A nurse is caring for a child who has Hirschsprung disease. Which of the following findings should the nurse expect?
A.
Ridged abdomen
B.
Ribbonlike, foul-smelling stools
C.
Projectile vomiting
D.
Chronic hunger
The correct answer and Explanation is :
For a child with Hirschsprung disease, the expected finding would be:
B. Ribbonlike, foul-smelling stools
Explanation:
Hirschsprung 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. This absence of nerve cells disrupts the normal peristaltic movement of the intestines, leading to problems with bowel movements and stool passage.
Here’s why the other options are less likely:
A. Ridged abdomen: A ridged (or distended) abdomen might be seen in Hirschsprung disease due to accumulated stool and gas in the colon, but it is not as characteristic as the stool changes. The primary symptom to look for is related to stool output rather than abdominal rigidity.
C. Projectile vomiting: Projectile vomiting is more commonly associated with conditions like pyloric stenosis rather than Hirschsprung disease. Hirschsprung disease typically presents with constipation and difficulty passing stools rather than vomiting.
D. Chronic hunger: Chronic hunger is not a common symptom of Hirschsprung disease. The condition primarily affects bowel movements and stool consistency. Children may experience discomfort or distress from constipation, but chronic hunger is not a typical symptom.
B. Ribbonlike, foul-smelling stools is the most accurate finding. The ribbonlike appearance of stools is due to the narrowing of the colon segment affected by the disease, which causes stool to pass through a narrower area, resulting in a ribbon-like appearance. The foul-smelling aspect of the stools can be attributed to the accumulation of fecal material that has been stagnant in the colon for extended periods, leading to fermentation and bacterial overgrowth.
In summary, ribbonlike, foul-smelling stools are a hallmark of Hirschsprung disease due to the obstruction and abnormal stool passage caused by the lack of ganglionic cells in the colon.