Intussusception and Hirschsprung Disease (10 Questions)

1. Mme Cloutier rushes into the emergency department with her 8-month-old son, Jules. She is frantic and states, "He was playing happily, then suddenly screamed and pulled his legs up to his chest like he was in severe pain. Then he stopped and seemed fine for 20 minutes, but it just happened again." Upon assessment, Jules is lethargic.

Question:
Which additional finding, often a late sign, would the nurse check the diaper for to support a diagnosis of Intussusception? *
2. Baby Marchand, 11 months old, is admitted for observation due to bilious vomiting and episodes of inconsolable crying. The physician suspects Intussusception. You are performing an abdominal assessment while the infant is resting between pain episodes.

Question:
Which specific palpation finding is consistent with this diagnosis? *
3. The diagnosis of Intussusception is confirmed for Baby Thériault via ultrasound. The infant is stable, and there are no signs of bowel perforation or shock. The physician orders a therapeutic procedure to attempt to correct the defect without surgery.

Question:
How should the nurse explain this procedure to the parents? *
4. You are preparing Baby Vachon for transport to the radiology department for an air enema to treat Intussusception. While changing the diaper, you notice the infant has passed a large, formed, normal brown stool. The infant appears comfortable and is cooing.

Question:
What is the priority nursing action? *
5. Baby Lavoie underwent a successful hydrostatic reduction for Intussusception 4 hours ago. He has started clear fluids. The mother calls the nurse and says, "He started crying again and pulling his knees up, just like before."

Question:
What complication is the nurse most concerned about? *
6. You are working in the newborn nursery. Baby Bédard, born at 40 weeks gestation, is now 36 hours old. The mother is attempting to breastfeed, but the baby is refusing to latch, seems irritable, and has a distended abdomen. A review of the chart shows no record of a bowel movement.

Question:
The failure to pass meconium within the first 24-48 hours is the primary diagnostic sign of which condition? *
7. Mme Tessier brings her 9-month-old son to the clinic for "chronic severe constipation." She states, "He never poops without a suppository. When he does go, the poop looks very strange, like flat ribbons, and it smells terrible."

Question:
Why does the stool typically appear "ribbon-like" in Hirschsprung Disease? *
8. Baby Giroux is scheduled for surgery to remove the affected section of the colon (pull-through procedure). The father asks, "I don't understand. Why is his stomach so swollen if the problem is in his bottom?"

Question:
What is the best explanation by the nurse? *
9. Baby Fortin, a 2-month-old awaiting surgery for Hirschsprung Disease, is brought to the ER. The mother reports, "He suddenly got a high fever, he is very sleepy, and he just had explosive, foul-smelling diarrhea." You measure his abdominal girth and note it has increased by 4 cm since the last visit.

Question:
What life-threatening complication is occurring, and what is the priority? *