A nurse is caring for a child who has Hirschsprung’s disease. Which of the following findings should the nurse expect?

Choice A reason: Hirschsprung’s disease, caused by absent ganglion cells in the colon, leads to functional obstruction, resulting in ribbon-like, foul-smelling stools due to fecal retention and bacterial overgrowth. This is a hallmark finding, as narrowed stools reflect the aganglionic segment’s inability to propel feces normally, causing constipation and malodorous output. Choice B reason: A rigid abdomen is not typical in Hirschsprung’s disease, which causes distension from fecal retention, not rigidity. Rigidity suggests peritonitis or other acute conditions. Ribbon-like stools are more characteristic, reflecting the chronic obstruction, making this an incorrect expected finding in this congenital disorder. Choice C reason: Projectile vomiting is associated with pyloric stenosis, not Hirschsprung’s disease, which affects the colon, causing constipation and stool abnormalities. Vomiting may occur in severe obstruction but is not primary. Ribbon-like stools are more specific, making projectile vomiting an incorrect expected finding in this condition. Choice D reason: Chronic hunger is not a feature of Hirschsprung’s disease, which causes constipation and abdominal distension, potentially reducing appetite due to discomfort. Nutritional issues arise from obstruction, not hunger. Ribbon-like stools reflect the disease’s pathophysiology, making chronic hunger an incorrect expected manifestation in affected children.