Pyloric Stenosis

A new mother brings a male infant, 2 weeks old, to the pediatric clinic for a checkup. The mother is concerned that the infant may be at risk for pyloric stenosis due to his age and because her husband had surgery for the condition when he was an infant. Which responses by the nurse are the most appropriate based on this data? A) "Your baby has a greater risk for the condition due to a familial history." B) "Your baby would have an increased risk if the infant was a girl." C) "Due to your age, your son is at an increased risk for the condition." D) "As long as your baby has bowel movements there is nothing to worry about."

Answer: A The infant is at a greater risk for developing pyloric stenosis because of the familial history. Pyloric stenosis is more common in males than females. The mother's age is not correlated with an increased risk of pyloric stenosis. While bowel movements are important, this is not indicative of not having pyloric stenosis.

A nurse is caring for an infant postsurgery for pyloric stenosis. Which nursing interventions are appropriate when providing care for this infant? Select all that apply. A) Administer analgesics, per order. B) Instruct the parents on proper diapering to avoid pressure over the incision. C) Encourage swaddling and rocking to facilitate relaxation. D) Teach the parents to remove the Steri-Strips during the infant's first bath postsurgery. E) Monitor temperature once per shift.

Answer: A, B, C Nursing interventions for an infant postsurgery for pyloric stenosis include administering analgesics, per order; instructing the parents on proper diapering to avoid pressure on the incision; and encouraging swaddling and rocking to facilitate relaxation. Postoperatively the incision is covered with collodion or Steri-Strips and should be kept clean and dry. The parents should be taught to allow the Steri-Strips to come off on their own. The infant's temperature should be monitored every 4 hours due to the increased risk for infection.

The nurse is caring for an infant who is admitted for possible pyloric stenosis. When assessing the infant, which actions are appropriate? Select all that apply. A) Observe the infant's abdomen. B) Auscultate bowel sounds. C) Provide oral feeding. D) Palpate the right upper quadrant of the abdomen. E) Pass a nasogastric tube.

Answer: A, B, D During the assessment of an infant suspected of having pyloric stenosis, the nurse will observe the infant's abdomen for a peristaltic wave, auscultate the bowel sounds, and palpate the right upper quadrant of the abdomen for an olive-shaped mass. Providing oral feedings and passing a nasogastric tube are nursing interventions and not tasks that are completed during the assessment process.

The nurse is caring for an infant who is scheduled for surgery for pyloric stenosis. When planning the infant's care, which nursing diagnoses are appropriate? Select all that apply. A) Deficient Fluid Volume related to inadequate intake and vomiting B) Hyperbilirubinemia related to poor liver function C) Sleep Pattern Disturbance related to discomfort and hunger D) Parental Anxiety related to surgery E) Imbalanced Nutrition: Less than Body Requirements related to inadequate intake and vomiting

Answer: A, C, D, E Appropriate nursing diagnoses to include in the infant's plan of care include Deficient Fluid Volume due to poor intake and vomiting; Sleep Pattern Disturbance related to the discomfort and hunger; Parental Anxiety related to the need for surgical correction; and Imbalanced Nutrition: Less than Body Requirements due to inadequate intake and vomiting. Jaundice is not a clinical manifestation of pyloric stenosis.

A 42-year-old male client is diagnosed with adult pyloric stenosis. Which of the following symptoms would the nurse least expect to encounter in this client? A) Weight loss B) Upper abdominal pain C) Increase of appetite D) Nausea

Answer: C The nurse would not expect to find an increase of appetite in this client. Symptoms of adult pyloric stenosis include weight loss, easy satiety, loss of appetite, and gradual increase of upper abdominal pain. Nausea and vomiting are also common.

The nurse is providing care to an infant who underwent surgery for pyloric stenosis. Which actions by the nurse will decrease the risk for infection when caring for this infant? Select all that apply. A) Monitor temperature every hour. B) Place pressure on the incision. C) Inspect the incision for redness, swelling, or discharge. D) Auscultate the lungs to assess for any adventitious sounds. E) Give the infant a tub bath.

Answer: C, D The infant who is postsurgery after the correction of pyloric stenosis will be at an increased risk for infection. Appropriate interventions include inspecting the incision site for redness, swelling, or discharge and auscultating the lungs for adventitious breath sounds which could indicate pneumonia. The nurse will monitor the infant's temperature every 4 hours. Care must be taken to decrease pressure on the incision. The infant should be provided with a sponge bath until the surgical incision has healed.

Which of the following clients is most likely to develop adult pyloric stenosis? A) 11-year-old female client with acute pancreatitis B) 22-year-old male client with acute hepatitis B C) 33-year-old female client with GERD D) 44-year-old male client with gastritis

Answer: D The 44-year-old male client, because of his age, gender, and complaint of gastritis, is the most likely of these clients to develop adult pyloric stenosis. Although adult pyloric stenosis is uncommon, it occurs most commonly in middle-aged men. When it does occur in adults, pyloric stenosis may be classified as primary or secondary. The primary type can occur without an apparent cause. The secondary type is the result of other problems in the GI tract such as ulcer, hernia, a malignancy, or gastritis.

A nurse is providing care to an infant who underwent a laparoscopic pyloromyotomy. After providing discharge instructions to the infant's caregivers, which statements indicate appropriate understanding? Select all that apply. A) "I will burp my baby every 1-2 ounces during feedings." B) "It is important to slide the diaper under my baby when changing the diaper." C) "I will feed my baby 3 times per day." D) "I will hold my baby in an upright position for 15 minutes after each feeding." E) "I will clean the incision site with warm, soapy water twice per day."

Answer: A, B Appropriate care for an infant after a laparoscopic pyloromyotomy includes burping the infant after every 1-2 ounces of formula and sliding the diaper under the baby versus pulling on the legs in order to decrease the pressure on the incision site. The baby should be fed on demand, not three times per day. The infant should be held upright for 30 minutes after each feeding. The incision site should be kept clean and dry.

The nurse is providing care to a 1-month-old infant who is brought to the pediatric clinic for projectile vomiting. Which data collected during the assessment process would support the diagnosis of pyloric stenosis? Select all that apply. A) Blood-tinged vomit B) Low-grade fever C) Persistent hunger D) Peristaltic wave E) Consistent weight gain

Answer: A, C, D Along with the projectile vomiting, the nurse would expect reports of blood-tinged vomit, persistent hunger, and a peristaltic wave. A low-grade fever and weight gain are not expected. The infant may lose weight due to pyloric stenosis.