Hirschsprung’s Disease Nursing care and Intervention

Definition:

• Hirschsprung’s disease results in obstruction from inadequate motility in part of the intestine or absence of parasympathetic ganglion cell in one segment of colon, this cause accumulation of intestinal contents and bowel distention.

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Manifestations

– Failure to pass meconium ( in newborn)

– Bile stained vomits and abdominal distention

– The child has constipation

– Passage of ribbon like, foul smell stools

Diagnosis

– Barium enema, colon will appear enlarged

Temporary colostomy
Post-operative: Stoma Car

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Nursing intervention

Preoperative care:

– Bowel empty with repeated saline enema

– Colon irrigation and observe output

– NG tube may be inserted to prevent abdominal distention

– Rectal tube may be inserted to allow for escape of accumulated fluid and gas

– Prepare child and parents for colostomy (temporary)

• Postoperative care:

– Routine care includes; NPO, IV, NG suctioning.

– Frequent abdominal dressing changes

– Teach the parents about the importance of colostomy care

– Drainage from the colostomy is measured

– Perform good skin care (around colostomy)

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