A nurse is caring for a child who has a tracheostomy. After suctioning the tracheostomy, which of the following findings should the nurse use to determine that the procedure was effective?

Choice A reason: Absent bowel sounds are not a finding that indicates perforation of the appendix. Absent bowel sounds could be a sign of ileus, obstruction, or peritonitis, but they are not specific to appendicitis.

Choice B reason: Low-grade fever is not a finding that indicates perforation of the appendix. Low-grade fever could be a sign of infection, inflammation, or dehydration, but it is not specific to appendicitis.

Choice C reason: Sudden decrease in abdominal pain is a finding that indicates perforation of the appendix. Sudden decrease in abdominal pain means that the pressure inside the appendix has been released, causing the appendix to rupture and spill its contents into the peritoneal cavity. This can lead to severe complications such as sepsis, abscess, or shock.

Choice D reason: Flaccid abdomen is not a finding that indicates perforation of the appendix. Flaccid abdomen could be a sign of muscle relaxation, sedation, or paralysis, but it is not specific to appendicitis.

Choice A reason: Pyloric stenosis is a condition in which the muscle at the outlet of the stomach (the pylorus) becomes thickened and obstructs the passage of food into the small intestine. It usually occurs in infants between 2 and 8 weeks of age, and is more common in males. The main symptoms are projectile vomiting after feeding, dehydration, weight loss, and a palpable olive-shaped mass in the right upper quadrant of the abdomen.

Choice B reason: Gastroesophageal reflux is a condition in which the lower esophageal sphincter fails to close properly, allowing the stomach contents to flow back into the esophagus. It is common in infants, especially those who are bottle-fed, and usually resolves by 12 months of age. The main symptoms are regurgitation, spitting up, irritability, and poor weight gain.

Choice C reason: Celiac disease is a condition in which the immune system reacts to gluten, a protein found in wheat, barley, and rye, and damages the lining of the small intestine. It can affect people of any age, but is usually diagnosed in childhood. The main symptoms are diarrhea, abdominal pain, bloating, weight loss, and failure to thrive.

Choice D reason: Lactose intolerance is a condition in which the body lacks the enzyme lactase, which is needed to digest lactose, a sugar found in milk and dairy products. It can affect people of any age, but is more common in adults and certain ethnic groups. The main symptoms are diarrhea, gas, bloating, and abdominal cramps after consuming lactose-containing foods.