A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?
The infant has passed several tar-like stools.
The infant has not gained weight and has stooled once.
The infant has not stooled.
The infant has passed hard, pellet-like stools.
The Correct Answer is C
Rationale:
A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.
B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.
C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.
D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.
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Correct Answer is D
Explanation
Rationale:
A. Oral penicillin is not a primary treatment for nephrotic syndrome. Antibiotics may be used if there is an associated infection, but they are not central to the management of nephrotic syndrome itself.
B. Labetalol is a medication used for hypertension and would not be specifically indicated for nephrotic syndrome unless hypertension is present.
C. Aggressive intravenous fluid resuscitation is not typically used in nephrotic syndrome; instead, fluid management focuses on balancing fluid intake and output carefully.
D. Prednisone, a corticosteroid, is commonly used to reduce inflammation and proteinuria in nephrotic syndrome. It helps to manage the condition effectively by addressing the underlying inflammation.
Correct Answer is A
Explanation
Rationale:
A. Myelomeningocele is a type of spina bifida where there is a protrusion of the meninges and spinal cord through a defect in the vertebrae. This condition can result in partial to complete paralysis in the lower extremities due to the involvement of the spinal cord.
B. A unilateral port-wine birthmark is typically associated with conditions like Sturge-Weber syndrome, not myelomeningocele.
C. A protruding sac containing abdominal contents is characteristic of omphalocele, not myelomeningocele.
D. Fusion of cranial suture lines is not associated with myelomeningocele but rather with craniosynostosis.