During physical assessment of a 4-month-old infant with Hirschsprung’s disease

During physical assessment of a 4-month-old infant with Hirschsprung’s disease, the nurse should most likely note which of the following?

1. Scaphoid-shaped abdomen.
2. Weight less than expected for height and age.
3. Cyanosis of the fingers and toes.
4. Hyperactive deep tendon reflexes.

The Correct Answer and Explanation is :

The correct answer is:

2. Weight less than expected for height and age.

Explanation:

Hirschsprung’s disease (congenital aganglionic megacolon) is a condition in which the nerve cells (ganglion cells) in the large intestine are missing, leading to chronic constipation and difficulty passing stool. It results in an obstruction of the intestines due to the inability of the affected bowel segment to relax and allow stool to pass.

During a physical assessment of a 4-month-old infant with Hirschsprung’s disease, the nurse is likely to note weight less than expected for height and age due to poor feeding, chronic constipation, and malabsorption caused by prolonged bowel dysfunction. Infants with this condition may have difficulty gaining weight because of abdominal distention, vomiting, and decreased appetite. Malnutrition occurs because the baby cannot properly digest and absorb nutrients.

Explanation of the Incorrect Options:

1. Scaphoid-shaped abdomen – Incorrect. A scaphoid (sunken) abdomen is more commonly seen in diaphragmatic hernia. In Hirschsprung’s disease, infants typically present with abdominal distension due to stool accumulation.
2. Cyanosis of the fingers and toes – Incorrect. Cyanosis is not a common finding in Hirschsprung’s disease. Cyanosis is usually associated with cardiovascular or respiratory disorders, not gastrointestinal conditions.
3. Hyperactive deep tendon reflexes – Incorrect. There is no neurological involvement that would cause hyperactive deep tendon reflexes in Hirschsprung’s disease. Neurological abnormalities are not characteristic of this condition.

Conclusion:

Weight loss or failure to thrive is a hallmark sign in infants with Hirschsprung’s disease due to persistent feeding difficulties and malabsorption. Early diagnosis and surgical intervention are essential to prevent severe complications such as enterocolitis, which can be life-threatening.

Now, I will generate an image related to Hirschsprung’s disease in an infant.

Here is the generated medical illustration of a 4-month-old infant with Hirschsprung’s disease, showing an enlarged, distended abdomen due to stool accumulation and signs of failure to thrive. Let me know if you need any modifications or further explanations!