Pyloric Stenosis and Celiac Disease (10 Questions)

1. Mme Tremblay brings her 5-week-old son, Léo, to the emergency department. She states that for the past week, he has been spitting up after feeds, but today it has changed. "Now, the vomit shoots across the room immediately after he eats. It smells sour, but there is no green color in it." Léo appears hungry immediately after vomiting.

Question:
Based on the description, which specific symptom is Léo exhibiting that is pathognomonic for Pyloric Stenosis? *
2. You are performing an abdominal assessment on Baby Gagnon, a 4-week-old male admitted with suspected Pyloric Stenosis. The infant is currently quiet and drinking a small amount of electrolyte solution.

Question:
Which specific physical assessment finding, if palpated in the right upper quadrant (RUQ), would confirm the diagnosis? *
3. Baby Roy is scheduled for a pyloromyotomy tomorrow morning. He has been vomiting for 3 days. His fontanels are sunken, and he has poor skin turgor. The physician orders admission labs.

Question:
Which metabolic imbalance does the nurse anticipate finding due to prolonged forceful vomiting? *
4. Baby Lefebvre is admitted for correction of Pyloric Stenosis. He is NPO (nothing by mouth) and has an IV running. He is crying and rooting, appearing extremely hungry. The mother is distressed seeing him cry.

Question:
What is the most appropriate nursing intervention to maintain the infant’s comfort? *
5. Baby Poirier is 24 hours post-pyloromyotomy. He has tolerated three feeds of Pedialyte and one half-strength formula feed without vomiting. The mother asks, "What if he throws up when we get home? Did the surgery fail?"

Question:
What is the correct discharge teaching? *
6. Émilie, a 6-year-old, has just been diagnosed with Celiac Disease. You are reviewing dietary restrictions with her father, M. Caron. He asks, "I packed her lunch for tomorrow. Can you tell me if this is safe?" The lunch contains: A corn tortilla wrap with turkey and cheese, an apple, and a granola bar made with oats.

Question:
Which item in the lunch requires further investigation or removal? *
7. Mme Dubois brings her 2-year-old daughter, Sophie, to the clinic. Sophie has "wasted-looking" buttocks and thin extremities, but a very distended, protruding abdomen. Mme Dubois reports, "She is so cranky all the time, and her poop is terrible—it's pale, smells awful, and looks greasy."

Question:
The nurse identifies the stool description as steatorrhea. What creates this symptom in Celiac Disease? *
8. Lucas, age 14, has known Celiac Disease but admits to "cheating" on his diet when he is with friends because "one piece of pizza doesn't give me a stomach ache."

Question:
Regardless of the absence of immediate abdominal pain, what is a serious long-term consequence of non-compliance for a teenager? *
9. Mme Fortin has a history of Celiac Disease. She wants to know if her 18-month-old son should be tested. The child is growing well and has no symptoms.

Question:
What is the first-line screening test the nurse should anticipate the physician will order? *
10. Béatrice, a 3-year-old with Celiac Disease, is admitted with severe acute gastroenteritis. She has profuse watery diarrhea and vomiting. She is lethargic. Her potassium is 2.9 mmol/L and she has metabolic acidosis.

Question:
What is this life-threatening complication known as? *