 1 mg/dL
-no: glucose, ketones, RBCs, HgB, WBCs, casts, nitrates
-*production 1-2 cc/kg/hour*
UTI: Etiology - ANSWER -alteration of defense mechanisms increases risk of
UTI
-female anatomy is predisposing factor
-organisms usually introduced via ascending route from urethra from
urologic instrumentation, sex, or other
-E. coli, streptococci, staphylococcus saprophysticus
-fungal and paristic pathogens
UTI: manifestations - ANSWER -no sx or nonspecific sx: fatigue,
