Question

Corrective surgery for hypertrophic pyloric stenosis is completed, and the infant is returned to the pediatric unit with an intravenous (iv) infusion in progress. what is the priority nursing action?

Answer 1

The answer is: 1.- Surgical wound: -Exudate control, color and skin temperature.

- Monitor the condition of the dressing and change if it is in poor condition.

-Cure of the wound.

2.- Control of vital signs

-Constant control including temperature

-Valuation of the general state.

Explanation:

The treatment is surgical and consists of a Pyloromyotomy (surgery to dilate the pylorus). Surgery usually relieves all symptoms.

The steps to follow are: Collection of data on a patient undergoing Pyloromyotomy and preparation of a post-surgical treatment plan with NANDA, NIC and NOC diagnoses.

NURSING CARE:

1.- Surgical wound: -Exudate control, color and skin temperature.

- Monitor the condition of the dressing and change if it is in poor condition.

-Cure of the wound.

2.- Control of vital signs :

-Constant control including temperature

-Valuation of the general state.

3.- Hygiene:

-Avoid the bathroom. You can perform showering in parts and avoiding wetting the dressing.

4.- Pain:

-Valuation of pain.

-Administration of intravenous analgesia and subsequently orally according to tolerance.

-Valuation of effectiveness.

5.- Intake:

-Progress of intake: diet will begin after 6 hours of surgery offering small amounts that will increase gradually according to tolerance.

-Control of the amount of intake.

-Tolerance: control of nausea and vomiting.

-Daily weight

6.- Depositions:

-Quantity and appearance of bowel movements.

7.-Diuresis:

-Control of first postoperative urination.

- Diaper weight.

8.-Therapeutic devices: -venous catheter

-Control of venous catheter.

-Maintenance of dressing and permeability check.

-Control signs of infection.

9.-Caregivers:

-Rating coping with parents.

-Active listening to the family.

-Carer role assessment.

-Family dynamic valuation.

-Active listening.

The answer is: 1.- Surgical wound: -Exudate control, color and skin temperature.

- Monitor the condition of the dressing and change if it is in poor condition.

-Cure of the wound.

2.- Control of vital signs

-Constant control including temperature

-Valuation of the general state.

Answer 2

The answer would be: Apply adequate restraints

The infant just had a surgery and probably still in effect of the sedatives. When the sedative stopped, the infant might remove the i.v. line. It is important to keep the intravenous infusion intact by giving restraint. Using sedative could work but it will be dangerous and less safe. Assessing for infiltration is not related to the condition.