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.
Risk for Fluid Volume Deficit
- Risk for Fluid Volume Deficit
May be related to
- Postoperative status (NPO status)
Possibly evidenced by
- [not applicable]
- Client will experience adequate fluid volume.
|Assess onset of nausea and vomiting,
quality, quantity and presence of blood, bile, food, and odor.
|Provides information about emesis and defining characteristics.|
|Assess skin turgor, mucous membranes,
weight, fontanelles of an infant, last void, and behavior changes.
|Provides information about hydration status; including extracellular fluid losses,
decreased activity levels, malaise, weight loss, poor skin turgor, concentrated urine.
|Assess vital signs, including apical pulse.||Provides monitoring of cardiovascular response to dehydration (weak, thready pulse, drop in blood pressure). Increased respiratory rate may contribute to fluid loss.|
|Monitor urine specific gravity, color, and amount every voiding or as ordered.||Concentrated urine with an increased specific gravity indicates lack of fluids to
|Monitor laboratory data results, as ordered (electrolytes, BUN, CBC, pH, etc.).||Allows identification of fluid losses and electrolyte imbalances.|
|Maintain NPO status, if prescribed.||Provides rest for the gastrointestinal tract because of nausea and vomiting and
associated medical conditions.
|Position child on side or sitting up when vomiting; keep suction available.||Avoids aspiration of emesis.|
|Administer antiemetics as ordered.||Given as a prophylaxis and treatment to postoperative nausea and vomiting.|
|Initiate and monitor IV administration of nutrients as prescribed.||Provides fluid and nutritional support to replace active fluid loss and prevention of fluid overload.|
|Initiate small amounts of clear liquids, as tolerated when nausea and vomiting subside; offer oral hydration fluids; breastfed babies need frequent short feedings at the breast.||Provides fluids in minimal amounts until nausea and vomiting resolved.|
|Instruct parents regarding causes of
nausea and vomiting, signs of dehydration, and when to report them to the physician.
|Provides information for immediate treatment of excessive loss of fluids and electrolytes caused by nausea and vomiting.|
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