A nurse is caring for a newborn who may have pyloric stenosis. Which of the following manifestations should the nurse expect?

Presence of Dance sign

Projectile vomiting

Always seems full

Excessive weight gain

Answer and Explanation

The Correct Answer is B

A. Presence of Dance sign. Dance sign (an empty right lower quadrant on palpation) is associated with intussusception, not pyloric stenosis. Pyloric stenosis is characterized by hypertrophy of the pyloric sphincter, leading to gastric outlet obstruction.

B. Projectile vomiting. Forceful, non-bilious projectile vomiting is the hallmark symptom of pyloric stenosis. It occurs due to the narrowing of the pyloric sphincter, preventing stomach contents from passing into the small intestine. Vomiting usually begins around 2 to 6 weeks of age and worsens over time.

C. Always seems full. Infants with pyloric stenosis actually experience hunger and irritability after vomiting because food is not reaching the intestines for digestion and absorption.

D. Excessive weight gain. Instead of gaining weight, infants with pyloric stenosis often experience weight loss or poor weight gain due to repeated vomiting and inadequate nutrient absorption.

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Correct Answer is B

Explanation

A. Schedule the child for a follow-up blood test to monitor lead levels over the coming weeks. While ongoing monitoring is important, it is not the immediate priority in a child with extreme lead poisoning. Immediate intervention is needed to manage acute symptoms and prevent further complications.

B. Provide supportive care to manage common symptoms of nausea and pain. This is the correct first action. Severe lead poisoning can cause neurological and gastrointestinal symptoms, including abdominal pain, vomiting, and irritability. Supportive care addresses these symptoms while preparing for further interventions like chelation therapy.

C. Promote a balanced diet rich in calcium and iron to help mitigate lead absorption. Nutritional support is beneficial in mild to moderate cases, as calcium and iron reduce lead absorption, but it is not the first priority in extreme poisoning. Immediate medical treatment takes precedence.

D. Notify the health department to investigate potential lead exposure sources. Identifying the source of lead exposure is crucial for long-term prevention, but in cases of severe poisoning, immediate medical care is the priority before environmental interventions.

A. Administering the insulin injection quickly to minimize discomfort B. Explaining the procedure in simple terms to the client before administering the insulin C. Asking the client to look away during the injection to reduce anxiety D. Using a larger needle to ensure accurate insulin delivery

Correct Answer is B

Explanation

A. Administering the insulin injection quickly to minimize discomfort. Administering an injection quickly may reduce discomfort, but it does not address the emotional and psychological aspects of atraumatic care. The goal is to minimize fear and distress, not just physical pain.

B. Explaining the procedure in simple terms to the client before administering the insulin. Providing a clear, age-appropriate explanation helps reduce anxiety and fosters trust between the child and the nurse. Understanding what to expect allows the child to feel a sense of control, which is a key principle of atraumatic care.

C. Asking the client to look away during the injection to reduce anxiety. While looking away may help some children, it does not promote understanding or involvement in their care. Instead, explaining the procedure allows the child to develop coping strategies and feel more secure.

D. Using a larger needle to ensure accurate insulin delivery. Insulin is administered using a small-gauge needle to minimize pain. A larger needle is unnecessary and could increase discomfort, contradicting the principles of atraumatic care.

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A nurse is caring for a newborn who may have pyloric stenosis. Which of the following manifestations should the nurse expect?

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Explanation

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Explanation

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