MATERNAL AND CHILD HEALTH NURSING

LECTURE / NCM 109

INTESTINAL DISORDERS: 4. Contrast enema

INTUSSUSCEPTION
DESCRIPTION
• The invagination or telescoping of one
portion of the intestine into an adjacent
portion causing obstruction.
• typically affects children between ages 3
months and and 12 months (2nd half of the
first year of life).
• The point of the invagination is generally
the juncture of the distal ileum and
proximal colon
• If treatment is delayed for longer than 24
hours, bowel strangulation may occur,
leading to the following:
o Necrosis
o Hemorrhage
o Peritonitis
o Shock
ETIOLOGY
• UNKNOWN
• It may be associated with viral infections,
intestinal polyps, Meckel’s diverticulum,
and lymphoma
• follows nasogastric
decompression and the
administration of IV fluids
THERAPEUTIC CLINICAL MANAGEMENT
1. Surgery
2. Reduction by instillation of a water-soluble
solution, barium enema, or air (pneumatic
insufflation)
3. Antibiotics and IV fluids
NURSING DIAGNOSIS
1. Pain related to abnormal abdominal
peristalsis
2. Risk for deficient fluid volume r/t bowel
obstruction
3. Risk for impaired parenting r/t infant’s
illness
THERAPEUTIC NURSING MANAGEMENT
1. Promote adequate hydration
2. Promote adequate nutrition according to
the child’s age & nutritional requirements.
3. Monitor bowel elimination status for
return to normal function
4. Monitor for infection
5. Support the parents.

ASSESSMENT FINDINGS
CLINICAL MANIFESTATIONS
1. Severe paroxysmal abdominal pain,
causing the child to draw his legs or
knees to the abdomen and scream at
approximately 15-20 minutes apart.
2. Vomiting of gastric contents
3. “currant jelly” stools containing blood
and mucus appear, bile-stained or
fecal vomitus and shocklike syndrome
may progress to death.
4. Tender, distended abdomen, possibly
a palpable mass.
5. Elevated temperature
LAB & DIAGNOSTIC STUDY FINDINGS
1. Increased WBC
2. ↓ potassium, ↓ Calcium, metabolic
alkalosis, ↓H2CO3
3. Sonogram

RICCI D. CASTRO / BSN 2

1