Chapter 24: Umbilical Hernia (Children) Flashcards
1
Q
Umbilical Hernia
A
most common type in infants
- protrusion of the intestine through the abdominal fascia
- identifiable during crying, defecation, or coughing
2
Q
How does an Umbilical Hernia Occur?
A
as a result of failure of the umbilical ring to close, which normally begins at the end of the first trimester
3
Q
Signs and Symptoms
A
- majority are asymptomatic
- more prominent when infant is crying
4
Q
Diagnosis
A
identified as a soft midline swelling in the umbilical area
-can be reduced with pressure
5
Q
Prevention
A
may not be prevented
-good prenatal care promotes optimal fetal development in utero
6
Q
Nursing Care
A
- 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
7
Q
Surgical Care
A
considered for a persistent hernia beyond age of 5, an incarcerated hernia, or a hernia that enlarges dramatically
8
Q
Postoperative care
A
- 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)
9
Q
Education/ Discharge
A
- 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