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Medical Surgical Nursing
Hernia
‫الصحة‬ ‫معهد‬
‫العالي‬
‫المادة‬ ‫مدرس‬
‫م‬
.
‫إختصاص‬ ‫جامعي‬
‫الوهاب‬ ‫عبد‬ ‫نزار‬ ‫صـالح‬
‫تمـريض‬ ‫علــوم‬ ‫ماجـستير‬
Salah Nazar Abdulwahhab  M.Sc. Nursing
www.slideshare.net
1
HERNIA
Protrusion of an organ or part of an organ through the wall of the cavity that normally
contains it.
Common Types Of Hernia
Hiatal hernia: protrudes up through the diaphragm near the esophagus
Epigastric Hernia: between breast bone and navel
Incisional Hernia: in previously incision in the abdominal wall
Umbilical Hernia: weakness in the muscle of umbilicus
Femoral Hernia: abdominal viscera passes through femoral ring
Inguinal Hernia: occur at the inguinal canal in the groin region (where the spermatic
cord in males or the round ligament in females)
- direct Inguinal Hernia: usually occur only in male adults and are caused by a
weakness in the muscles of the abdominal wall that develops over time
- indirect Inguinal Hernia: caused by a defect in the abdominal wall that is congenital,
or present at birth
2
Types of Hernias
3
General Causes of hernia
Any increases at the pressure of the abdominal cavity may form hernia
like:
- Obesity
- Heavy lifting things
- Coughing or sneezing
- Straining during a bowel movement or urination
- Fluid in the abdominal cavity
- Hereditary
- Pregnancy
4
Clinical Manifestation
- An abnormal bulging seen in the affected area especially when straining
or coughing
- discomfort due to tension on tissues around the hernia.
- The herniation may disappear when the patient lies down.
- If the intestinal mass easily returns to the abdominal cavity or can be
manually placed back ,it is called (reducible hernia).
When adhesions or edema occur between the sac and its contents, the
hernia becomes (irreducible hernia)
5
Nursing Education to Prevent Hernia
- Not smoking
- Seeing doctor to avoid developing a persistent cough
- Maintaining normal weight
- Avoiding straining during bowel movements or urination
- lifting objects with knees not back
- Avoiding lifting heavy weights
- Wear a support binder when lifting weights
- Eating high-fiber foods to prevent constipation
6
The Treatment
Treatment options include
- Observing the hernia
- Using short term support devices
- Surgery to cure the hernia
Emergency surgery for (strangulation or bowel obstruction)
Herniorrhaphy : replacing the contents of the hernial sac, sewing the
weakened tissue, and closing the opening.
Hernioplasty : replacing the hernia into the abdomen and reinforcing the
weakened muscle wall with wire, fascia, or mesh.
Bowel resection or a temporary colostomy may be necessary if the hernia
is strangulated
7
Preoperative Nursing Care
- Patients should be encouraged to drink plenty of fluids for two days
before operation.
- Patients should be encouraged to eat foods containing fibers to avoid
constipation and pain after the operation.
- Patients can take laxatives if needed.
8
Postoperative Nursing Care
1. Give the patient medications and I.V. fluids as prescribed
2. Check Vital signs
3. Wound care
4. Ice packs and elevation of the scrotum to reduce the swelling
5. Perform deep breathing to keep lungs clear postoperatively, but should avoid coughing.
6. Report difficulty urinating, bleeding, and signs and symptoms of infection, such as
redness, incisional drainage, fever, or severe pain.
7. Avoid lifting, driving, or sexual activities for 2 to 6 weeks
8. Support the wound during sneezing or coughing with raise the head towards the ceiling
9
Thank You
10

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3 Hernia . pptx

  • 1. Medical Surgical Nursing Hernia ‫الصحة‬ ‫معهد‬ ‫العالي‬ ‫المادة‬ ‫مدرس‬ ‫م‬ . ‫إختصاص‬ ‫جامعي‬ ‫الوهاب‬ ‫عبد‬ ‫نزار‬ ‫صـالح‬ ‫تمـريض‬ ‫علــوم‬ ‫ماجـستير‬ Salah Nazar Abdulwahhab M.Sc. Nursing www.slideshare.net 1
  • 2. HERNIA Protrusion of an organ or part of an organ through the wall of the cavity that normally contains it. Common Types Of Hernia Hiatal hernia: protrudes up through the diaphragm near the esophagus Epigastric Hernia: between breast bone and navel Incisional Hernia: in previously incision in the abdominal wall Umbilical Hernia: weakness in the muscle of umbilicus Femoral Hernia: abdominal viscera passes through femoral ring Inguinal Hernia: occur at the inguinal canal in the groin region (where the spermatic cord in males or the round ligament in females) - direct Inguinal Hernia: usually occur only in male adults and are caused by a weakness in the muscles of the abdominal wall that develops over time - indirect Inguinal Hernia: caused by a defect in the abdominal wall that is congenital, or present at birth 2
  • 4. General Causes of hernia Any increases at the pressure of the abdominal cavity may form hernia like: - Obesity - Heavy lifting things - Coughing or sneezing - Straining during a bowel movement or urination - Fluid in the abdominal cavity - Hereditary - Pregnancy 4
  • 5. Clinical Manifestation - An abnormal bulging seen in the affected area especially when straining or coughing - discomfort due to tension on tissues around the hernia. - The herniation may disappear when the patient lies down. - If the intestinal mass easily returns to the abdominal cavity or can be manually placed back ,it is called (reducible hernia). When adhesions or edema occur between the sac and its contents, the hernia becomes (irreducible hernia) 5
  • 6. Nursing Education to Prevent Hernia - Not smoking - Seeing doctor to avoid developing a persistent cough - Maintaining normal weight - Avoiding straining during bowel movements or urination - lifting objects with knees not back - Avoiding lifting heavy weights - Wear a support binder when lifting weights - Eating high-fiber foods to prevent constipation 6
  • 7. The Treatment Treatment options include - Observing the hernia - Using short term support devices - Surgery to cure the hernia Emergency surgery for (strangulation or bowel obstruction) Herniorrhaphy : replacing the contents of the hernial sac, sewing the weakened tissue, and closing the opening. Hernioplasty : replacing the hernia into the abdomen and reinforcing the weakened muscle wall with wire, fascia, or mesh. Bowel resection or a temporary colostomy may be necessary if the hernia is strangulated 7
  • 8. Preoperative Nursing Care - Patients should be encouraged to drink plenty of fluids for two days before operation. - Patients should be encouraged to eat foods containing fibers to avoid constipation and pain after the operation. - Patients can take laxatives if needed. 8
  • 9. Postoperative Nursing Care 1. Give the patient medications and I.V. fluids as prescribed 2. Check Vital signs 3. Wound care 4. Ice packs and elevation of the scrotum to reduce the swelling 5. Perform deep breathing to keep lungs clear postoperatively, but should avoid coughing. 6. Report difficulty urinating, bleeding, and signs and symptoms of infection, such as redness, incisional drainage, fever, or severe pain. 7. Avoid lifting, driving, or sexual activities for 2 to 6 weeks 8. Support the wound during sneezing or coughing with raise the head towards the ceiling 9