hirschsprung disease nursing care plan

hirschsprung disease nursing care plan
by garest - http://garest.net/hirschsprung-disease-nursing-care-plan.html
hirschsprung disease nursing care
plan
hirschsprung disease nursing care plan
Hirschsprung disease is a congenital disorder causing impaired intestinal passage (Mansjoer
Ariff, et al. 2000). First introduced by Hirschsprung in 1886. Zuelser and Wilson, 1948 suggests
that the narrowing of the intestinal wall is not found parasympathetic ganglion.
A. Assessment.
1. Identity.
The Hirschsprung disease is mostly found in infants and is a single disorder. Rarely in
premature infants or in conjunction with other congenital abnormalities. In this segment from
the anus to the sigmoid aganglionosis is more common in boys than girls. While abnormalities
that exceeds even the entire sigmoid colon or small intestine are found as much in boys and
girls (Ngastiyah, 1997).
2. History of Nursing.
a. The main complaint.
Obstipasi is the hallmark and the newborn. Trias is often found is a slow exit meconium (more
than 24 hours after birth), flatulence and vomiting green. Other symptoms are vomiting and
diarrhea.
b. History of present illness.
It is a congenital abnormality that is functional intestinal obstruction. Total obstruction at birth
with vomiting, abdominal distension and absence of meconium evacuation. Babies often suffer
from constipation, vomiting and dehydration. Mild symptoms of constipation for several weeks
or months followed by acute intestinal obstruction. But there is also a mild constipation,
enterocolitis with diarrhea, abdominal distension, and fever. Fetid diarrhea may occur.
c. History of the disease first.
No previous illnesses that affect the occurrence of Hirschsprung disease.
d. Family medical history.
No family suffered from the disease passed down to his son.
e. History of environmental health.
No association with environmental health.
f. Immunization.
There is no immunization for infants or children with Hirschsprung disease.
g. History of growth and development.
h. Nutrition.
3. Physical examination.
a. Cardiovascular system.
No abnormalities.
b. Respiratory system.
Shortness of breath, respiratory distress.
c. The digestive system.
Generally obstipasi. Abdominal bloating / abdominal strain, vomiting green. In older children
there are chronic diarrhea. In anal plug will feel pinching fingers and when withdrawn will be
followed by the release of air and meconium or feces spraying.
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hirschsprung disease nursing care plan
by garest - http://garest.net/hirschsprung-disease-nursing-care-plan.html
d. Genitourinarius system.
e. Nervous system.
No abnormalities.
f. Locomotor system / musculoskeletal.
Impaired sense of comfort.
g. The endocrine system.
No abnormalities.
h. Integumentary system.
Akral warm.
i. Auditory system.
No abnormalities.
4. Diagnostic tests and results.
a. Plain abdominal upright will look dilated intestines or lower there is a picture of intestinal
obstruction.
b. With barium enema examination found the transition region, the picture intestinal
contractions are not regular at the narrowing, widening enterocolitis in segments and there is
retention of barium after 24-48 hours.
c. Suction biopsy, looking for ganglion cells in the sub mucosa.
d. Rectal muscle biopsy, which is taking rectal muscle layer.
e. Examination of acetylcholine esterase enzyme activity where there is increased activity of
the enzyme acetylcholine eseterase.
B . nursing diagnoses that may appear in Hirschsprung disease
1. Elimination Disorders CHAPTER: obstipasi associated with spastic colon and absence of
thrust.
2. Alteration in nutrition less than body requirements related to the inadekuat intake.
3. Lack of body fluids associated vomiting and diarrhea.
4. Impaired sense of comfort associated with the presence of abdominal distension.
5. Ineffective family coping related to the state of children’s health status.
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