Chapter 24: Inguinal Hernia (Children)

Question 1

Inguinal Hernia

Answer 1

most common type
-arises from the failure of the processus vaginalis to atrophy (waste away) and close during the eighth month of gestation; this provides a canal that allows for abdominal fluid or structure (bowel, ovary, or fallopian tube) to extend up to or through the inguinal ring into the scrotum or labia

Question 2

Signs and Symptoms

Answer 2

• bulge on either side of the pubic bone
• burning, gurgling, or aching sensation at the bulge
• pain or discomfort that increases while bending, coughing, or lifting
• heavy or dragging sensation in groin
• weakness or pressure in groin

Question 3

Diagnosis

Answer 3

identified by swelling in the inguinal area that extends toward or into the scrotum
-most observed by 6 months of age

Question 4

Prevention

Answer 4

may not be prevented

-good prenatal care promotes optimal fetal development

Question 5

Nursing Care

Answer 5

• managed through surgical correction on an outpatient basis
• parental education and preoperative preparation of the child
• after surgery, nurse can inform the parents that the child’s vital signs are monitored frequently and that the child’s position will be changed often to avoid undue stress on the surgical area

Question 6

Surgical Care

Answer 6

Elective surgical correction is treatment choice

Question 7

Traditional Post-operative measures

Answer 7

• assessing child’s vital signs and bowel sounds
• maintaining fluid and electrolyte balance
• monitoring pain
• ensuring return to normal bowel elimination
• complications can be prevented by educating parents on keeping the wound clean and dry and to change wet or soiled diapers ASAP for children who are not toilet trained

Question 8

Incarcerated Hernia

Answer 8

a portion of the intestine that cannot be returned to the abdominal cavity

• causes obstruction or pain and if left untreated can lead to strangulation
• requires prompt referral and correction to prevent bowel from becoming strangulated and necrotic

Question 9

Education/ Discharge

Answer 9

• tell parents that the surgery will repair the defect caused by the hernia
• recovery is usually rapid, and child will return home same day of surgery
• discharge instructions: wound care and keep site clean and dry
• child can resume normal activity in 4 to 6 weeks
• may be given a prescription for stool softeners to prevent straining during defecation