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Elevated serum T3 and T4 would not be expected in congenital hypothyroidism; these levels are typically low.

Tachycardia, diarrhea, and tremors are more indicative of hyperthyroidism, not hypothyroidism.

In congenital hypothyroidism, the thyroid-stimulating hormone (TSH) is typically elevated as the body attempts to stimulate the thyroid gland to produce more hormones.

Urinary and bowel continence is expected by age 4, so this does not warrant further investigation.

Tying shoes is a skill typically developed later, around 5-6 years of age, so not being able to do so at age 4 is not concerning.

Having an imaginary friend is common in children around this age and is not a cause for concern.

Large amounts of bilious emesis would suggest an obstruction beyond the pylorus, which is not characteristic of pyloric stenosis.

Watery diarrhea is not associated with pyloric stenosis, which typically causes dehydration and constipation.

Steatorrhea, or fatty stools, is not a feature of pyloric stenosis but rather is associated with malabsorption syndromes.

. While pain management is important, the primary treatment for pyloric stenosis is surgical correction, not just analgesic medication.

A barium enema is not used in the diagnosis or treatment of pyloric stenosis; it is typically used to diagnose other gastrointestinal conditions.

Thickened feedings with rice cereal are not indicated for pyloric stenosis and would not resolve the obstruction.

Restricting fiber is not necessary; instead, administering vitamin C with iron can enhance absorption.

Iron supplements can cause dark stools, but not blood in the stools. Blood in the stools requires further investigation.

Iron supplements are better absorbed on an empty stomach; taking them with meals can reduce their absorption.

Tender inguinal lymph nodes are not associated with celiac disease and are more indicative of localized infections or lymphadenopathy.

An enlarged liver is not typically related to celiac disease but may occur in other conditions such as fatty liver disease.

Periorbital edema is not characteristic of celiac disease and is more commonly seen in conditions like nephrotic syndrome.

Dry mouth is expected postoperatively, especially if the child is not drinking adequate fluids, but it is not a sign of a complication.

Mild to moderate pain is expected after a tonsillectomy and should be managed with analgesics.

Dried flecks of blood in oral secretions can be normal immediately after surgery, but active bleeding would be concerning.

Bronchiolitis usually presents with wheezing and difficulty breathing, not drooling or inability to cough.

Asthma typically presents with wheezing, shortness of breath, and coughing, but not with drooling or an inability to cough.

Nasopharyngitis, or the common cold, usually causes symptoms like runny nose, cough, and sore throat, but not drooling or agitation.

Increasing fiber intake is beneficial for overall digestive health and can prevent constipation, which may help in reducing the risk of UTIs.

Wiping from front to back is crucial in preventing the spread of bacteria from the anal area to the urinary tract, reducing the risk of recurrent UTIs.

Follow-up with a specialist may be necessary if the child has recurrent UTIs, to rule out underlying issues such as vesicoureteral reflux.

Offering a pacifier is contraindicated after cleft lip and palate repair as it can disrupt the surgical site and interfere with healing.

The Trendelenburg position is not recommended as it can increase pressure on the surgical site and compromise breathing.

An ice collar may be used for pain relief in older children or adults but is not typically used in infants, and it may not be feasible in this population.