The neonate with suspected Hirschsprung disease is scheduled to undergo testing to definitively diagnose the disorder. Which assessment finding prompts the nurse to request the procedure be postponed?

Oozing from a 6-hour-old venipuncture site. A diagnosis of Hirschsprung disease is confirmed by a full-thickness rectal biopsy to assess for the presence or absence of ganglion cells in the colon. The patient who continues to ooze from a 6-hour-old venipuncture site may be at an increased risk for hemorrhage during the procedure. This would prompt the nurse to “stop the line” until the cause of the oozing is determined and fixed. Hirschsprung disease is suspected in neonates who have failed to pass meconium in the first few days of life. They also can have significant abdominal distention that compromises respiratory effort. The need for intubation may be related to the inability of the infant to adequately inflate the lungs in the setting of severe abdominal distention. The patient would be intubated for the general anesthesia needed for the procedure, so this is not a contraindication. Low urine output indicates decreased kidney function but also depends on fluid intake; the patient will not receive contrast dye during the procedure, so this is less of a concern. Bilious emesis is not an unexpected finding in a patient with abdominal distention due to Hirschsprung disease and represents intestinal obstruction.

The neonate with suspected Hirschsprung disease is scheduled to u...

Category: Reduction of Risk Potential
Difficulty: 8

Topics: Communication & Documentation Gastrointestinal Hematology/Oncology Neonatal Care

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