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Constipation and Deficient Fluid Volume - NCP for Hirschsprung's Disease

Nursing Care Plan for Hirschsprung's Disease

Symptoms and signs can vary based on the severity of their condition sometimes appear soon after birth. At other times they may not appear until the baby grows into a teenager or adult.

In the new birth signs may include :
  • Failure to issue a stool in the first day or two of birth.
  • Vomiting : include vomit green liquid called bile - digestive fluid produced in the liver.
  • Constipation or gas.
  • Diarrhea.

In children older, signs may include :
  • Distended abdomen.
  • Slight weight gain.
  • Problems in the absorption of nutrients, which leads to weight loss, diarrhea or keduanyadan delay or slow growth.
  • Infection of the colon, especially newborn child or young ones, which can include enterocolitis, a serious infection with diarrhea, fever and vomiting and sometimes dangerous colonic dilatation. In children or older adults, symptoms may include constipation and low values ​​of red blood cells (anemia) due to blood loss in the stool.

Nursing Diagnosis for Hirschsprung's Disease

1. Risk for constipation related to narrowing of the colon, secondary, mechanical obstruction.

Goal: normal defecation pattern

Outcomes: the patient does not experience constipation, maintain a patient's defecation every day.

  1. Observations bowel sounds, and check the patient for abdominal distention. Monitor and record the frequency and stool characteristics.
  2. Record intake and output accurately.
  3. Encourage the patient to consume 2.5 L of fluid every day, if there are no contraindications.
  4. Perform defecation program. Patients in the upper chamber pot or commode at certain times each day, as close as possible to time the usual defecation (if known).
  5. Provide a laxative, enema, or suppository according to instructions.

  1. To plan an effective treatment in preventing constipation and faecal impaction.
  2. To assure hydration and fluid replacement therapy.
  3. To improve hydration and fluid replacement therapy.
  4. To assist adaptation to the normal physiological function.
  5. To increase the elimination of solid stool or gas from the digestive tract, monitor effectiveness.

Nursing Diagnosis for Hirschsprung's Disease

2. Risk for Deficient Fluid Volume related to discharge fluid from vomiting, inability absorps water by instentinal.

Goal: fluid requirements are met

Outcomes: elastic and normal skin turgor, CRT less than < 3 seconds

  1. Measure the patient's body weight each day before breakfast.
  2. Measure fluid intake and urine output to fluid status.
  3. Monitor urine specific gravity.
  4. Check the mucous membranes in the mouth every day.
  5. Determine what is the preferred fluid of patients and save the liquid in a patient's bedside, as instructed.
  6. Monitor serum electrolyte levels.
  1. To help detect changes in fluid balance.
  2. Decrease intake or increased fluid output increase deficits.
  3. Increased specific gravity of urine indicates dehydration. Low urine specific gravity, indicating excess fluid volume.
  4. Dry mucous membranes is an indication of dehydration.
  5. To increase intake.
  6. Changes in electrolyte values ​​may indicate the onset of fluid imbalance.