Page 971 - Saunders Comprehensive Review For NCLEX-RN

B. Assessment

1. Vomiting that progresses from mild

regurgitation to forceful and projectile vomiting; it
usually occurs after a feeding.
2. Vomitus contains gastric contents such as milk or
formula, may contain mucus, may be blood-tinged,
and does not usually contain bile.
3. The child exhibits hunger and irritability.

4. Peristaltic waves are visible from left to right

across the epigastrium during or immediately after a
feeding.

5. An olive-shaped mass is in the epigastrium just

right of the umbilicus.
6. Signs of dehydration and malnutrition
7. Signs of electrolyte imbalances
8. Metabolic alkalosis
C. Interventions
1. Monitor strict intake and output.
2. Monitor vomiting episodes and stools.
3. Obtain daily weights.
4. Monitor for signs of dehydration and electrolyte
imbalances.
5. Prepare the child and parents for pyloromyotomy if
prescribed.

D. Pyloromyotomy

1. Description: An incision through the muscle fibers of
the pylorus; may be performed by laparoscopy
2. Preoperative interventions
a. Monitor hydration status by daily
weights, intake and output, and urine
for specific gravity.
b. Correct fluid and electrolyte
imbalances; administer fluids
intravenously as prescribed for
rehydration.
c. Maintain NPO status as prescribed.
d. Monitor the number and character of
stools.
e. Maintain patency of the nasogastric
tube placed for stomach
decompression.
3. Postoperative interventions
a. Monitor intake and output.

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