1. Joseph Williams is a 2-year-old patient
1. Joseph Williams is a 2-year-old patient who presents to the emergency room with abrupt onset of severe, paroxysmal, colicky abdominal pain. The child appears weak, ill, and lethargic and does not cry when the nurse starts an IV. Joseph’s mother, Lisa, states, “Joseph had jelly-like stool yesterday, but I thought he was just getting a stomach bug. He had a brief episode of pain, but then was acting perfectly normal and playing five minutes later. I thought he just had gas until it happened again today and hasn’t gone away.” (Learning Objectives: 3, 4, 6) a. What is the pathophysiology behind intussusception? b. Why is Joseph’s abdominal pain intermittent instead of continuous? c. What treatment would the nurse expect to implement for this patient? 2. Highlight the differences between Crohn Disease and ulcerative colitis. Focus on the differences in assessment findings, symptoms, and treatments. How would either of these diseases impact developmental ages/stages? 3. A 9-month-old child presents to the emergency room with a volvulus and required operative resection of the colon. The child lost a large percentage of the bowel and now has short gut syndrome. a. What vitamins and mineral deficiencies is this child most at risk for? What are the clinical manifestations you would see from these deficiencies? b. What nutrition interventions will likely take place for this child? 4. A 1-day-old child is born with an omphalocele. The mother is tearful and asks the nurse if she will still be able to breastfeed. In the hallway, the orientee asks the primary nurse what the difference is between omphalocele and gastroschisis. 5. A 5-week-old male child presents to the healthcare clinic with projectile vomiting and dehydration. The patient’s mother states that the patient began forcefully vomiting after feedings yesterday, but was previously healthy with no medical conditions or allergies. a. What condition do you suspect this patient has? What symptoms lead you to that conclusion? b. What nursing interventions should be included in the plan of care to prevent dehydration in this patient? a. What should the nurse tell the mother about nutrition in patients with omphaloceles? b. What should the nurse tell the orientee about the difference between omphaloceles and gastroschisis? 6. A newborn male infant presents to the healthcare clinic for a well-care examination. The mother requests circumcision for the child. During the genitourinary assessment, the healthcare provider notes that the urethral opening is on the dorsal aspect of the penis. a. What type of genitourinary defect does this child have? b. Should the child receive circumcision at this time? Why or why not? c. What are the postoperative priority nursing interventions for this patient? 7. A 5-month-old male child presents to the healthcare clinic for a well-care examination. The father reports concern that the infant’s testicles have not yet descended into the scrotum. a. What positioning, environment, and assessment techniques should be used to assess for cryptorchidism? b. What is the expected treatment for this condition? 8. A 2-year-old child presents to the emergency room for dehydration. The child weighs 12.5 kg and the nurse assesses decreased skin turgor and dry mucous membranes. a. What urine output should this child have? b. What developmental-based anatomical differences in the genitourinary system predispose this child for dehydration?
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