Hypertrophic Pyloric Stenosis

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Author:
japanice27
ID:
306910
Filename:
Hypertrophic Pyloric Stenosis
Updated:
2015-08-27 04:37:11
Tags:
pyloric stenosis
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pedia
Description:
review about pyloric stenosis
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  1. Hypertrophic Pyloric Stenosis
    • -(+)hypertrophy (the enlargement of an organ or tissue from the increase in size of its cells) of the circular muscles of the pyloric causes NARROWING of the pyloric canal bet the stomach and duodenum.
    • -the stenosis develops in the first few weeks of life, causing projectile vomiting, dehydration, met. acidosis and failure to thrive. 
  2. Assessment:
    • ~vomiting that progresses to mild regurgitation to forceful and projectile vomiting; occurs AFTER FEEDING. 
    • ~VOMITUS⇨ (+)milk, formula and does not usually contains bile.
    • (+)olive-shaped mass is in the epigastrium, just above the umbilicus.
    • (+) hunger and irritability
    • (+) peristaltic wave frm left to right across the epigastrium during or immediately after feeding.
    • (+)dehydration
    • (+)malnutrition
    • (+)met imbalance
    • (+)met ALKA

    ***Peristalsis, involuntary movements of the longitudinal and circular muscles, primarily in the digestive tract but occasionally in other hollow tubes of the body, that occur in progressive wavelike contractions.Peristaltic waves occur in the esophagus, stomach, and intestines.
  3. INTERVENTIONS:
    • -monitor strict I&O. vomitus and stool.
    • -daily weights
    • -monitor for signs of DEHYDRATION and ELECTROLYTE IMB.
  4. PYLOROMYOTOMY:
    -an incision to the muscle fibers of the pylorus; may be performed by laparoscopy.

    • PREOP:
    • -monitor hydration status (daily weight, I&O and urine specific gravity)
    • -IV fluids for rehydration
    • -NPO
    • -monitor number and character of stools
    • -patent NGT

    • POSTOP:
    • -I&O
    • -begin small frequent feedings (gradually increase)
    • -handle infant minimally; feed infant slowly and burp infant frequently.
    • -wound care, and monitor wound.

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