Nursing Pediatrics Clinicals
Pediatric Case Study Pyloric Stenosis
S.B. is the only child of Mr. and Mrs. B. The family has been living out of their car for the past 2 months; Mr. B. lost his job 2 weeks after S.B.’s birth and looks for work every day. Mrs. B. takes advantage of the good weather and spends most of the day playing with S.B. in the park. As the triage nurse in the emergency department (ED), you ask why they have brought S.B. to the hospital. Mrs. B. states that S.B. breast fed well for the first couple of weeks, but since then “throws up all the time like he’s forcing all his feedings out. He looks skinny and sick, and he cries and is fussy all the time.”
1. What additional information will you need to obtain from Mr. and Mrs. B.?
2. What would you include in your physical assessment of S.B.?
3. The emergency physician orders lab work and x-rays. What labs would you expect to be ordered, and what results would you expect to find knowing that S.B. has been vomiting frequently and that he may be diagnosed with dehydration and metabolic alkalosis?
4. What is the underlying cause for S.B.’s diagnosis of metabolic alkalosis?
5. What physical assessment findings occur with metabolic alkalosis?
6. What additional assessment findings might reflect the consequences of frequent vomiting in the infant?
CASE STUDY PROGRESS
S.B. is diagnosed with pyloric stenosis, admitted to the pediatric unit, and scheduled for surgery. S.B.’s parents are worried because they have no insurance and “don’t want anything bad to happen to our baby.”
7. What are your responsibilities as you admit S.B. and get him ready for surgery?
8. What are the implications of the family’s homelessness, financial situation, and lack of insurance?
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