Preoperative Care for Hirschsprung Disease
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Questions and Answers

How do parents often define constipation?

  • Passing more than three stools per week
  • Passing hard stools once a day
  • Passing soft stools twice a day
  • Passing less than three stools per week (correct)

    • What is the term for extremely long intervals between defecation?

  • Encopresis
  • Hirschsprung disease
  • Hypercalcemia
  • Obstipation (correct)

    • Which medication may be associated with constipation?

  • Antibiotics
  • Antiviral medications
  • Anti-inflammatory drugs
  • Opioids (correct)

    • What structural disorder of the intestine may be associated with constipation?

    <p>Hirschsprung disease</p> Signup and view all the answers

    What do fever and diarrhea accompanying vomiting suggest?

    <p>Infection</p> Signup and view all the answers

    Which medication blocks receptors in the chemoreceptor trigger zone?

    <p>Ondansetron (Zofran)</p> Signup and view all the answers

    What is the major focus of nursing care in vomiting cases?

    <p>Observing and reporting vomiting behavior</p> Signup and view all the answers

    What is the most sensitive guide to fluid needs in vomiting cases?

    <p>Thirst mechanism</p> Signup and view all the answers

    Which medication competes for H1-receptor sites?

    <p>Promethazine (Phenergan)</p> Signup and view all the answers

    What should be administered before a trip for children prone to motion sickness?

    <p>Dimenhydrinate (Gravol)</p> Signup and view all the answers

    What is the preferred feeding approach after vomiting has stopped?

    <p>Small, frequent feedings of fluids or foods</p> Signup and view all the answers

    What position should a vomiting infant or child be placed in to prevent aspiration?

    <p>On their side or semi-reclining</p> Signup and view all the answers

    What is a common issue in affected children with chronic fecal retention?

    <p>Abdominal pain</p> Signup and view all the answers

    What is prevalent in the majority of affected children with constipation?

    <p>Idiopathic constipation</p> Signup and view all the answers

    What may cause chronic constipation in children?

    <p>A combination of environmental and psychosocial factors</p> Signup and view all the answers

    What should be assessed in newborns who do not pass meconium within 24 to 36 hours of birth?

    <p>Intestinal atresia, Hirschsprung disease, hypothyroidism, meconium plugs, or meconium ileus</p> Signup and view all the answers

    What may be required for meconium plugs?

    <p>Irrigation with a hypertonic solution or contrast medium</p> Signup and view all the answers

    What may result in constipation in infancy?

    <p>Organic causes such as Hirschsprung disease, hypothyroidism, and strictures or dietary practices</p> Signup and view all the answers

    What is constipation in early childhood often due to?

    <p>Discomfort during bowel movements leading to stool withholding</p> Signup and view all the answers

    What may cause new-onset constipation in school-age children?

    <p>Fear of using school bathrooms and hurried departure for school</p> Signup and view all the answers

    What is the aim of therapeutic management of constipation?

    <p>To produce soft, painless stools and prevent reaccumulation of feces</p> Signup and view all the answers

    What does the treatment of constipation involve?

    <p>Promoting regular bowel movements through dietary changes, behavior therapy, and disimpaction</p> Signup and view all the answers

    What may be necessary for retraining the bowel and avoiding reimpaction in constipation management?

    <p>Maintenance regimen of oral osmotic laxatives and stool-softening agents</p> Signup and view all the answers

    What is included in behavior therapy for constipation?

    <p>Developing a toilet sitting schedule, using a footstool for support, and keeping a stool frequency diary for review at the next appointment</p> Signup and view all the answers

    What is the incidence of Hirschsprung Disease in live births?

    <p>1 in 5,000 live births</p> Signup and view all the answers

    What is the gender difference in the occurrence of Hirschsprung Disease?

    <p>Four times more common in males</p> Signup and view all the answers

    What is the primary pathophysiological feature of Hirschsprung Disease?

    <p>Absence of ganglion cells in affected areas</p> Signup and view all the answers

    How is the diagnosis of Hirschsprung Disease confirmed?

    <p>Rectal biopsy</p> Signup and view all the answers

    What is the primary therapeutic management for Hirschsprung Disease?

    <p>Surgery to remove aganglionic portion of the bowel</p> Signup and view all the answers

    What is a potential complication after the pull-through procedure for Hirschsprung Disease?

    <p>Anal stricture and incontinence</p> Signup and view all the answers

    What is the primary focus of nursing care for Hirschsprung Disease?

    <p>Helping parents adjust to their child's congenital defect</p> Signup and view all the answers

    What are the clinical manifestations of Hirschsprung Disease in newborns?

    <p>Distended abdomen, feeding intolerance, and delay in passing meconium</p> Signup and view all the answers

    What may persist as chronic conditions in a small proportion of patients after surgical correction for Hirschsprung Disease?

    <p>Constipation and fecal incontinence</p> Signup and view all the answers

    What is the primary factor in the initiation of a self-perpetuating cycle of constipation in children?

    <p>Discomfort during bowel movements</p> Signup and view all the answers

    What does the nursing assessment for constipation involve?

    <p>Evaluating bowel habits, diet, events associated with onset, medications, and stool characteristics</p> Signup and view all the answers

    What is the surgical procedure to remove aganglionic mucosa in the management of Hirschsprung Disease?

    <p>Transanal Soave endorectal pull-through procedure</p> Signup and view all the answers

    What may malnourished children with Hirschsprung disease need before surgery?

    <p>Enemas, high-calorie diet, and total parenteral nutrition</p> Signup and view all the answers

    What is the preoperative care for newborns with Hirschsprung disease?

    <p>They usually do not need additional bowel preparation</p> Signup and view all the answers

    What does emergency preoperative care for Hirschsprung disease involve?

    <p>Monitoring vital signs, fluid and electrolyte replacements, and observing for signs of bowel perforation</p> Signup and view all the answers

    How is psychological preparation for colostomy procedure in children with Hirschsprung disease approached?

    <p>It depends on the child's age and is explained using concrete terms and visual aids</p> Signup and view all the answers

    What does postoperative care for Hirschsprung disease involve?

    <p>Similar to that for any abdominal surgery</p> Signup and view all the answers

    What is involved in discharge care for children with Hirschsprung disease?

    <p>Instruction on colostomy care for parents and school-age children may take on total responsibility for the care</p> Signup and view all the answers

    What does green bilious vomiting suggest in children with Hirschsprung disease?

    <p>Bowel obstruction</p> Signup and view all the answers

    What is cyclic vomiting, as mentioned in the text?

    <p>A rare disorder characterized by bouts of vomiting</p> Signup and view all the answers

    What may vomiting in children with Hirschsprung disease indicate?

    <p>Various causes including infections, obstructions, and psychogenic issues</p> Signup and view all the answers

    What is measured to monitor abdominal distension in children with Hirschsprung disease?

    <p>Abdominal circumference</p> Signup and view all the answers

    What are parents involved in regarding the care of children with Hirschsprung disease?

    <p>Daily anal dilatations and colostomy care if necessary</p> Signup and view all the answers

    Study Notes

    Preoperative Care for Hirschsprung Disease

    • Preoperative care for children with Hirschsprung disease varies based on age and clinical condition
    • Malnourished children may need symptomatic treatment, enemas, high-calorie diet, and total parenteral nutrition before surgery
    • Newborns usually do not need additional bowel preparation, while other children may require saline enemas and antibiotics
    • Emergency preoperative care involves monitoring vital signs, fluid and electrolyte replacements, and observing for signs of bowel perforation
    • Abdominal circumference is measured to monitor abdominal distension, and the tape measure can be left in place to reduce stress for the child
    • Psychological preparation for colostomy procedure depends on the child's age and is explained using concrete terms and visual aids
    • Postoperative care for Hirschsprung disease is similar to that for any abdominal surgery
    • Parents are involved in the care, including daily anal dilatations and colostomy care if necessary
    • Discharge care involves instruction on colostomy care for parents and school-age children may take on total responsibility for the care
    • Vomiting in children is a complex process under CNS control and can have various causes including infections, obstructions, and psychogenic issues
    • Characteristics of the emesis and pattern of vomiting help determine the cause, such as green bilious vomiting suggesting bowel obstruction
    • Cyclic vomiting is a rare disorder characterized by bouts of vomiting, but research on its etiology and treatment protocols is lacking

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    Description

    Test your knowledge of the preoperative care for Hirschsprung disease with this quiz. Explore the specific considerations for different age groups, emergency care, psychological preparation, and postoperative care. Also, learn about the complexities of vomiting in children and its potential causes.

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