hernias, ppt(print)

7/28/2019 Hernias, Ppt(Print)

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HERNIASHERNIAS

By:

Farid Indra Sukmawan

Nur Alva Rachmawati

Reni Octaviani

Sigit Agus Gunawan


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DEFINITION

A hernia is a protrusion of a tissue,

structure, or part of an organ through the

muscular tissue or the membrane bywhich it is normally contained.

The hernia has three parts: the orifice

through which it herniates, the hernial sac,and its contents.


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ETIOLOGY

Two main factors predisposing to hernia are:

Increased intra cavity pressure

A weakened abdominal wall

In abdomen, increase pressure occurs as Heavy lifting

COPD

Straining to pass urine

Straining to pass feces

Abdominal distention/change the abdominal content


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TYPES OF HERNIAS

Inguinal Hernias

Femoral Hernias

Umbilical Hernias Insicional Hernias

Diaphragmatic Hernias

Other types of Hernias


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1. Inguinal Hernias

Indirect

Which the inguinal canal is entered via a

congenital weakness at its entrance (the

internal inguinal ring)

Direct

Where the hernia contents push through aweak spot in the back wall of the inguinal

canal. More common in men.


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Direct Hernia Indirect Hernia


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2. Femoral Hernias

It occurs when

abdominal contents

pass into the weak

area at the posteriorwall of the femoral

canal.

It is common in

women.


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3. Umbilical Hernias

It involves protrusion of intraabdominal

contents through a weakness at the site of

passage of the umbilical cord through the

abdominal wall.

It is happened in infants of Africa, and

occur more in boys.

In adult, it is happened in obese and

pregnant woman


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4. Incisional Hernias

An incisional hernia occurs when the

defect is the result of an incompletely

healed surgical wound.

When these occur in median laparotomy

incisions in the linea alba, they are termed

ventral hernias.


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5. Diaphragmatic Hernias

When part of the

stomach or

intestineprotrudes into the

chest cavity

through a defect

in the diaphragm


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Contd

1. Sliding

Which the gastroesophageal junction

itself slides through the defect into the

chest.

2. Non Sliding

Which case the junction remains fixedwhile another portion of the stomach

moves up through the defect


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6. Other types of hernias

Brain hernia

Cooper's hernia

Epigastric hernia

Littre's hernia Lumbar hernia

Obturator hernia

Pantaloon hernia Perineal hernia

Properitoneal hernia

Sliding hernia

Sciatic hernia

Spigelian hernia

Sports hernia Velpeau hernia

Spinal disc herniation

Double hernia Richter's hernia


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COMPLICATIONS

An untreated hernia may complicate by:

Inflammation

Irreducibilty Obstruction

Strangulation

Hydrocele of the hernial sac


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TREATMENTS

Herniorrhaphy Principally repaired by pushing back the

herniated tissue, and then mending the

weakness in muscle tissue. It is performed for uncomplicated hernias.

Tension Free Modern muscle reinforcement techniques

involve synthetic materials (a meshprosthesis) that avoid over-stretching ofalready weakened tissue


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Tension Free


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ASSESSMENT

Subjective data:

Pain at the site of the hernias.

Objective:There is a bulge through the abdominal

wall.


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NURSING DIAGNOSIS

Acute pain related to tissue edema.

Ineffective tissue perfusion

(gastrointestinal) related to strangulation.


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INTERVENTIONS

Dx 1: Acute pain related to tissue edema.

Administer analgesics as ordered. Evaluate aggravating activities.

Educate regarding sign of complication

and when to notify staff of symptom.


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Contd

Dx 2: Ineffective tissue perfusion relatedto strangulation

Assess abdomen for bowel sounds every4 hours.

Insert NGT to decrease abdominal

distention as ordered. Prepared client for surgery as ordered.

Administer IV hydration as ordered.

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