47 Questions
How do parents often define constipation?
Passing less than three stools per week
What is the term for extremely long intervals between defecation?
Obstipation
Which medication may be associated with constipation?
Opioids
What structural disorder of the intestine may be associated with constipation?
Hirschsprung disease
What do fever and diarrhea accompanying vomiting suggest?
Infection
Which medication blocks receptors in the chemoreceptor trigger zone?
Ondansetron (Zofran)
What is the major focus of nursing care in vomiting cases?
Observing and reporting vomiting behavior
What is the most sensitive guide to fluid needs in vomiting cases?
Thirst mechanism
Which medication competes for H1-receptor sites?
Promethazine (Phenergan)
What should be administered before a trip for children prone to motion sickness?
Dimenhydrinate (Gravol)
What is the preferred feeding approach after vomiting has stopped?
Small, frequent feedings of fluids or foods
What position should a vomiting infant or child be placed in to prevent aspiration?
On their side or semi-reclining
What is a common issue in affected children with chronic fecal retention?
Abdominal pain
What is prevalent in the majority of affected children with constipation?
Idiopathic constipation
What may cause chronic constipation in children?
A combination of environmental and psychosocial factors
What should be assessed in newborns who do not pass meconium within 24 to 36 hours of birth?
Intestinal atresia, Hirschsprung disease, hypothyroidism, meconium plugs, or meconium ileus
What may be required for meconium plugs?
Irrigation with a hypertonic solution or contrast medium
What may result in constipation in infancy?
Organic causes such as Hirschsprung disease, hypothyroidism, and strictures or dietary practices
What is constipation in early childhood often due to?
Discomfort during bowel movements leading to stool withholding
What may cause new-onset constipation in school-age children?
Fear of using school bathrooms and hurried departure for school
What is the aim of therapeutic management of constipation?
To produce soft, painless stools and prevent reaccumulation of feces
What does the treatment of constipation involve?
Promoting regular bowel movements through dietary changes, behavior therapy, and disimpaction
What may be necessary for retraining the bowel and avoiding reimpaction in constipation management?
Maintenance regimen of oral osmotic laxatives and stool-softening agents
What is included in behavior therapy for constipation?
Developing a toilet sitting schedule, using a footstool for support, and keeping a stool frequency diary for review at the next appointment
What is the incidence of Hirschsprung Disease in live births?
1 in 5,000 live births
What is the gender difference in the occurrence of Hirschsprung Disease?
Four times more common in males
What is the primary pathophysiological feature of Hirschsprung Disease?
Absence of ganglion cells in affected areas
How is the diagnosis of Hirschsprung Disease confirmed?
Rectal biopsy
What is the primary therapeutic management for Hirschsprung Disease?
Surgery to remove aganglionic portion of the bowel
What is a potential complication after the pull-through procedure for Hirschsprung Disease?
Anal stricture and incontinence
What is the primary focus of nursing care for Hirschsprung Disease?
Helping parents adjust to their child's congenital defect
What are the clinical manifestations of Hirschsprung Disease in newborns?
Distended abdomen, feeding intolerance, and delay in passing meconium
What may persist as chronic conditions in a small proportion of patients after surgical correction for Hirschsprung Disease?
Constipation and fecal incontinence
What is the primary factor in the initiation of a self-perpetuating cycle of constipation in children?
Discomfort during bowel movements
What does the nursing assessment for constipation involve?
Evaluating bowel habits, diet, events associated with onset, medications, and stool characteristics
What is the surgical procedure to remove aganglionic mucosa in the management of Hirschsprung Disease?
Transanal Soave endorectal pull-through procedure
What may malnourished children with Hirschsprung disease need before surgery?
Enemas, high-calorie diet, and total parenteral nutrition
What is the preoperative care for newborns with Hirschsprung disease?
They usually do not need additional bowel preparation
What does emergency preoperative care for Hirschsprung disease involve?
Monitoring vital signs, fluid and electrolyte replacements, and observing for signs of bowel perforation
How is psychological preparation for colostomy procedure in children with Hirschsprung disease approached?
It depends on the child's age and is explained using concrete terms and visual aids
What does postoperative care for Hirschsprung disease involve?
Similar to that for any abdominal surgery
What is involved in discharge care for children with Hirschsprung disease?
Instruction on colostomy care for parents and school-age children may take on total responsibility for the care
What does green bilious vomiting suggest in children with Hirschsprung disease?
Bowel obstruction
What is cyclic vomiting, as mentioned in the text?
A rare disorder characterized by bouts of vomiting
What may vomiting in children with Hirschsprung disease indicate?
Various causes including infections, obstructions, and psychogenic issues
What is measured to monitor abdominal distension in children with Hirschsprung disease?
Abdominal circumference
What are parents involved in regarding the care of children with Hirschsprung disease?
Daily anal dilatations and colostomy care if necessary
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
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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