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