A child has been diagnosed with Hirschsprung’s disease. Which of the following findings would the nurse expect the parents to report in the child’s history? Select all that apply.
A.
Ribbon-like stools.
B.
Distended abdomen.
C.
Chronic constipation.
D.
Black and tarry stools.
The correct answer and Explanation is :
For a child diagnosed with Hirschsprung’s disease, the nurse would expect the parents to report the following findings in the child’s history:
A. Ribbon-like stools.
B. Distended abdomen.
C. Chronic constipation.
Explanation:
Hirschsprung’s disease, also known as congenital aganglionic megacolon, is a condition where there is a lack of nerve cells (ganglia) in a portion of the colon, which impairs peristalsis and leads to obstruction. This absence of ganglion cells in the rectum and sometimes extending up to the colon results in functional obstruction of the bowel. Here’s how each of the selected findings fits into this context:
- Ribbon-like stools: Due to the lack of proper nerve function in the affected segment of the bowel, the passage of stool can become very narrow and shaped like a ribbon. This is because the obstructed bowel forces the stool to pass through a constricted segment, leading to this characteristic appearance.
- Distended abdomen: When the segment of the bowel that is aganglionic cannot effectively move stool, it causes a backup of fecal material. This accumulation leads to abdominal distention or swelling, as the intestines become filled with gas and fecal matter that cannot be evacuated normally.
- Chronic constipation: Hirschsprung’s disease often presents with chronic constipation because the affected portion of the colon cannot propel stool forward due to the absence of the ganglion cells. This results in a buildup of stool in the colon, leading to infrequent bowel movements and severe constipation.
D. Black and tarry stools are not typical of Hirschsprung’s disease. This finding, known as melena, is more indicative of upper gastrointestinal bleeding and is not a common symptom of Hirschsprung’s disease.
In summary, ribbon-like stools, abdominal distention, and chronic constipation are the findings expected in a child with Hirschsprung’s disease due to the obstructive nature of the condition and the associated bowel dysfunction.