Mother Baby
Mother-Baby Exam 4 Study Guide
Questions and Answers UPDATED 2025
What are the 3 types of dehydration that a child or infant may experience?
isotonic dehydration, hypotonic dehydration, or hypertonic dehydration
What is isotonic dehydration?
loss of water and sodium
What is hypotonic dehydration?
loss of sodium in excess water
What is hypertonic dehydration?
loss of water in excess sodium
What are some manifestations of these types of dehydration?
change in LOC from irritability to lethargy, altered response to stimuli, prolonged
capillary refill, decreased skin elasticity & tugor, increased HR, sunked eyes and
fontanels
What are some ways to correct these types of dehydration?
oral rehydration or parenteral fluid therapy
When is oral rehydration a good option?
if the child is alert, awake, and not in danger
(used in mild cases of dehydration)
When is parenteral fluid therapy a good option?
if the child is unable to drink, uncontrollably vomiting, or has severe gastric distention
(used in severe cases of dehydration)
What should the nurse monitor for when trying to correct the dehydration?
signs of dehydration, frequent I&O assessments, VS, skin, fontanels
What is Hirschsprung's disease?
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there is aganglionic cells in the sigmoid colon; no peristalsis is happening when food gets
to this area which causes it to back-up and poop just stops moving throughout the
digestive system
When is Hirschsprung's disease usually diagnosed?
mostly found at birth or within the first few months of life
What are the manifestations of Hirschsprung's disease?
abdominal distention, hard palpitation, failure to pass meconium in first 24-48 hours,
refusal to feed, BILIOUS vomiting
What is there a risk of if a newborn has Hirschsprung's disease?
enterocolitis - due to poop just sitting in colon
When trying to tidentify Hirschsprung's disease early, what diagnostic studies are
preformed?
complete and careful history, x-ray, barium edema studies, anorectal manometric
examination, rectal biopsy to confirm diagnosis
What surgery should be anticipated for Hirschsprung's disease?
Soave pull-through
How does the Soave pull-through work?
the section of the colon without cells to help with peristalsis is removed, and then the
good part of the colon is pulled through
What should the nurse anticipate pre-op care would look like for a Soave pull-through?
saline enemas, antibiotics, colonic irrigations, abdominal measurements, prevent
enterocolitis
A newborn's colon is sterile, so they would not need a saline enema during the pre-op
care for a Soave pull-through.
True
1 multiple choice option
What should the nurse anticipate post-op care would look like for a Soave pull-through?
anal dilations, antibiotics
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What is gastroesophageal reflux (GER/GERD)?
transfer of gastric contents into the esophagus
When do manifestations of gastroesophageal reflux (GER/GERD) typically occur?
throughout the day, after meals, at bedtime
When does gastroesophageal reflux (GER/GERD) usually diagnosed and when does it
typically resolve?
peak at 4 months, usually resolves by 12 months
When does GER turn into GERD?
when a secondary complication occurs because of GER
EX: failure to thrive, decreased weight
What is there a risk of when a newborn vomits?
increased risk of aspiration and pneumonia
What type of education should the nurse give to a mother about preventing aspiration
and pneumonia?
prop newborn up for 30 minutes before laying them down
What are the manifestations of gastroesophageal reflux (GER/GERD) in infants?
spitting up, regurgitation, vomiting, excessive crying, irritability, aching of back with neck
extension, weight loss, failure to thrive, respiratory issues, apnea or ALTE
What are the manifestations of gastroesophageal reflux (GER/GERD) in children?
heartburn, abdominal pain, chest pain, dysphagia, chronic cough, nocturnal asthma,
recurrent pneumonia
What is a primary cause of gastroesophageal reflux (GER/GERD)?
inappropriate relaxation of lower esophageal sphincter
How is gastroesophageal reflux (GER/GERD) typically diagnosed?
H&P, upper GI, intraesophageal pH monitoring
How is gastroesophageal reflux (GER/GERD) managed?
Mother Baby
Mother-Baby Exam 4 Study Guide
Questions and Answers UPDATED 2025
What are the 3 types of dehydration that a child or infant may experience?
isotonic dehydration, hypotonic dehydration, or hypertonic dehydration
What is isotonic dehydration?
loss of water and sodium
What is hypotonic dehydration?
loss of sodium in excess water
What is hypertonic dehydration?
loss of water in excess sodium
What are some manifestations of these types of dehydration?
change in LOC from irritability to lethargy, altered response to stimuli, prolonged
capillary refill, decreased skin elasticity & tugor, increased HR, sunked eyes and
fontanels
What are some ways to correct these types of dehydration?
oral rehydration or parenteral fluid therapy
When is oral rehydration a good option?
if the child is alert, awake, and not in danger
(used in mild cases of dehydration)
When is parenteral fluid therapy a good option?
if the child is unable to drink, uncontrollably vomiting, or has severe gastric distention
(used in severe cases of dehydration)
What should the nurse monitor for when trying to correct the dehydration?
signs of dehydration, frequent I&O assessments, VS, skin, fontanels
What is Hirschsprung's disease?
Mother Baby
,Mother Baby
there is aganglionic cells in the sigmoid colon; no peristalsis is happening when food gets
to this area which causes it to back-up and poop just stops moving throughout the
digestive system
When is Hirschsprung's disease usually diagnosed?
mostly found at birth or within the first few months of life
What are the manifestations of Hirschsprung's disease?
abdominal distention, hard palpitation, failure to pass meconium in first 24-48 hours,
refusal to feed, BILIOUS vomiting
What is there a risk of if a newborn has Hirschsprung's disease?
enterocolitis - due to poop just sitting in colon
When trying to tidentify Hirschsprung's disease early, what diagnostic studies are
preformed?
complete and careful history, x-ray, barium edema studies, anorectal manometric
examination, rectal biopsy to confirm diagnosis
What surgery should be anticipated for Hirschsprung's disease?
Soave pull-through
How does the Soave pull-through work?
the section of the colon without cells to help with peristalsis is removed, and then the
good part of the colon is pulled through
What should the nurse anticipate pre-op care would look like for a Soave pull-through?
saline enemas, antibiotics, colonic irrigations, abdominal measurements, prevent
enterocolitis
A newborn's colon is sterile, so they would not need a saline enema during the pre-op
care for a Soave pull-through.
True
1 multiple choice option
What should the nurse anticipate post-op care would look like for a Soave pull-through?
anal dilations, antibiotics
Mother Baby
, Mother Baby
What is gastroesophageal reflux (GER/GERD)?
transfer of gastric contents into the esophagus
When do manifestations of gastroesophageal reflux (GER/GERD) typically occur?
throughout the day, after meals, at bedtime
When does gastroesophageal reflux (GER/GERD) usually diagnosed and when does it
typically resolve?
peak at 4 months, usually resolves by 12 months
When does GER turn into GERD?
when a secondary complication occurs because of GER
EX: failure to thrive, decreased weight
What is there a risk of when a newborn vomits?
increased risk of aspiration and pneumonia
What type of education should the nurse give to a mother about preventing aspiration
and pneumonia?
prop newborn up for 30 minutes before laying them down
What are the manifestations of gastroesophageal reflux (GER/GERD) in infants?
spitting up, regurgitation, vomiting, excessive crying, irritability, aching of back with neck
extension, weight loss, failure to thrive, respiratory issues, apnea or ALTE
What are the manifestations of gastroesophageal reflux (GER/GERD) in children?
heartburn, abdominal pain, chest pain, dysphagia, chronic cough, nocturnal asthma,
recurrent pneumonia
What is a primary cause of gastroesophageal reflux (GER/GERD)?
inappropriate relaxation of lower esophageal sphincter
How is gastroesophageal reflux (GER/GERD) typically diagnosed?
H&P, upper GI, intraesophageal pH monitoring
How is gastroesophageal reflux (GER/GERD) managed?
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