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Exam 2: NSG 434/ NSG434 (Latest 2024/ 2025 Update) Nursing Care of the Childbearing Family Complete Guide| Qs & As| 100% Correct| Grade A (Verified Answers)- GCU $10.99
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Exam 2: NSG 434/ NSG434 (Latest 2024/ 2025 Update) Nursing Care of the Childbearing Family Complete Guide| Qs & As| 100% Correct| Grade A (Verified Answers)- GCU

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Exam 2: NSG 434/ NSG434 (Latest 2024/ 2025 Update) Nursing Care of the Childbearing Family Complete Guide| Qs & As| 100% Correct| Grade A (Verified Answers)- GCU Q: Hirschsprung disease Answer: -Lack of innervation often in lower portion of bowel, no peristaltic waves causing chronic con...

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  • September 12, 2024
  • 51
  • 2024/2025
  • Exam (elaborations)
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  • exam 2 nsg 434 nsg434 l
  • NSG434/ NSG 434
  • NSG434/ NSG 434
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nurse_steph
ExamI2:INSGI434/INSG434I(LatestI2024/I
2025IUpdate)INursingICareIofItheI
ChildbearingIFamilyICompleteIGuide|IQsI
&IAs|I100%ICorrect|IGradeIAI(VerifiedI
Answers)-IGCU

Q:IHirschsprungIdisease

Answer:
-
LackIofIinnervationIoftenIinIlowerIportionIofIbowel,InoIperistalticIwavesIcausingIchronicIcons
tipationIaboveIthisIarea,Imegacolon
-RectalIsphincterIfailsItoIrelax:Iribbon-likeIstoolIfromIpassingIthroughItheInarrowIsegment
-Etiology:IbothIgeneticIandIenvironmentalIfactors,IbutItheIexactIetiologyIisIunknown
-MostIcommonlyIobservedIinIneonatesI-I4xImoreIcommonIinImales
-AbsenceIofIganglionIcellsIinItheIrectumIorIinItheIcolon
-AbnormalIorIabsentIperistalsis
-TotalIabsenceIofIspontaneousIbowelIevacuation

ClinicalIManifestations:
-Neonate:IfailureItoIpassImeconiumIwithinI24-48IhoursIofIbirth,IbiliousIvomiting
-InfancyI&Ichildhood:Iconstipation,IrecurrentIdiarrhea,Iribbon-like,Iflat,Ifoul-
smellingIstool,IfailureItoIthrive

-RectalIbiopsyItoIdetectIabsenceIofIganglionIcellsIisIdefinitiveIdiagnosis

Treatment:
-One-stageIsurgicalItreatment:ItransanalIpull-through
-ColostomyI(temporary)IandIthenIremovalIofIaganlionicIsection
-
IfItheIproximalIbowelIisInotIextremelyIdistendedI(possibleIwithIearlyIdiagnosis),IwhenItheIinf
antIisIbetweenI6ItoI12ImonthsI(orI8ItoI10Ikg)ItheIsurgeonIwillIperformIaIrectalIpull-
thruIprocedureIinIwhichIallItheIaganglionicIbowelIisIremovedIandItheInormalIbowelIisIreconn
ectedItoItheIanus.I

,-IfIaItransanalIpull-
thruIisInotIpossible,IthenItheIsurgeonIwillIperformIaIremovalIofItheIdefectiveIbowelIandIcolost
omyItoIdecompressItheIbowelIandIdivertItheIfecalIcontents.I
-
TheIcolostomyIallowsItheIdilatedIandIhypertrophiedIportionIofItheIbowelItoIregainInormalIton
eIandIsizeI(takesIapproximatelyI3ItoI4Imonths)
-Post‐
op:IassessIsite,INPOIuntilIbowelIsoundsIreturn,IIVIfluids,ImayIrequireIdailyIanalIdilations




Q:IgastroesophagealIreflux

Answer:
-
TheIpresenceIofIabnormalIamountsIofIgastricIcontentsIinItheIesophagus,IupperIairways,IandItr
acheobronchialIarea.
-TheIrefluxIofIgastricIcontentsIcanIleadItoIinflammationIandIstrictureIofItheIesophagus
-ResultingIeffects:
•AspirationIofIgastricIcontents
•RecurrentIpneumonia
•PulmonaryIdisease
•Esophagitis
•EsophagealIstricture

-ResolutionIofIGERIisIoftenIaImaturationalIprocess
-PeakIincidenceIisI4ImonthsIofIage.I85%IofIinfantsIoutgrowIbyI12Imonths
-TheIchildImayIrequireIsurgeryIifItheyIdoInotIrespondItoImedicalImanagement
-Predisposed:IpretermIinfantsIandIbronchopulmonaryIdysplasia
-Diagnostic:Iweight,Ilength,IOFC,IchestIx-
rayIforIrespiratoryIsymptoms,IpHIprobe,IsometimesIendoscopy
-Ranitidine,Izantac,Iprevised,IPrilosecIgivenItoIkids

ConservativeITreatment:
-FeedingIthickenedIformula
-FeedingIsmall,IfrequentImeals
-
Positioning:IelevatingIheadIofItheIbed,IholdIinfantIinIanIuprightIpositionIforI30IminutesIfollo
wingIaIfeeding
-AcidIsuppressionIandIneutralizationImedications:
•DecreasesIstomachIacidIsoIitIwillInotIbeIasIirritatingIifItheIchildIspitsIup

,•AdministerIPPIsI30IminutesIbeforeIbreakfastIandIifIaIsecondIdoseIisIprescribed,I30IminutesIb
eforeItheIeveningImeal.
•RemindIparentsIthatItheyImayInotIseeIresultsIrightIawayIasIitItakesIseveralIdaysIforIaIsteadyI
stateIofIacidIsuppression.
•RanitidineI-Izantac,IlansoprazoleI-Iprevacid,IomeprazoleI-Iprilosec

SurgicalITreatment:
-NissanIfundoplication
•UpperIendIofIstomachI(fundus)IisIwrappedIaroundItheIlowerIportionI(inferior)IofItheIesophag
usIcreatingIaIlowerIesophagealIsphincterIorIcardiacIsphincter
•LowerI2-3IcmIofIesophagus
•Laparoscopic
•ThisIsurgeryIisIirreversible




Q:Iappendicitis

Answer:
EarlyISymptoms:
-DevelopIslowly,IoverIaI12IhourIperiod
-Anorexia
-ChildIdoesn'tIseemI"normal"
-N&V,IlowIgradeIfever
-KneesIbent
-PainIisIdiffuseIatIfirstIthenIgraduallyIlocalizesItoIRLQI(reboundItenderness)
-
McBurney'sIpoint:IaIpointImidwayIbetweenItheIanteriorIsuperiorIiliacIcrestIandItheIumbilicus;I
doesn'tIhurtIwhenIyouIpressIthere,IhurtsIwhenIyouIletIgo
-IfIpainIisIsuddenlyIrelievedIwithoutIintervention,IsuspectIperforation

DiagnosticITesting:
-CBC
-UA
-CT

Pre-Op:
-NPO,IIVItherapyI(antibiotics,Ifluids,IandIelectrolytes)
-PositionIofIcomfort
-PrepareIforIsurgeryI(laparoscopicIifInon-perforated)

Post-Op:

, -MonitorIVS
-MaintainIIVIandIthenIadvanceIdietIasItolerated
-AssessIforIpain
-EncourageIambulation
-MonitorIincisionalIsite(s)
-DischargeIteaching

RupturedIAppendix:
-Peritonitis:
•IVIantibiotics
•NPO,INGItubeItoIlowIcontinuousIsuctioning
•MayIhaveIaIdrainIplacedIinIsurgery
•PainImanagement
•LongerIhospitalIstay
•RequiresI7-14IdaysIofIantibiotics




Q:IinflammatoryIbowelIdisease

Answer:
-TwoIgastrointestinalIconditions:
•UlcerativeIcolitis
•Crohn'sIDisease
-Autoimmune
-EtiologiesIareIunknown
-PrognosisIisIdependentIon:
•AgeIofIonsetIandIrapidityIofIonset
•ResponseItoImedicalItreatment
•ExtentIofIinvolvement

SimilarIInitialISigns:
-Diarrhea
-RectalIbleeding
-AbdominalIpain
-Fever
-Malaise
-AnorexiaIandIweightIloss
-Anemia
-MayIincludeIvagueIsymptoms:
•GrowthIfailure
•JointIpainsI(dueItoIinflammation)

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