Certified Pediatric Nurse (CPN)

In the management of a child with pyloric stenosis, what is the priority intervention during the preoperative phase?

1. Administering pain medication

2. Ensuring adequate hydration and electrolyte balance

3. Monitoring vital signs every 4 hours

4. Starting a high-protein diet

The correct answer is: Ensuring adequate hydration and electrolyte balance

During the preoperative phase for a child with pyloric stenosis, ensuring adequate hydration and electrolyte balance is the priority intervention. Pyloric stenosis leads to projectile vomiting, which can result in significant fluid loss and electrolyte imbalances. Before any surgical intervention can take place, it is essential to stabilize the child's condition to minimize the risk of complications during and after surgery. Maintaining hydration may involve IV fluids to replenish lost fluids and administer electrolytes, particularly potassium, which can be depleted due to vomiting. This intervention directly addresses one of the critical issues faced by these patients and serves as a foundation for safe surgical management. While the other options are also important aspects of care, as pain management and vital sign monitoring are part of comprehensive patient management, they do not take the precedence that hydration and electrolyte balance do in this specific situation. A high-protein diet would not be appropriate before surgery in this scenario, as the child may not be able to tolerate oral intake effectively due to the condition. Thus, prioritizing hydration and balancing electrolytes is crucial in preparing the child for the surgical procedure.