C - Pyloric Stenosis

Question 1

Whats Pyloric Stenosis?

Answer 1

Genetic & env factors -> increase in number & size of cells in pyloric muscle -> pylorus thickens inwards & narrows -> food stuck at pylorus -> gastric distension & vomiting -> non-bilious projectile vomiting

Pylorus = last part of stomach, contracts & relaxes to allow food to enter small intestine

Question 2

Symptoms of Pyloric Stenosis? (5)

Answer 2

1. Palpable olive shaped mass
2. Visible peristalsis waves from L to R - obstruction makes stomach’s smooth muscle work harder to push food through
3. Persistent non-bilious vomiting
4. Sunken eyes & fontanelle due to dehydration
5. Pale

• use FLACC scale: Face, legs, activity, cry, consolability to assess pain

Question 3

Nursing management of Pyloric Stenosis? (9)

Answer 3

1. Administer IV fluids, monitor serum electrolyte levels and daily weight
2. Assess hydration status
3. Check for readiness for surgery by checking his fontanelle, skin turgor, and mucous membranes.
4. Use comfort measures like pacifiers, swaddling, and maintaining a quiet environment.
5. Maintain NPO status and monitor patency of NGT

PostOP:
6. start with small, frequent feedings
7. Feed slowly, burp frequently, keep Owen’s head elevated.

8. Reassure that some postoperative vomiting may occur for 1 to 2 days due to swelling that occurs after the procedure.
9. Reduce risk for infection by providing incision care and observing the site for drainage or signs of inflammation.