Which of the following assessment findings would the nurse expect in an infant with Hirschsprung's disease?
a. foul-smelling fatty stool
b. currant jelly-like stool
c. thick, black, tarry stool
d. constipation alternating with ribbonlike stools.
D
Hirschsprung's disease/megacolon is a partial or complete mechanical obstruction resulting from inadequate motility of part of the colon. There is an absence of parasympathetic ganglion cells, which causes an absence of peristalsis. The affected portion of the bowel narrows, becomes dilated, and fills with feces and gas. An infant usually does not have a bowel movement within the first 24 hours. The nurse should assess for passage of stool in the first 24 hours, observe for constipation and malformed or ribbonlike stools, and assess weight gain and nutritional status.
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The nurse is reviewing the results of a Hemoccult test with the client. Which question, asked by the nurse, is important to screen for the potential of a false-positive result. Select all that apply
A) "Do you take an iron supplement on a daily basis?" B) "Does your diet include a moderate amount of vitamin C?" C) "Are you prescribed regular strength aspirin daily?" D) "Can you tell me the amount of alcohol that you drink on an average week?" E) "When was the last time that you included red meat in your diet?"
The nurse is caring for a client with renal failure whose blood gas reflects a pH of 7.21. Which of the following is correct regarding the hydrogen ion and acid?base balance?
1. As the hydrogen ion concentration increases, the pH decreases. 2. As the hydrogen ion concentration increases, the pH increases. 3. As the hydrogen ion concentration decreases, the pH decreases. 4. When present in proper concentration, the hydrogen ion maintains the normal pH of the body between 6.8 and 7.8.
Which current prescriptions should the nurse be concerned with for a client requiring dopamine?
A. MAO inhibitor B. Phenytoin C. Beta blocker D. Digoxin E. Aspirin
The nurse in the figure below is assessing function and strength of the ____________________ muscle. (Your answer should appear as a number [e.g., 1, 2, 3, or 4].)
1. Sternocleidomastoid 2. Trapezius 3. Deltoid 4. Pectoralis major