Question

The nurse is obtaining the history of an infant with a suspected intestinal obstruction. Which response regarding newborn stool patterns would indicate a need for further evaluation for Hirschsprung disease?

A) Has had diarrhea for 3 days
B) Passed a meconium plug
C) Constipated and passing gas for 2 days
D) Passed a meconium stool in the first 24 to 48 hours of life

Answer 1

A newborn exhibiting constipation and gas for more than 48 hours after birth could indicate Hirschsprung disease and should be evaluated further, as this disease can lead to difficulty in stool passage due to missing nerve cells in the colon.

Step-by-step explanation:

Among the options provided, the response that would indicate a need for further evaluation for Hirschsprung disease is C) Constipated and passing gas for 2 days. Hirschsprung disease is a condition that affects the large intestine and causes problems with passing stool. It is due to missing nerve cells in the muscles of part or all of the baby's colon. A newborn with Hirschsprung disease typically fails to pass meconium within the first 24 to 48 hours of life and may have symptoms such as a swollen belly, constipation, and gas.

While the other responses may be concerning for different reasons (such as the passage of a meconium plug which could be normal or passing meconium stool within the first day which is expected), persistent constipation and gas without a bowel movement beyond the typical 48-hour window can be a sign of Hirschsprung disease and should prompt further evaluation by a healthcare professional.