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GI (pediactrics)
Pyloric Stenosis
25
Medical
Undergraduate 2
04/17/2009

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Cards

Term
obstruction at the pylori sphincter by hypertrophy of the cirular musle of the pylorus
Definition
pyloric stenosis
Term
what is one of the most ommon surgical disorders of early infany?
Definition
pylori stenosis
Term
When is pyloric stenosis seen?
Definition
soon after birth with vomiting that beomes progressively more severe and PROJECTILE
Term
Cause of the increased size of the pyloric muulature?
Definition
unknown
Term
What are the infants with pyloric stenosis like the first week of life?
Definition
typially are well
Term
The projectile vomiting usually develops when? and my lead to obstruction by when?
Definition
**a week/4-6weeks
Term
If dx of pyloric stenosis is inonclusive from hx and physical signs what will be done next?
Definition
gastrointestinal X-ray study
Term
what will gastrointestinal xray studies reveal in a child with Pyloric stenosis?
Definition
delayed gastric emptying and an elongated threadlike pyloric channel
Term
What does lab findings in pyloric stenosis reflect?
Definition
metabolic alterations reated by severe depletion of both water and eletrolytes from the extensive and prolonged vomiting.
Term
Lab values for pyloric stenosis: sodium, potassium
Definition
both decreased
Term
If sodium and potassium lab values are normal in a client with pyloric stenosis what does that mean?
Definition
may be masked by the hemoconcentration from extracellular fluid depletion
Term
Greatest diagnostic lab values in client with pyloric stenosis? What is this characteristic of?
Definition
decrease in serum chloride levels and increases in pH and bicarbonate..characteristic metabolic acidosis
Term
Standard treatment for pyloric stenosis?
Definition
Surgical relief of the pyloric obstruction by pyloromyotomy
Term
When are feedings begun postop pylormyotomy? What kind of feedings?
Definition
4-6hrs, beginning with small frequent feedings of glucose in water or electrolyte solutions.
Term
What is the preop emphasis in a child with pyloric stenosis?
Definition
restoring hydration and electrolyte balance and beginning replacement of depleted body fat and protein stores.
Term
What is the infant placed on directly after pyloromyotomy?
Definition
IV glucose and electrolyte replacement based on lab and electrolyte values.
Term
What should a nurse do if a child is vomiting postop pyloromyotomy?
Definition
nothing.. it is not uncommon and most infants, even wtih successful surgery exibit some vomiting during the first 24-48hrs
Term
How long are IV fluids administered after pyloromyotomy?
Definition
until the infant is taking and retaining adequate amts by mouth
Term
When is the NG tube removed from a child with pyloric stenosis? Preop? Postop?
Definition
may be maintained after surgery for a variable length of time
Term
Nursing care for a child with pyloric stenosis?
Definition
*monitor resp status*hydration status*IVF's electrolytes,*NG tube care*Daily weight*I/Ohourly*small frequent meals (clears)*NPO prior to surgery
Term
The effectiveness of nursing interventions of a client with pyloric stenosis is determined by?
Definition
reassessment based on observing feeding behavior, especially vomiting episodes
Term
How often should client with pyloric stenosis be weighed?
Definition
daily
Term
What position should a child with pyloric stenosis be in?
Definition
Right side/semi-fowler's after feeding
Term
Why is a client with pyloric stenosis to be positioned on right side?
Definition
right side allows for better gastric emptying.
Term
Is burping contraindicated in a child with pyloric stenosis? Why or why not
Definition
No- bc burping allows for less air in the stomach decreasing the chnce of vomiting and aspiration.
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