The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which of the following questions to the mother will most specifically elicit information regarding this disorder?
1. "Does your infant have diarrhea?"
2. "Is your infant constantly vomiting?"
3. "Does your infant constantly spit up feedings?"
4. "Does your infant have foul-smelling, ribbon-like stools?"
4
Rationale: Chronic constipation, beginning in the first month of life and resulting in pellet-like or ribbon stools that are foul-smelling, is a clinical manifestation of Hirschsprung's disease. Delayed passage or absence of meconium stool in the neonatal period is the primary sign. Bowel obstruction, especially in the neonatal period, abdominal pain and distention, and failure to thrive are also clinical manifestations. "Does your infant have diarrhea?" "Is your infant constantly vomiting?" and "Does your infant constantly spit up feedings?" are not specific clinical manifes-tations of this disorder.
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