A hernia occurs when abdominal contents protrude through an opening in a weakened area of a muscle. An umbilical hernia is the bulging of the intestine and omentum through the umbilical ring as a result of incomplete closure following birth. An inguinal hernia is the protrusion of intestine through the inguinal ring caused by a failure of the vaginal process to atrophy to close prior birth allowing for a hernial sac to develop along the inguinal canal.
An umbilical hernia usually resolves by the age of 4-5 years old. Surgery is recommended for those that become enlarged and to those that do not disappear by school age. An inguinal hernia is commonly associated with a hydrocele that becomes prevalent in the infant by 2 to 3 months of age when intra-abdominal pressure increases enough to open the sac. Both are corrected by surgical repair (herniorrhaphy) to prevent obstruction and eventual incarceration of a loop of bowel.
Nursing Care Plans
Rendering effective nursing care is important after a surgical repair for hernia which includes providing comfort, educating parents and child as appropriate with information related with the postoperative condition and care measures, and preventing the occurrence of complications.
Here are four (4) nursing care plans (NCP) for umbilical and inguinal hernia:
Acute Pain: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage; sudden or slow onset of any intensity from mild to severe with anticipated or predictable end and a duration of <6 months.
May be related to
- Surgical repair
Possibly evidenced by
- Change in facial expression in the child
- Irritability in infant
- Verbalization of pain
- Guarding behavior
- Crying, Moaning
- Refusal to move
- Client will express feelings of comfort and reduce pain as described using a pain scale.
|Assess incision pain and nonverbal signs of pain such as crying, lethargy, facial grimace.||Determines the need for the initiation of analgesic therapy.|
|Administer analgesic appropriate for the severity of pain and age.||Allays pain and discomfort caused by the incision.|
|Maintain position of comfort.||Facilitates comfort and decreases pain caused by the strain on incision.|
|Apply an ice compress on the scrotal area if hydrocele is corrected and apply scrotal support if appropriate.||Promotes comfort by decreasing the swelling.|
|Provide support to the buttocks during lifting or position changes.||Avoid strain and pull on incision site.|
|Encourage parents to change diapers frequently.||Prevents irritation and pain at incision area caused by wet diapers.|
|Provide toys, games for quiet play.||Facilitates diversionary activity to detract from pain.|
|Instruct parents to hold the infant during feeding or when irritable, frequently burp to remove swallowed air.||Reduces strain on the incision and promotes comfort.|
|Educate parents on the causes of pain and interventions needed to relieve it.||Promotes understanding of treatments for pain postoperatively.|
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