Question

Case study Ch. 41

Pyloric Stenosis

Lucy is a 44-day-old formula-fed infant with a 4-day history of vomiting.

Subjective Data

Mother states that the infant has:

Been vomiting undigested formula after feedings.
Has not had fever or diarrhea.
Has had eight wet diapers in the last 24 hours.
Objective Data

Weight: 4.8 kg

Birth weight: 3.5 kg

Vital signs: temp, 37.1º C (rectal); pulse, 130 bpm; resp, 30 breaths/min; blood pressure,
92/52 mm Hg

Moist mucous membranes; flat and soft anterior fontanel

Awake and alert, lusty cry

Good muscle tone

Olive-sized mass palpated at epigastrium

Questions:

What test will be used to diagnose pyloric stenosis?
What actions should the nurse take in this clinical situation? Prioritize the actions.

Answer 1

1. ON PHYSICAL EXAMINATION : FOR PYLORIC STENOSIS

- see for feel olive shaped mass lump which is an enlargement of pylorus muscle

- peristaltic waves in abdomen are sign for pyloric stenosis

DIAGNOSTIC TESTS FOR PYLORIC STENOSIS

- ultrasonography to view pylorus and it is an confirmation test for pyloric stenosis

- blood test is done to check for dehydration or for electrolyte imbalance

- in some cases x ray for digestive system is done in order to check for pyloric stenosis

2.ACTIONS TAKEN BY THE NURSE

- provide the adequate nutrition and rehydrate the baby by intravenous fluids and electrolytes

- maintaing the skin integrity

- maintaining the mouth integrity by rehydration and by giving oral fluids

- and explain the situation and importance of the operation and procedure of the operation and releaving parents anxiety

TREATMENT

- pyloromyotomy which is an surgical procedure done for permanent treatment for pyloric stenosis