Which of the following is the main clinical feature of pyloric stenosis?

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Projectile vomiting is the hallmark clinical sign of pyloric stenosis.
It is caused by the stomach's forceful peristaltic contractions attempting to push milk through the narrowed, hypertrophied pyloric sphincter.
The vomiting is characteristically non-bilious because the obstruction is proximal to the ampulla of Vater, where bile enters the duodenum.
Initially, vomiting may be simple regurgitation but progresses in force and frequency over several days.

Option A: Irritability is a non-specific symptom in infants and, in this case, is a result of constant hunger and discomfort from the underlying condition, not the primary diagnostic feature.
Option B: Weight loss, or failure to gain weight, is a significant but secondary consequence of pyloric stenosis. It results from the inability to retain and absorb nutrients due to persistent vomiting.
Option D: Constipation is a secondary sign resulting from dehydration and the reduced volume of food passing into the intestines. It is not the primary presenting complaint.

Clinical Relevance

Nursing practice connection: Knowing Clinical Manifestations of Pyloric Stenosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing projectile vomiting as a key sign of pyloric stenosis is critical for nurses to facilitate early diagnosis and intervention, preventing severe dehydration, electrolyte imbalance, and malnutrition.
Nurses play a vital role in pre-operative stabilization by managing IV fluids, monitoring electrolytes, and keeping the infant NPO, ensuring the patient is safe for surgery.
Post-operatively, the nurse's careful reintroduction of feeds and monitoring for tolerance is key to a successful recovery.

How to Approach the Question

First, identify the core subject of the question: 'pyloric stenosis'.
Next, focus on the keyword in the lead-in: 'main clinical feature'. This asks for the most characteristic or hallmark sign, not just any symptom.
Evaluate each option. Think about which symptom is the direct and most defining result of the pathophysiology (a blocked stomach outlet).
Recall or deduce that a blockage at the stomach's exit would cause forceful expulsion of its contents (projectile vomiting).
Differentiate this primary sign from secondary consequences like weight loss, irritability (from hunger), and constipation (from dehydration), which result from the primary problem.

Concept Tested & Keywords

Q85YX3W-M7zLTWBTna7CgG

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 295-297

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 158-160

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 58-60

Practise the full IGNOU PB Bsc Nsg Entrance-2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.