Intussusception is a telescoping of one portion of the bowel into another portion which results in obstruction to the passage of the intestinal contents and inflammation and impaired blood flow to the parts of the intestinal walls that are pressing against one another. If not treated, tissue necrosis, intestinal perforation, and peritonitis may occur. The symptoms of intussusception include colicky abdominal pain, nausea, vomiting, lethargy, and blood or mucus in the stools (sometimes referred to as “currant jelly” stool).
It is most commonly occur in infants ages 3 to 12 months or in children 12 to 24 months of age. The cause of intussusception is unknown but children with Meckel’s diverticulum, celiac disease, cystic fibrosis, diarrhea, or constipation increases the likelihood of incurring this condition. Surgical correction is done if the obstruction of the involved segment does not resolve through manual reduction or by hydrostatic pressure or if bowel becomes necrotic.
Nursing Care Plans
Nursing care planning goals of a child with intussusception revolve toward providing appropriate information about the child’s condition, restoring fluid volume and preventing dehydration, and observing resolution or improvement (relief of abdominal pain, return of normal bowel sounds).
Risk for Injury
May be related to
- Bowel dysfunction
Possibly evidenced by
- [not applicable]
- Intussusception will be reduced by hydrostatic pressure.
- Client will pass a normal brown stool.
|Assess presence of acute abdominal
pain accompanied by loud crying and drawing knees up to chest which may be episodic, vomiting, passage of a brown stool followed by red, currant jelly-like stool, pallor, irritability.
|Provides information that intussusception is present which may result in obstruction and if left untreated, will lead to peritonitis.|
|Monitor older child for presence of diarrhea, constipation, and vomiting episodes.||Reveals presence of intussusception and a further assessment is needed.|
|Observe bowel elimination and
characteristics of stool and ability to eliminate barium following the procedure.
|Signifies that the procedure in reducing the affected bowel is successful as the condition may recur within 36 hours.|
|Provide NG tube attached to suction,
IV fluids to decompress bowel and
maintain hydration status and maintain patency of therapy as ordered.
|Avoids episodes of vomiting and dehydration and prepares the child for barium enema procedure to diagnose and reduce the invagination.|
|Provide information on the therapeutic regimen and allow for an opportunity to inquire questions about procedures.||Decreases anxiety and helps eliminate the fear of the unknown.|
|Provide reassurance to parents and allow to accompany the child during the procedure.||Promotes trust and reduces anxiety.|
|Inform parents on the purpose for IV
and NG tube, NPO status.
|Provides information about treatments for understanding and lessening of anxiety.|
|Inform parents that surgical reduction may be needed if barium enema fail to reduce the invagination.||Prepares parents for a possibility of surgical correction.|
|Reinforce information given by the physician.||Provides information about surgical intervention if barium enema reduction is unsuccessful or if bowel obstruction and necrosis is present.|
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