Pediatric Nursing Demystified

Test Results

Abdominal ultrasound: Increased size of pyloric sphincter

Endoscopy: Increased size of pyloric sphincter

Upper GI series: Delayed gastric emptying

Blood chemistry: Decreased calcium, sodium, potassium

Blood gases: Metabolic alkalosis

Treatment

Insert NG tube to decompress the GI tract.

Administer IV fluids and electrolytes to maintain fluid and electrolytes

balance.

Surgery: Pyloromyotomy to repair the pyloric sphincter.

Nursing Intervention

Nothing by mouth.

Strict intake and output to assess for dehydration.

Daily weight.

Assess vomitus for character and frequency.

Monitor vital signs.

Postoperative care:

• Monitor intake and output.


• Elevate the child’s head when feeding.


• Burp frequently.


• Small frequent feedings until the pyloric sphincter function returns
  to normal.
  Explain the disorder and treatment to the family.

Nursing alert Position the child on her right side to prevent aspiration and to

use gravity to help emptying of the stomach.

Tracheoesophageal Fistula/Esophageal Atresia

What Went Wrong?

A tracheoesophageal fistula is a congenital anomaly in which the trachea and

the esophagus are connected. A child with a tracheoesophageal fistula is likely to

have an esophageal atresia where the esophagus ends in a blind pouch preventing

food from entering the stomach. These disorders occur approximately at 5 weeks

of gestation when the foregut normally develops into the trachea and esophagus.

Nursing alertTracheoesophageal fistula and esophageal atresia are an emergency

condition.

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(^246) Pediatric Nursing Demystified