08-22-2014, 06:22 AM
A 9-month-old infant is brought to the office by his mother for a follow-up visit. He was born with esophageal atresia that was surgically corrected at birth. He had a gastrostomy in the
hospital and had normal weight gain with tube feedings. His weight gain slowed slightly after the tube was removed and oral feedings began; since 3 months of age his weight has been
above the 50th percentile. During the past 6 weeks he has not gained weight despite a normal increase in length. His mother admits that the family is under a lot of stress because her
husband was recently laid off from his job because of a positive urine screening test for marijuana. Which of the following is the most appropriate step at this time?
A) Arrange family counseling for the husband's drug problem
~ B) Contact child protective services
C) Do upper gastrointestinal barium study
D) Recommend a visiting nurse for observation and recommendations on feeding
E) Reinsert the gastrostomy tube
hospital and had normal weight gain with tube feedings. His weight gain slowed slightly after the tube was removed and oral feedings began; since 3 months of age his weight has been
above the 50th percentile. During the past 6 weeks he has not gained weight despite a normal increase in length. His mother admits that the family is under a lot of stress because her
husband was recently laid off from his job because of a positive urine screening test for marijuana. Which of the following is the most appropriate step at this time?
A) Arrange family counseling for the husband's drug problem
~ B) Contact child protective services
C) Do upper gastrointestinal barium study
D) Recommend a visiting nurse for observation and recommendations on feeding
E) Reinsert the gastrostomy tube