University:
Northwest College
Course:
VN420 | Child Health
Academic year:

2024
Views:

484

Pages:

2
Author:

Yesenia M.

OMPHALOCELE AND GASTROSCHISIS Congenital anomalies of the anterior abdominal wall. Omphalocele- defect of the umbilical ring that allows evisceration of the abdominal contents into an external peritoneal sac Gastroschisis- herniation of the abdominal contents through an abdominal wall defect, usually to the L or R of the umbilicus ; DIFFERENT from omphalocele bc there is NO peritoneal sac protecting the herniated organs and exposure to amniotic fluid makes them thickened, edematous, and inflamed. Assessment Risk factors: maternal illness, infection, drug use, smoking, genetic abnormalities → all contribute to placental insufficiency and the birth of a SMGA or preterm NB (most affected population of this defect ) Can be readily seen on birth Protrusion on the abdomen w evidence of sac/no sac Nursing management Focus is on preventing hypothermia, maintaining perfusion to the eviscerated abdominal contents, minimizing fluid loss, protecting the exposed abdominal contents from trauma and infection. Cover abdominal contents w nonadherent sterile dressing Strict sterile technique needed ** Radiant warmer- to maintain NB’s temp Covering dressing w plastic wrap can help prevent heat and fluid loss Low suction to an orogastric tube to prevent intestine distention IV line for IVF and electrolyte replacement ABX Monitor exposed bowel for vascular compromise, change in color or temp Post op care Sx repair for either defect occurs after initial stabilization Pain management Monitor RR and cardia status Monitor I/O BE ALERT FOR COMPLICATIONS- SHORT BOWEL SYNDROME PROMOTE PARENT- NB INTERACTION **