Certified Pediatric Nurse (CPN)

Which assessment finding is expected in a child with pyloric stenosis?

1. Projectile vomiting of the bile-tinged emesis

2. Palpable pea-like mass in the abdomen

3. Metabolic alkalosis

4. Non-projectile vomiting

The correct answer is: Metabolic alkalosis

In children with pyloric stenosis, the expected assessment finding is metabolic alkalosis. This condition occurs due to the persistent vomiting that these children experience, which leads to a loss of hydrochloric acid and results in an imbalance of electrolytes. As the stomach contents, including acid, are ejected forcefully, the body compensates and the bicarbonate levels rise, causing alkalosis. Although projectile vomiting of bile-tinged emesis, a palpable mass, and non-projectile vomiting may seem relevant, they do not accurately describe the classic features of pyloric stenosis. The vomiting in pyloric stenosis is typically non-bile-tinged and projectile due to the obstruction at the pylorus preventing food from passing into the intestine. Additionally, a "olive-like" mass may be palpable in the abdomen, but this is more characteristic of the physical examination than a specific assessment finding indicative of metabolic status.