A 6-week-old infant with pyloric stenosis is scheduled for a pyloromyotomy. Which pre-operative nursing action has highest priority?

Rationale: A. Monitor amount of intake and infant's response to feedings: Feeding issues are a hallmark of pyloric stenosis, but by the time surgery is scheduled, feedings are typically withheld. This is useful earlier in the diagnosis, but not the top priority just before surgery. B. Mark an outline of the "olive-shaped" mass in the right epigastric area: Palpation of the mass is diagnostic but not relevant once the diagnosis is confirmed and surgery is planned. It offers no clinical benefit at the pre-operative stage. C. Instruct parents regarding care of the incisional area: Parental teaching is important, but it is more appropriate after the procedure. The infant’s immediate physiological stability takes precedence before surgery. D. Initiate a continuous infusion of IV fluids per prescription: Infants with pyloric stenosis often experience vomiting, leading to dehydration and electrolyte imbalances (e.g., hypokalemia, hypochloremia). Restoring fluid and electrolyte balance is the highest priority before surgery to ensure safety under anesthesia.