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NURSING CARE STUDY OF A PATIENT WITH UMBILICAL HERNIA

Project Topic: Nursing Care Study of a Patient with Umbilical Hernia


 CHAPTER ONE

Mr. J.N. is a 22 year old man. He is from Odume in Anambra State.

He presented in the General Outpatient Department of University of Nigeria Teaching Hospital Ituku Ozalla, on the 3rd of August 2011.

He was then referred to Surgical OutPatient Department (SOP) of University of Nigeria Teaching Hospital Ituku Ozalla. He complained of recurrent abdominal pain with bilateral swelling on the groin. The swelling expands on coughing which causes discomfort to him. His condition was becoming worse with the abdominal pain which makes him to sweat during each episode. He then came to UNTH, Ituku Ozalla for proper management.

He was clerked and assessed. He was admitted for investigation and proper Management into Ward 3 (Male Surgical Ward) in University of Nigeria Teaching Hospital Ituku Ozalla.

In the Ward, investigations and examination were done and a diagnosis of umbilical hernia was made. Hernia is the protrusion of an organ or part of an organ through the wall of the cavity that normally contains it.

There are various types of hernia namely:

  1. Umbilical
  2. Inguinal – Indirect or direct inguinal hernia
  3. Hiatal
  4. Femoral hernia
  5. Incisional hernia
  6. Spigelian hernia
  7. Obturator hernia
  8. Epigastric hornia

Umblical hernia develops in the area of the umbilicus. A congenital weakness exists in the naval area in the region where vessels of the fetal and infant umbilical cord exited through the muscle of the abdominal wall.

After birth, although the umbilical cord disappears. Hernias can occur in this area of weakness at any time from birth throughout adulthood as the weakness progressively bulges and opens, allowing abdominal contents to protrude through. The hernia bulge pushes out upon the skin directly at or around the navel, distorting its contour, creating an “outie” instead of a normal “innie” navel.

In infants most often, it gradually close by 3 or 4 years and surgery can be delayed.  In adults umbilical hernias do not close, they gradually increase in size, often becoming progressively problematic as they enlarge.

I developed interest in Mr. J.N’s condition so as to enable me acquire knowledge into the causes and management of such condition.

Mr. J.N. was used to represent the name of the patient for privacy and confidentiality.

 

CHAPTER TWO

ABDOMINAL CAVITY

The abdominal cavity is the largest cavity in the body and it is oval shaped.

BOUNDARIES

Superiorly: The diaphragm which separates it from thoracic cavity

Anteriorly: Muscles of the anterior abdominal wall which are the

  1. External oblique
  2. Internal Oblique
  3. Transversus abdominis
  4. Rectus abdominis and pyramidalis

Posteriorly: The Lumbar vertebrae and muscles of the posterior abdominal wall

Laterally:   The lower ribs and parts of the muscle of the abdominal wall

Inferiorly:  Pelvic cavity

THE REGIONS OF THE ABDOMINAL CAVITY

Usually nine regions are delineated by two vertical and two horizontal lines. The vertical line corresponds to mid clavicular line when extended downwards it reaches the mid inguinal point.

The lower transverse line is drawn between the tubercles of the iliac crest – intertubercular plane.

The upper transverse line is in transpyloric plane

Using these four lines 3 central regions are defined from above downwards: epigastric, umbilical and hypogastric. Similarly there are 3 lateral regions on each side hypochondrical, lumbar and iliac regions.

 Contents

The organs and glands involved in digestion are seen in the abdominal cavity. These are

  • The stomach, small intestine and most of the large intestine
  • The liver, gall bladder, bile ducts and pancreas
  • The spleen
  • 2 kidneys and the upper parts of the ureters
  • 2 adrenal glands
  • numerous blood vessels, lymph vessels and nerves
  • lymph nodes

PATHOPHYSIOLOGY

Hernias that occur in the abdominal cavity involve protrusion of the abdominal content through a weakness in the abdominal wall. In hiatal hernia it is through the oesophageal opening at the level of 10th thoracic vertebra

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Project Topic: Nursing Care Study of a Patient with Umbilical Hernia

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