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 C
Explanation
Rationale:
A. Neurologic function is not typically affected by nephrotic syndrome, so improvement in this area is not an indicator of recovery.
B. Weight gain might indicate fluid retention rather than recovery in nephrotic syndrome.
C. The absence of protein in the urine indicates that the kidneys are functioning properly and that the syndrome is resolving. Proteinuria is a hallmark of nephrotic syndrome, so its resolution is a key sign of recovery.
D. A negative gram stain is more relevant to infections, not nephrotic syndrome.
Correct Answer is B
Explanation
Rationale:
A. Fluid intake is usually restricted to prevent fluid overload, which can worsen edema and hypertension in acute glomerulonephritis.
B. Administering antibiotics may be necessary, especially if the condition is secondary to a streptococcal infection, which is a common cause of acute glomerulonephritis.
C. Rest is typically encouraged rather than frequent ambulation, as activity can exacerbate symptoms.
D. Daily weights, not weekly, are crucial for monitoring fluid balance in acute glomerulonephritis.