A nurse is caring for a 6-week-old infant admitted to the pediatric unit for evaluation of a suspected pyloric stenosis. Which of the following findings should the nurse expect?

A. Projectile vomiting

Projectile vomiting is a classic symptom of pyloric stenosis in infants. It typically occurs within 30 minutes of feeding and is forceful, often projecting several feet away from the infant. This occurs due to the obstruction at the pyloric sphincter, leading to the stomach forcefully emptying its contents.

B. Metabolic acidosis

Metabolic acidosis is not a typical finding associated with pyloric stenosis. Pyloric stenosis leads to vomiting, which can result in dehydration and electrolyte imbalances, but it typically does not cause metabolic acidosis directly.

C. Effortless regurgitation

Effortless regurgitation is not a characteristic finding of pyloric stenosis. In pyloric stenosis, vomiting is forceful and projectile, rather than a passive regurgitation of stomach contents.

D. Distended abdomen

A distended abdomen can be a finding in pyloric stenosis. The obstruction at the pyloric sphincter can lead to gastric retention, causing the stomach to become distended over time. However, it's important to note that not all infants with pyloric stenosis will present with a visibly distended abdomen.

A. Abdominal wall defect:

Failure to pass meconium within the first 24 hours after birth can indicate a potential obstruction in the gastrointestinal tract. While an abdominal wall defect could potentially cause gastrointestinal issues, it is not specifically associated with failure to pass meconium.

B. Celiac disease:

Celiac disease is an autoimmune disorder characterized by an abnormal immune response to gluten. While celiac disease can cause gastrointestinal symptoms, such as diarrhea and abdominal pain, it is not typically associated with failure to pass meconium in the newborn period.

C. Intussusception:

Intussusception occurs when one segment of the intestine telescopes into another, causing a bowel obstruction. While intussusception is a cause of bowel obstruction in infants, it typically presents with symptoms such as colicky abdominal pain, vomiting, and the passage of "currant jelly" stool, rather than failure to pass meconium.

D. Hirschsprung disease:

Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal portion of the colon, leading to functional obstruction. Failure to pass meconium within the first 24 hours after birth is a classic sign of Hirschsprung disease. This condition requires surgical intervention to remove the affected portion of the colon and restore normal bowel function.