Chapter 24: Umbilical Hernia (Children)

Question 1

Umbilical Hernia

Answer 1

most common type in infants

• protrusion of the intestine through the abdominal fascia
• identifiable during crying, defecation, or coughing

Question 2

How does an Umbilical Hernia Occur?

Answer 2

as a result of failure of the umbilical ring to close, which normally begins at the end of the first trimester

Question 3

Signs and Symptoms

Answer 3

• majority are asymptomatic

- more prominent when infant is crying

Question 4

Diagnosis

Answer 4

identified as a soft midline swelling in the umbilical area

-can be reduced with pressure

Question 5

Prevention

Answer 5

may not be prevented

-good prenatal care promotes optimal fetal development in utero

Question 6

Nursing Care

Answer 6

• most resolve spontaneously by 3 to 5 years of age, though a decreased likelihood for hernia larger than 1.5 cm in diameter or for one with a large, proboscis-like defect (elongated or extensible tubular process)
• parental education
• preoperative preparation of the child

Question 7

Surgical Care

Answer 7

considered for a persistent hernia beyond age of 5, an incarcerated hernia, or a hernia that enlarges dramatically

Question 8

Postoperative care

Answer 8

• vital signs done frequently
• keeping wound clean and dry
• managing child’s pain
• pressure dressing applied for 48 hours
• may resume a normal diet and activity (avoid strenuous activities for 2 to 3 weeks)

Question 9

Education/ Discharge

Answer 9

• prior to surgery, nurse instructs parents about umbilical hernia and prognosis for the spontaneous resolution
• if surgery is required, parents instructed to have the child avoid strenuous activities after surgical correction for 2 to 3 weeks and resume a normal diet as tolerated