The nurse is performing an assessment on a 2-day-old infant with suspected Hirschsprung disease. Which findings should the nurse anticipate? Select all that apply.

Question

Quizplus · Accepted Answer

11ecbb05_cc1c_7476_b433_17175e5c8199_MD0009_00 Hirschsprung disease occurs when a child is born with some sections of the distal large intestine missing nerve cells; this renders the internal anal sphincter unable to relax. As a result, there is no peristalsis and stool is not passed. Newborns exhibit symptoms of distal intestinal obstruction. They have a distended abdomen and will not pass meconium within the expected 24-48 hours. They will also have difficulty feeding and often vomit green bile. (Option A) An infant with Hirschsprung disease will not have passed meconium. Bright red bleeding from the rectum would not occur. However, rectal bleeding could be a symptom of Meckel's diverticulum, a remnant of the umbilical cord that should have disintegrated at 8 weeks in utero but became an out pouch in the small intestine. (Option D) Nonbilious vomiting is seen in conditions where the pathology is proximal to the pylorus (eg, hypertrophic pyloric stenosis). Bilious (green) vomiting is seen in conditions where the pathology is distal to the duodenum as the common bile duct drains at the duodenum. In Hirschsprung disease, the pathology is at the distal colon; green bilious vomiting is expected. Educational objective: Hirschsprung disease is caused by a lack of specialized nerve cells in portions of the distal large intestine; this renders the internal sphincter unable to relax. Infants with Hirschsprung disease will not pass meconium but will have distended abdomens and bilious emesis.

The Nurse Is Performing an Assessment on a 2-Day-Old Infant