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NURS 3512 - Class 1-6 > Week 5 - Hernia and Hemorrhoids > Flashcards

Week 5 - Hernia and Hemorrhoids Flashcards

1
Q

what is a hernia

A
  • protrusion of a viscus (usually intestines or tissue) thru an abnormal opening or a weakened area in the wall of the cavitity in which it is normally contained
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2
Q

what is a reducible hernia

A
  • if the hernia can be pushed back into the abdominal cavity
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3
Q

what is an irreducible hernia

A
  • if the hernia cannot be pushed back into the abdominal cavity
  • either by manipulation or when they lie down
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4
Q

what is a strangulated hernia

A
  • when the hernia is irreducible and the intestinal blood flow and blood supply are obstructed
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5
Q

what does a strangulated hernia result in

A
  • acute intestinal obstruction and ischemia
  • necrosis & gangrene if not immediate care
    = needs surgery
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6
Q

what are types of hernia (4)

A
  • inguinal
  • femoral
  • umbilical
  • incisional (or ventral)
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7
Q

where does a hernia commonly occur

A
  • over the involved area when the pt stands or strains
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8
Q

what are symptoms of a strangulated hernia (4)

A

S&S of bowel obstruction

  • vomitting
  • crampy abdominal pain
  • distension
  • and severe pain
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9
Q

what are symptoms of a hernia

A
  • pain to area of hernia
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10
Q

what can be used to diagnose a hernia

A
  • history

- physical exam

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11
Q

what is the treatment of choice for hernias and why?

A
  • surgery

- to prevent the complication of strangulation

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12
Q

what is the surgical repair of a hernia called

A
  • herniorrhaphy
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13
Q

what may be needed to treat a strangulated hernia (2)

A
  • bowel resection of involved area

- temporary ostomy

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14
Q

what may be used to keep a hernia in place

A
  • a truss
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15
Q

what is a truss and what does it do

A
  • a firm pad placed over the hernia and held in place w a belt
  • keeps hernia from protruding
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16
Q

when should a truss not be used

A
  • if the hernia is not reducible
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17
Q

what nursing care is involved w a truss

A
  • check for skin irritation caused by the rubbing and pressure of the truss
18
Q

what is a hernoplasty

A
  • surgical reinforcement of the weakened area w fascia or mesh
19
Q

describe post-op care for hernia (6)

A
  • may have difficulty voiding = observe for bladder distension and I&Os
  • scrotal edema may occur
  • coughing not encouraged
  • DB should be done
  • if pt needs to cough or sneeze, splint w pillow
  • position to decrease P on suture line
20
Q

what is scrotal edema

A
  • painful complication of an inguinal hernia repair
21
Q

what can be used to relieve discomfort of scrotal edema

A
  • use of scrotal support
22
Q

after discharge, what is imp to teach the pt r/t hernia surgery

A
  • may be restricted from heavy lifting or activities for 6-8 weeks (however some surgeons dont put limits on activities)
23
Q

what are hemorrhoids

A
  • varicosities in the lower rectum or anus caused by congestion in the veins
24
Q

hemorrhoids may be..

A
  • internal (occur above internal sphincter)

- external (occur outside external sphincter)

25
Q

what can cause hemorrhoids(6)

A

things that increase P

  • straining to defecate
  • pregnancy
  • prolonged constipation
  • heavy lifting
  • prolonged standing & sitting
  • portal HTN
26
Q

what are symptoms of internal hemorrhoids (4)

A
  • may be asymptomatic
  • if become constricted, experience pain
  • bleeding
  • chronic, dull, aching discomfort
27
Q

what are symptoms of external hemorrhoids (7)

A
  • reddish blue color
  • seldem bleed or cause pain unless a vein ruptures
  • if blood clot, get inflamed and painful
  • intermittent pain
  • pain on palpation
  • itching
  • burning
  • bleeding w defecation

(textbook kinda contradicts itself abt the pain and bleeding??)

28
Q

what can be used to diagnose hemorrhoids

A
  • digital exam, anoscopy, sigmoidoscopy for internal

- visual inspection and digital exam for external

29
Q

describe collaborative care for hemorrhoids (5)

A

directed towards causes and symptoms

  • constipation prevention
  • surgery
  • nonsurgical procedures
  • anti-inflamm, astringents, and anaesthetics to relieve discomfort
  • sitz baths for pain
30
Q

what interventions can be used to prevent constipation r/t hemorrhoids (3)

A
  • increased fluids
  • high fibre
  • stool softeners
31
Q

what are some nonsurgical procedures for treatment of hemorrhoids (4)

A
  • band ligation
  • infrared coagulation
  • cyrotherapy
  • laser treatment
32
Q

describe how band ligation works for treatment of hemorrhoids

A
  • thru an anoscope, the hemorrhoid is identified and then ligated w rubber band
  • the constrictive effect impairs circulation, tissue becomes necrotic, seperates, and sloghs off
33
Q

what is infrared coagulation for hemorrhoids

A
  • used to treat bleeding internal hemorrhoids
34
Q

what is cyrotherapy for treatment of hemorrhoids

A
  • involves rapid freezing of the hemorrhoid
35
Q

what us laser treatment for treatment of hemorrhoids

A
  • used to treat internal hemorrhoids
36
Q

what surgical procedure is used for treatment of hemorrhoids

A
  • hemorrhoidectomy
37
Q

what is a hemorrhoidectomy

A
  • surgical excision of hemorrhoids
38
Q

when is surgery indicated w hemorrhoids? (4)

A
  • if there is prolapse
  • excessive pain
  • excessive bleeding
  • large hemorrhoids
39
Q

describe discharge teaching for a pt with hemorrhoids (10)

A
  • how to prevent constipation
  • avoid prolonged standing or sitting
  • proper use of OTC drugs available for hemorrhoidal symptoms
  • seek medical care if severe symptoms of hemorrhoids (excessive pain, bleeding, prolapse)
  • use of sitz baths to reduce discomfort and swelling
  • importance of diet
  • care of anal area
  • avoid constipation & straining
  • hemorrhoids may recurr
  • regular checkups imp.
40
Q

how often should a pt with hemorrhoids use a sphincter bath

A
  • 15-0 min, 2-3xday, for 7-10 days
41
Q

describe nursing mngmt after a hemorrhoidectomy (7)

A
  • narcotics for sphincter spasm
  • sitz baths 1-2 days after surgery
  • dressing and packing changes
  • maintain privacy during dressing change
  • pain meds before first BM
  • stool softeners (Colace)
  • if no BM within first 2-3 days, give oral laxative

NURS 3512 - Class 1-6 (47 decks)

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