A nurse is assessing a 1-year-old toddler who notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect?

Choice A reason: Ridged abdomen is not an expected finding for an infant who has pyloric stenosis, as it indicates abdominal rigidity or guarding, which can be a sign of peritonitis or bowel obstruction. Pyloric stenosis is a narrowing of the pyloric sphincter, which causes gastric outlet obstruction and delayed gastric emptying.

Choice B reason: Red currant jelly stools are not an expected finding for an infant who has pyloric stenosis, as they indicate blood and mucus in the stools, which can be a sign of intussusception or necrotizing enterocolitis. Pyloric stenosis does not affect the lower gastrointestinal tract, and the infant may have constipation or dehydration due to vomiting.

Choice C reason: Projectile vomiting is an expected finding for an infant who has pyloric stenosis, as it occurs after feeding due to the increased pressure in the stomach and the inability to pass food into the duodenum. Projectile vomiting can cause weight loss, dehydration, electrolyte imbalance, and metabolic alkalosis.

Choice D reason: Distended neck veins are not an expected finding for an infant who has pyloric stenosis, as they indicate increased central venous pressure, which can be a sign of heart failure or superior vena cava syndrome. Pyloric stenosis does not affect the cardiovascular system, and the infant may have sunken fontanels or poor skin turgor due to dehydration.

Choice A reason: Recurrent epigastric pain is not a complication of peptic ulcer disease, but rather a common symptom of it. Peptic ulcer disease is the erosion of the mucosal lining of the stomach or duodenum, which can cause pain, burning, or discomfort in the upper abdomen.

Choice B reason: Hyperactive bowel sounds are not a complication of peptic ulcer disease, but rather a normal finding in a child who has not eaten for a while. Hyperactive bowel sounds indicate increased peristalsis, which can be caused by hunger, stress, or infection.

Choice C reason: Yellowish-red emesis is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Bleeding can occur when the ulcer erodes the blood vessels or the protective layer of the mucosa. Yellowish-red emesis means that the blood has been partially digested by the stomach acid, giving it a coffee-ground appearance.

Choice D reason: Melena stool is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Melena stool is black and tarry, and it has a foul odor. It means that the blood has passed through the entire digestive tract, and has been altered by the intestinal bacteria and enzymes.