A nurse is caring for a child who has Hirschsprung’s disease. Which of the following findings should the nurse expect? (Select all that apply)

Choice A reason: Diminished peristalsis is a hallmark of Hirschsprung’s disease, caused by absent ganglion cells in the colon, leading to impaired peristalsis and functional obstruction. This results in fecal retention, constipation, and narrowed stools, as the aganglionic segment fails to propel intestinal contents, making diminished peristalsis a key expected finding in affected children. Choice B reason: Failure to thrive is common in Hirschsprung’s disease due to chronic constipation and nutrient malabsorption from intestinal obstruction. Inadequate caloric intake and energy expenditure from discomfort impair growth, making this a typical finding, reflecting the disease’s impact on nutrition and development in young children. Choice C reason: Vomiting occurs in Hirschsprung’s disease, especially in severe cases, due to intestinal obstruction from aganglionic segments, causing backup of intestinal contents. This leads to bilious emesis, particularly in infants, as fecal stasis increases intraluminal pressure, making vomiting an expected symptom in this condition. Choice D reason: Ribbon-like stools are characteristic of Hirschsprung’s disease, resulting from narrowed, aganglionic colon segments that restrict fecal passage, producing thin, ribbon-shaped stools. This reflects the functional obstruction and chronic constipation caused by absent peristalsis, making it a key expected finding in affected children.