A 6-week-old infant with pyloric stenosis is scheduled for a pyloromyotomy. Which pre-operative nursing action has the highest priority?
A.
Mark an outline of the “olive-shaped” mass in the right epigastric area.
B.
Instruct parents regarding care of the incisional area.
C.
Monitor amount of intake and infant’s response to feedings.
D.
Initiate a continuous infusion of IV fluids per prescription.
The correct answer and Explanation is :
The correct answer is D. Initiate a continuous infusion of IV fluids per prescription.
Explanation:
Pyloric stenosis is a condition in which the pylorus, the valve between the stomach and the small intestine, becomes hypertrophied, leading to a gastric outlet obstruction. This condition results in severe vomiting, dehydration, and an electrolyte imbalance, making pre-operative management critical.
Pre-operative nursing care for an infant with pyloric stenosis includes:
- Initiate a Continuous Infusion of IV Fluids (Option D): This is the highest priority because the infant is likely to be dehydrated and electrolyte imbalances are common due to ongoing vomiting. The goal of IV fluid therapy is to correct these imbalances, ensure adequate hydration, and stabilize the infant’s condition before surgery. It is crucial to administer fluids as prescribed to prevent complications and prepare the infant for the upcoming procedure.
- Monitor Amount of Intake and Infant’s Response to Feedings (Option C): While monitoring intake and response to feedings is important, in the pre-operative phase, the focus is more on managing the effects of vomiting and ensuring the infant is hydrated and stable. This step is part of ongoing assessment but is not as critical as ensuring proper fluid resuscitation.
- Mark an Outline of the “Olive-shaped” Mass (Option A): This step is not a typical pre-operative priority. While identifying the mass can be useful for documentation and surgical planning, it does not address the immediate needs of the infant, such as correcting dehydration.
- Instruct Parents Regarding Care of the Incisional Area (Option B): Pre-operative teaching about post-operative care is important but secondary to ensuring the infant is stable and ready for surgery. This education is more relevant after the infant’s immediate needs have been addressed.
In summary, initiating a continuous IV fluid infusion is crucial for correcting dehydration and electrolyte imbalances before the surgery. This action helps ensure the infant is in the best possible condition for the pyloromyotomy, which is essential for successful surgical outcomes and recovery.