The infant with congestive heart failure has a need for:

Choice A reason: Surgery is the definitive treatment for hypertrophic pyloric stenosis, which is a condition in which the muscle of the pylorus (the outlet of the stomach) becomes thickened and blocks the passage of food into the small intestine. The surgery, called pyloromyotomy, involves cutting the muscle to widen the opening and allow food to pass through. The surgery is usually done laparoscopically, with small incisions and a camera, and has a high success rate and low complication rate¹.

Choice B reason: Dietary restrictions are not required throughout childhood for infants with hypertrophic pyloric stenosis. After the surgery, the infant can resume normal feeding, usually within a few hours or days. The infant may have some vomiting or spitting up for a short period, but this usually resolves without any special diet.

Choice C reason: Slow feeding is not a necessary intervention for infants with hypertrophic pyloric stenosis. Slow feeding may help reduce the amount of vomiting, but it does not address the underlying problem of the pyloric obstruction. Slow feeding may also cause the infant to become frustrated, hungry, or tired. The infant should be fed according to his or her appetite and cues, and burped frequently to prevent air swallowing.

Choice D reason: Chromosomal mutation is not the cause of hypertrophic pyloric stenosis. The exact cause of this condition is unknown, but it is likely influenced by both genetic and environmental factors. Some studies have found an association between hypertrophic pyloric stenosis and certain genes, but no single gene mutation has been identified as the cause. Other risk factors include being male, firstborn, premature, exposed to certain antibiotics, or having a family history of the condition².

Choice A reason: Semi-Fowler's position is a position in which the head of the bed is elevated to 30 to 45 degrees, and the knees may be slightly bent. This position can help relieve pain and facilitate drainage after an appendectomy, as it reduces the tension on the abdominal muscles and incision, and promotes the flow of blood and fluids away from the surgical site. It can also improve breathing and prevent pulmonary complications.

Choice B reason: Supine position is a position in which the person lies flat on their back, with the head and shoulders slightly elevated. This position is not recommended after an appendectomy, as it can increase the pressure on the abdominal muscles and incision, and cause pain and discomfort. It can also impair breathing and increase the risk of pneumonia.

Choice C reason: Trendelenburg position is a position in which the person lies flat on their back, with the head of the bed lowered and the feet elevated. This position is not advised after an appendectomy, as it can increase the pressure on the abdominal organs and incision, and cause pain and bleeding. It can also reduce the blood flow to the brain and cause dizziness, nausea, or fainting.

Choice D reason: Prone position is a position in which the person lies flat on their stomach, with the head turned to one side. This position is not suitable after an appendectomy, as it can stretch and irritate the abdominal muscles and incision, and cause pain and inflammation. It can also hinder breathing and drainage, and increase the risk of infection.