Question

Pyloric stenosis

1. What are the primary nursing concerns when a 4-week-old infant experiences forceful or projectile vomiting (pyloric stenosis)? Give 2 that are most important (minimum 250 words including reference).

2. What are complications of untreated hypertrophic pyloric stenosis? Give 4. (minimum 250 -300 words including reference)

3. What are the priority nursing diagnoses at this time? Give at least 4. (minimum 250-300 words including reference)

4. What are expected nursing outcomes related to this scenario? Give at least 5. (minimum 400 words including reference)

5. Discuss discharge teaching related to hypertrophic pyloric stenosis. Discuss at least 3

Answer 1

1Q).

Pyloric stenosis is an abnormality of the pyloric sphincter, characterized by obstructive narrowing of its opening. This condition is corrected by surgical intervention.

Pathophysiology:

Marked hypertrophy and hyperplasia of the muscular layers of the pylorus cause narrowing of the gastric antrum. The pyloric canal becomes enlarged, and the pylorus becomes thicken. The mucosa becomes thicken and edematous, and marked dilation of the stomach occurs due to obstruction in the pylorus. The causes of pyloric stenosis include both environmental and genetic factors.

It is diagnosed by using “barium swallow.” Upper gastrointestinal series (UGI) is a procedure in which the barium is swallowed (barium meal) to coat the outlines of esophagus, stomach, and duodenum. As the procedure involves swallowing of barium UGI is also known as a barium swallow.

The primary major concerns when a 4-week-old infant experiences forceful or projectile vomiting are,

1. Maintaining adequate fluid volume and nutrition: The dehydration should be corrected by providing appropriate intravenous fluid and electrolyte administration as needed.
2. Maintaining mouth and skin integrity: Providing mouth care is important as the infant’s oral mucous membranes may become dry due to repeated vomiting and dehydration. A pacifier can be used to satisfy the baby’s suckling needs. The diapers must be changed frequently, lanolin ointment should be applied to maintain humidity.
3. Relieving the anxiety of the family members: Caregivers should be prepared for surgery and the treatment plan is to be explained. The importance of intravenous fluid administration, barium swallow diagnostic methods, other medical procedures performed, and the duration of surgery is also needed to be explained to the family members.

Reference:

Luxner, K. L. (2005). Delmar's Maternal-infant Nursing Care Plans (Vol. 1). Cengage Learning.