Hernia is a protrusion or projection of an organ or organ part through an abnormal opening in the containing wall of its cavity, a hernia results. An inguinal hernia occurs when the omentum, the large or small intestine, or the bladder protrudes into the inguinal canal. In an indirect inguinal hernia, the sac protrudes through the internal inguinal ring into the inguinal canal and, in males, may descend into the scrotum. In a direct inguinal hernia, the hernial sac projects through a weakness in the abdominal wall in the area of the rectus abdominal muscle and inguinal ligament.

Hernia is classified into three types:

• Reducible, Hernias can be reducible if the hernia can be easily manipulated back into place
• Irreducible or incarcerated, this cannot usually be reduced manually because adhesions form in the hernia sac.
• Strangulated, if part of the herniated intestine becomes twisted or edematous and causing serious complications, possibly resulting in intestinal obstruction and necrosis.

Inguinal hernias can be direct which is herniation through an area of muscle weakness, in the inguinal canal, and inguinal hernias indirect herniation through the inguinal ring. Indirect hernias, the more common form, can develop at any age but are especially prevalent in infants younger than age 1. This form is three times more common in males.

Causes for Inguinal Hernia

An inguinal hernia is the result of either a congenital weakening of the abdominal wall, traumatic injury, aging, weakened abdominal muscles because of pregnancy, or from increased intra-abdominal pressure (due to heavy lifting, exertion, obesity, excessive coughing, or straining with defecation). Inguinal hernia is a common congenital malformation that may occur in males during the seventh month of gestation. Normally, at this time, the testicle descends into the scrotum, preceded by the peritoneal sac. If the sac closes improperly, it leaves an opening through which the intestine can slip, causing a hernia.

Complications for Inguinal Hernia

Inguinal hernia may lead to incarceration or strangulation. That can interfere with normal blood flow and peristalsis, and leading to intestinal obstruction and necrosis.

Diagnostic tests for Inguinal Hernia

Commonly No specific laboratory tests are useful for the diagnosis of an inguinal hernia. Diagnosis is made on the basis of a physical examination. Although assessment findings are the cornerstone of diagnosis, suspected bowel obstruction requires X-rays and a white blood cell count, which may be elevated.

Treatment for Inguinal Hernia

The choice of therapy depends on the type of hernia. For a reducible hernia, temporary relief may result from moving the protruding organ back into place. Afterward, a truss may be applied to keep the abdominal contents from protruding through the hernial sac. Although a truss doesn’t cure a hernia, the device is especially helpful for an elderly or a debilitated patient, for whom any surgery is potentially hazardous.

Herniorrhaphy is the preferred surgical treatment for infants, adults, and otherwise-healthy elderly patients. This procedure replaces hernial sac contents into the abdominal cavity and seals the opening. Another effective procedure is hernioplasty, which involves reinforcing the weakened area with steel mesh, fascia, or wire.

Strangulated or necrotic hernia requires bowel resection. Rarely, an extensive resection may require a temporary colostomy

Nursing care plan for Inguinal Hernia

Nursing Diagnosis Inguinal Hernia

Patient teaching home health guide for Inguinal Hernia

Appendectomy surgery video, Appendectomy is a surgical procedure to remove inflammation of the vermiform appendix, a narrow, blind tube that extends from the inferior part of the cecum just below the ileocecal valve. Without surgery, there will be life-threatening Complications For Appendicitis there include, Appendix ruptures or Perforates, Peritonitis, Appendiceal abscess, Pyelophlebitis

Appendicitis

Nursing Care Plans For Appendicitis, Appendicitis is an acute inflammation of the vermiform appendix, a narrow, blind tube that extends from the inferior part of the cecum just below the ileocecal valve. Although the appendix has no known function, it does regularly fill and empty itself of food. Appendicitis occurs when the appendix becomes inflamed from ulceration of the mucosa or obstruction of the lumen. If untreated, this disease is fatal.

Causes For Appendicitis

Obstruction of the vermiform appendix. Since the appendix is a small, finger-like Appendage of the cecum, it is prone to obstruction as it regularly fills and empties with intestinal contents. obstruction caused by a fecal mass, stricture, barium ingestion, or viral infection. This obstruction sets off an inflammatory process that can lead to infection, thrombosis, necrosis, and perforation.

Complications For Appendicitis

Common complication of appendicitis:

• Appendix ruptures or Perforates.
• Peritonitis.

Other complications include:

• Appendiceal abscess
• Pyelophlebitis.

Diagnostik tes

• Complete blood count
• Abdominal ultrasound
• Abdominal computed tomography (CT) scan

Nursing Assessment Nursing Care Plans For Appendicitis

Because other disorders can mimic appendicitis in sign and symptoms, diagnosis must rule out illnesses with similar symptoms: bladder infection, gastroenteritis, ileitis, colitis, acute salpingitis, tubo-ovarian abscess, diverticulitis, gastritis, ovarian cyst, pancreatitis, renal colic, and uterine disease

• Patients history of midabdominal pain as the disease process progresses, patients usually complain of a constant epigastric or periumbilical pain that eventually localizes in the right lower quadrant of the abdomen.
• The patient may also report anorexia, nausea, one or two episodes of vomiting, and a low-grade fever. Later signs and symptoms include malaise, constipation and, rarely, diarrhea.
• Inspection typically shows a patient who walks bent over to reduce right lower quadrant pain. When sleeping or lying in a supine position, he may keep his right knee bent up to decrease pain.
• Auscultation usually reveals normal bowel sounds.
• Palpation and percussion disclose no localized abdominal findings except diffuse tenderness in the midepigastric area and around the umbilicus. Tenderness in the right lowers abdominal. There may be pain in the right lower quadrant resulting from palpating the lower left quadrant (Rovsing’s sign).

Appendicitis Treatment

1. Appendectomy
2. If peritonitis develops, treatment involves GI intubation, parenteral replacement of fluids and electrolytes, and administration of antibiotics.

Nursing diagnosis Nursing Care Plans For Appendicitis

Common nursing diagnosis found in Nursing Care Plans For Appendicitis

• Acute pain
• Imbalanced nutrition: Less than body requirements
• Impaired skin integrity
• Ineffective tissue perfusion: GI
• Risk for deficient fluid volume
• Risk for infection
• Risk for injury

Nursing Key outcomes, Interventions and patients teaching Nursing Care Plans for Appendicitis