HERNIA

TYPES protrusion of a portion of an organ or organs through an abnormal opening. Organ constriction Incarcerated Hernia: cannot be reduced easily Strangulated Hernia: blood supply of the organ is impaired Diaphragmatic abdominal organs through opening in diaphragm Symptoms: Mild to severe respiratory distress Tachypnea Cyanosis Dyspnea Absent breath sounds

Diagnosis: Radiograph Prenatally 25th week AOG Therapeutic: Respiratory distress Acidosis ET GI decompression ECMO Nursing Preoperative: Reduce stimulation Prompt recognition Maintain suction, oxygen and IV Positioning Administer medication Postop Relieve pain and discomfort Support family

HIATAL Sliding: Protrusion of an abdominal structure through the esophageal hiatus Diagnosis: Fluoroscopy Symptoms: Therapeutic Management: -Dysphagia Positioning -Failure to thrive Pharmacologic treatment -Vomiting Surgical management -Respiratory problems Nursing: Routine Postop care

ABDOMINAL Umbilical: Weakness in the abdomen around umbilicus Premature and African-Americans Close spontaneously by 1 -2 years Symptoms Inspection Palpation Therapeutic: Small defects : No tx Operative repair 4 -6 Nursing

Be alert to significant signs Carry out routine postop care

Omphalocele Intraabdominal viscera into the base of umbilical cord Sac is covered with peritoneum w/o skin Gastroschisis Intraabdominal contents through the defect in abdominal wall lateral to the umbilical ring no peritoneal sac Symptoms: Inspection Note for other malformations

Therapeutic: -Surgical repair of defect: -Preop: >Large lesions gradual reduction of abdominal contents >Prophylactic antibiotics

Nursing(preop) Keep sac or viscera moist Use overhead warming unit Routine care of IV