A nurse is caring for a toddler whose parent states that while bathing the child, she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

Choice A reason: Pyloric stenosis is not a manifestation of inadequate motility of part of the intestine, but rather a hypertrophy of the pyloric muscle, which causes gastric outlet obstruction and delayed gastric emptying. Pyloric stenosis typically presents with projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the abdomen.

Choice B reason: Hirschsprung's disease is a manifestation of inadequate motility of part of the intestine, as it is caused by the absence of ganglion cells in the distal colon, which results in a lack of peristalsis and a functional obstruction. Hirschsprung's disease typically presents with constipation, abdominal distension, failure to thrive, and enterocolitis.

Choice C reason: Encopresis is not a manifestation of inadequate motility of part of the intestine, but rather a condition in which a child over 4 years of age involuntarily passes stool, usually due to chronic constipation and fecal impaction. Encopresis typically presents with soiling of the underwear, abdominal pain, low self-esteem, and behavioral problems.

Choice D reason: Enterocolitis is not a manifestation of inadequate motility of part of the intestine, but rather an inflammation of the mucosa of the small and large intestines, which can be caused by various infections, allergies, or ischemia. Enterocolitis typically presents with diarrhea, fever, abdominal pain, and dehydration.

Choice A reason: Keeping the baby in an upright position after feedings is an effective strategy to prevent or reduce gastroesophageal reflux, as it allows gravity to help the stomach contents stay down. The parent should hold the baby upright for at least 20 to 30 minutes after each feeding, and avoid placing the baby in a car seat or swing, which can increase the abdominal pressure.

Choice B reason: Feeding the baby formula rather than breast milk is not necessary for gastroesophageal reflux, as breast milk is easier to digest and less likely to cause reflux than formula. The parent should continue to breastfeed the baby, unless there is a medical reason to switch to formula. The parent should also avoid overfeeding the baby, and burp the baby frequently during and after feedings.

Choice C reason: Positioning the baby lying on his stomach is not recommended for gastroesophageal reflux, as it can increase the risk of aspiration, suffocation, and sudden infant death syndrome (SIDS). The parent should place the baby on his back to sleep, and elevate the head of the crib or bassinet by 30 degrees to reduce the reflux.

Choice D reason: Thickening the baby's formula with honey is not advised for gastroesophageal reflux, as honey can cause botulism, a serious and potentially fatal illness, in infants under one year of age. The parent should not add any thickening agents to the formula, unless prescribed by the provider. Some studies suggest that thickening the formula with rice cereal may reduce the reflux, but the evidence is inconclusive and the practice may have adverse effects, such as increased caloric intake, constipation, or food allergies.