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GRCC PN132 test1

GRCC PN132 Hernias

REDUCIBLE hernia Contents of the sac return to the abdominal cavity when intra-abdominal pressure is reduced (as with lying down) or manual pressure.
IRREDUCIBLE OR INCARCERATED hernia When contents of the hernia can't be returned to the abdominal cavity.
STRANGULATED hernia Twists and gangrene develops; The blood supply to the tissue is compromised and could lead to infarction (necrosis) of affected bowel with severe pain and perforation.
Ab pain and distention, nausea, vomiting, tachycardia, and fever. manifestations of STRANGULATED hernia
What happens to the contents of irreducible or incarcerated hernia? They get trapped, usually by a narrow opening to the hernia.
INDIRECT INGUINAL HERNIA Location is in the groin; Follows the pathway that the testicles made during fetal development, descending from the abdomen into the scrotum. This pathway normally closes before birth but may remain a possible site for a hernia in later life
Sometimes the hernia sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age. INDIRECT INGUINAL HERNIA
Direct inguinal hernia The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum.
Unlike the indirect hernia, this type of hernia can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because their abdominal walls weaken as they age. Location is the groin Direct inguinal hernia
Femoral hernia The path through which the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) to protrude into the canal.
This type of hernia causes a bulge just below the inguinal crease in roughly the mid-thigh area. Usually occurring in women, A femoral hernia
femoral hernias are particularly at risk of becoming irreducible (not able to be pushed back into place) & strangulated. Not all hernias that are irreducible are strangulated (have their blood supply cut off ), but all hernias that are irreducible need to be evaluated by a health-care provider.
They type of hernias occur in the abdominal wall Umbilical and Incisional (ventral) hernia
Umbilical hernias May be congenital or acquired; pregnancy, obesity, and ascites are common risk factors.
Incisional (ventral) hernias Result from inadequate healing of a surgical incision.
Hiatal hernia A portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing
Reducible hernia Can push hernia back in
irreducible hernia Blood flow is trapped and can't push the hernia back in. Becomes strangulated
Causes of hernias obesity,heavy lifting,coughing,straining during a bowel movement or urination, chronic lung disease, and fluid in the abdominal cavity.
Strangulated will result from surgery
Heavy lifting or heavy manual labor will be restricted Following surgery
If surgery is not an option Pt can lay down and gently push down against the mass. A binder or truss may be worn to prevent or control the protrusion.
Risk for injury R/T hernia Nursing dgx : pre-operative considerations
Strangulation (leads to gangrene)Nursing dgx : pre-operative considerations
Impaired skin integrity Nursing dgx : pre-operative considerations
Impaired urinary elimination nursing dgx ; POST-operative care
Constipation nursing dgx ; POST-operative care
Acute pain nursing dgx ; POST-operative care
Risk for injury R/T wound nursing dgx ; POST-operative care
Dehiscence Wound re-opens and comes back through incision.
Dehiscence nursing dgx ; POST-operative care
Knowledge Deficit nursing dgx ; POST-operative care
Ice to site Nursing interventions post-operatively
Monitor voiding Nursing interventions post-operatively
Education: no lifting for 6-8 weeks Nursing interventions post-operatively
Education: avoid coughing and straining Nursing interventions post-operatively
T or F: Surgery is usually recommended True
Herniorrhaphy hernia surgery where they push it down and sew it up.
Hernioplasty Put something on the hernia (like mesh) - so that hernia can't protude.
Surgical pt's Elderly may spend night following surgery; regular pt will go home same day post -op.
Before pt dc'd Assess abdomen, bowel sounds and whether or not they are voiding.
What does it mean when there is pain or tenderness of the hernia? May indicate incarceration
What does an abrupt increase in pain possibly indicate? Bowel ischemia due to strangulation.
As a nurse, what can you do to treat a pt who has signs of possible obstruction or strangulation? Have pt lay in supine position with hips elevated and knees slightly bent; keep NPO as they will likely go to surgery.
Created by: Wends1984