Nursing Care Plan for Hirschsprung's Disease

Hirschsprung’s Disease

Hirschsprung's disease is a blockage of the large intestine due to improper muscle movement in the bowel. It is a congenital condition, which means it is present from birth.


Symptoms

Symptoms that may be present in newborns and infants include:

• Difficulty with bowel movements
• Failure to pass meconium shortly after birth
• Failure to pass a first stool within 24 - 48 hours after birth
• Infrequent but explosive stools
• Jaundice
• Poor feeding
• Poor weight gain
• Vomiting
• Watery diarrhea (in the newborn)

Symptoms in older children:

• Constipation that gradually gets worse
• Fecal impaction
• Malnutrition
• Slow growth
• Swollen belly

Source : www.nlm.nih.gov

Nursing Care Plan for Hirschsprung's Disease

Nursing Assessment

1. The main complaint
   Obstipation is the main sign and in newborn infants. What is often found is a slow exit meconium (more than 24 hours after birth), flatulence and vomiting green. Other symptoms are vomiting and diarrhea.
2. History of present illness
   Is a congenital disorder that is a functional bowel obstruction. Total obstruction at birth with vomiting, abdominal distension and absence of meconium evacuation. Babies often experience constipation, vomiting and dehydration. Mild symptoms of constipation for several weeks or months, followed by acute intestinal obstruction. But there is also a mild constipation, enterocolitis with diarrhea, abdominal distension, and fever. Fetid diarrhea may occur.
3. History of previous illnesses
   No previous illnesses that affect the occurrence of Hirschsprung's disease.
4. Family health history
   No family who suffer from this disease descended to his son.
5. Immunization
6. History of growth and development of children
7. Nutrition
8. Physical examination
   • Respiratory system
     Shortness of breath, respiratory distress
   • Digestive system
     Generally obstipation. Abdominal bloating / abdominal strain, vomiting green. In older children there are chronic diarrhea. In the plug anus finger will feel the pins and on time withdrawn will be followed by the release of air and meconium or feces spraying.
   • Genitourinarius system
   • Locomotor system / musculoskeletal
     Impaired sense of comfort

Nursing Diagnosis and Nursing Interventions for Hirschsprung's Disease