Peds TEST-BANK20. Chapter 23: Alterations in Gastrointestinal Function

1. A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care for an omphalocele? A. At birth, protect the exposed bowel by gently manipulating it back into the abdominal cavity. B. Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. C. Administer corticosteroids as prescribed—either oral prednisone or prednisolone or as IV methylprednisolone. D. Insert an NG tube to decompress the stomach and to prevent gastric distention. ANS: B Rationale: For an omphalocele, protect the bowel by wrapping the exposed viscera with warm saline-soaked gauze and cover and seal with a plastic wrap or place in a "bowel bag" which will contain the defect, torso, and legs, to prevent heat and fluid loss from the exposed viscera. Obtain IV access. Give fluid resuscitation and correct any electrolyte abnormalities. Oral prednisone or prednisolone, or IV methylprednisolone, are administered for irritable bowel syndrome. An NG tube may be placed to decompress the stomach to prevent gastric distention when severe emesis is present with pancreatitis. PTS: 1 REF: p. 420 OBJ: 3 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 23: Gastrointestinal Disorders BLM: Cognitive Level: Apply 2. A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan? A. Help her ambulate with the bottles. B. Provide some time to talk to her several times a day. C. Help her give the bottles nicknames and personalities. D. Explain that TPN substitutes for normal food. ANS: B Rationale: Many children receiving alternative methods of feeding miss the conversation that goes with mealtime. Providing this helps them accept an alternative feeding method. PTS: 1 REF: p. 452 OBJ: 4 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 23: Gastrointestinal Disorders BLM: Cognitive Level: Apply 3. The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching? A. "Encourage a bland diet." B. "Implement clear liquids." C. "Provide plenty of 100% fruit juice." D. "Offer flavored gelatin if hungry." ANS: A TEST BANK FOR PEDIATRIC NURSING 1ST BY TAGHER WWW.NURSING-TESTBANK.COM N U R S I N G - T E S T B A N K . C O M Rationale: After rehydration is achieved, it is important to encourage the child to consume a bland diet in order to maintain energy and growth. The solid foods presented are easily digested and age appropriate. The parents should avoid prolonged used of clear liquids in the child with diarrhea because "starvation stools" might result. Fluids high in glucose such as fruit juice, gelatin, and so