General Nursing©

HERNIAS

In a patient with hiatal hernias, nurses prepare him for diagnostic tests, as needed. After endoscopy, signs of perforation (falling blood pressure, rapid pulse rate, shock, sudden pain) are being observed. After surgery, fluid intake and output are carefully recorded, including nasogastric or wound drainage.

In a patient with inguinal hernias, truss is applied only after hernia has been reduced. It is applied before patient gets out of bed. Signs of incarceration and strangulation are immediately reported. If severe intestinal obstruction arises, the doctor is informed immediately.

A nasogastric tube is inserted promptly to empty stomach and relieve pressure on hernia sac. Before surgery, vital signs are monitored. Administration of I.V. fluids and analgesics for pain are performed, as ordered. Fever is controlled with acetaminophen or tepid sponge baths, as ordered. The patient is placed in the Trendelenburg position to reduce pressure on the hernia site.

A special reassurance and support is given to a child scheduled for hernia repair. After surgery, the patient must have voided within 12 hours. The incision and dressing are checked at least three times a day. Normal bowel sounds are auscultated.

To reduce scrotal swelling, scrotum is supported with rolled towel; and ice bag is applied. Fluid intake is encouraged to maintain hydration and prevent constipation.

Hernias occur through a combination of weak abdominal muscles and increased pressure within the abdominal cavity. They can result from overweight or coughing. As a result, small parts of the bowel herniated (rupture) outward through the inguinal or femoral canals in the general area of the groin.

Prevention

Exercise is critical to maintain the strength of the abdominal muscles. Walking, running, bicycling and swimming are at least as important as direct exercise to strengthen the abdomen. Weight control helps improve muscle tone and decreases stress. Stopping to smoke is extremely important because the chronic smoker's cough more than doubles the risk of these conditions.