Primary Nursing Diagnosis

Pain (acute) related to inflammation

OUTCOMES. Comfort level; Pain control behavior; Pain level; Symptom severity

INTERVENTIONS. Analgesic administration; Anxiety reduction; Environmental management: Comfort; Pain management; Medication management; Patient-controlled analgesia assistance

U PLANNING AND IMPLEMENTATION Collaborative

Reduction of the intussusception is accomplished by hydrostatic pressure or pneumatic reduction (barium enema), surgical manipulation, or surgical resection. If the symptoms are less than 24 hours old and there is no evidence of complete obstruction, peritonitis, or shock, a barium enema can be used to reduce the high intestinal pressure. This technique has a 90% success rate. The maximum safe intraluminal air pressure for young infants is 80 mm Hg and 110 to 120 mm Hg for older children. If the procedure does not result in a change in the intussusception, the procedure is terminated and the patient is evaluated for surgery. If the patient is an adult, surgery is always the treatment of choice.

Surgical resection of the affected bowel segment is performed in several situations: if the manipulation is unsuccessful, if the bowel is strangulated, or if it has necrotic areas. Recurrence, usually within the first 36 to 48 hours after treatment, can occur with either the barium enema method or bowel manipulation in approximately 10% of patients who are treated nonoperatively. Parents need to understand that when the barium enema is attempted, the child is also prepared for the possibility of surgery. Preoperatively, the child may have a nasogastric (NG) tube and intravenous lines for fluid replacement; the child also needs medications administered as needed for pain relief. Postoperative management contains the same three components: management of NG drainage and decompression, fluid replacement, and pain relief. Also monitor the child for signs of bleeding and infection. If the child had a successful reduction using the hydrostatic barium enema, the parents need to understand that feedings will be in small amounts and that stools will be grayish-white until the barium is passed. Children are usually kept in the hospital until they have normal stools.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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