Omphalocele
Included In This Lesson
Study Tools For Omphalocele
Outline
Overview
- Congenital abnormality
- Occurs during weeks 9-10 in utero
- Abdominal contents coming through umbilicus while remaining within the peritoneal sac
Nursing Points
General
- Occurrence: 1 in 4000 births
- Diagnosed via prenatal ultrasound
- Differs from Gastroschisis where intestines protrude outside abdomen with no covering.
Assessment
- Mild
- Small loop of intestines present outside the abdomen
- Severe/Giant
- Most of the abdominal organs protruding outside the stomach
- Requires multiple surgeries
- Associated with
- Cardiac defects
- Small lung size
- Complications
- Hypothermia
- Dehydration
- Sepsis
Therapeutic Management
- Requires Surgical Repair
- Pre-Op
- Prevent exposed intestine from drying out
- Cover with a sterile gauze soaked in saline
- Keep clean and wet
- IV Fluids
- IV Antibiotics
- Monitor respiratory status
- Keep the infant warm
- Post-Op
- Parenteral Feeds
- Monitor weight
- Prolonged hospitalizations
- Pre-Op
Nursing Concepts
- Gastrointestinal/Liver Metabolism
- Elimination
- Infection Control
Patient Education
- Do not attempt to push intestines back inside
- Do not swaddle too tightly
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References:
Hockenberry, M., Wilson, D. & Rodgers, C. (2017). Wong’s essentials of pediatric nursing (10th ed.) St. Louis, MO: Elsevier Limited.
Lissauer, T. & Carroll, W. (2018). Illustrated textbook of pediatrics (5th ed.) Europe: Elsevier Limited.
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Omphalocele
Transcript
Hey guys, in this lesson we are going to be talking about a congenital anomaly called Omphalocele.
So, an omphalocele is a birth defect where intestines and stomach organs protrude through the umbilicus and are enclosed in a peritoneal sac. This actually happens in utero during about the 9th or 10th week of development. They are usually classified as being either mild or severe. A mild omphalocele is when only the intestines are involved. A severe omphalocele contains intestines and organs, like the liver. Other birth defects are often associated with a severe omphalocele- the two to be on the lookout for are cardiac defects and also lung problems, like small lung size.
So initially the most important thing to determine is if the omphalocele is mild or severe. We need to know if other organs are involved to help determine treatment. Once we know this we can better plan our nursing care. If it is a severe omphalocele we know we need to pay close attention to cardiac and lung function- assessing their respiratory rate and work of breathing.
The next thing you want to assess is the newborns temperature. They are going to be losing a lot of heat through the exposed bowels and could quickly become hypothermic.
They are also losing a lot of fluid through the exposed bowels so we have to assess their fluid status, looking for signs of dehydration.
And as you can imagine having part of their bowels exposed they are at increased risk for infection, this is especially true if the peritoneal sac is broken.
These babies are obviously going to need surgery. But before the baby can be taken to surgery it’s really important to keep the omphalocele clean and wet. So it needs to be covered with a sterile gauze that has been soaked in saline. Remember they are at risk for dehydration and hypothermia so we need to give fluids and keep them warm. Also keep in mind they are likely to have cardiac and lung problems so you’ve got to pay really close attention to their respiratory status.
If the omphalocele is small surgery will happen pretty quickly after birth. If the omphalocele is severe it will take several surgeries that need to be spread out over time. This is because their abdominal cavities and thoracic cavities are usually too small to immediately accommodate the organs being moved inside, so they have to wait until the baby grows and they can move the organs back in without trouble.
After they have surgery they will probably need to be on Parenteral nutrition until their bowels are ready to tolerate food. An issue that kids with severe omphalocele often face is difficulty with feedings. Because they have to be fed through and IV, they can miss all of these really important milestones for oral development and this really makes feeding difficult. They may have a lot of issues with textures and be really picky about their diet. So it’s really important that we provide support and keep an eye on their weight.
Your priority nursing concepts for a patient with an omphalocele are gastrointestinal and liver metabolism, elimination and infection control.
Okay, lets go over the key points for this lesson on omphaloceles. First, you’ve got to know that an omphalocele is when abdominal contents herniate through the belly button and are covered in a peritoneal sac. This can either be mild or severe. Kids with severe omphalocele often have cardiac and lung issues as well. The major complications to be on the lookout for are hypothermia, dehydration and infection.
Prior to surgery make sure the omphalocele is covered in wet gauze to keep it from getting infected and drying out.
After surgery they will probably need parenteral feeds. They can have a lot of issues with feeding so make sure to keep an eye on their weight as they are recovering!
That’s it for our lesson on how to care for an infant with an omphalocele. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!
Tiona RN
Concepts Covered:
- Studying
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Cardiac Disorders
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Central Nervous System Disorders – Brain
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- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Hematologic Disorders
- Newborn Care
- Adulthood Growth and Development
- Disorders of Pancreas
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Prenatal Concepts
- Tissues and Glands
- Developmental Considerations
- Factors Influencing Community Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Developmental Theories
- Basic
- Neonatal
- Pediatric
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Communication
- Basics of Mathematics
- Statistics
- Basics of Sociology
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
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- Integumentary Disorders
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Musculoskeletal Disorders
- EENT Disorders
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- Disorders of Thermoregulation
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- Basics of NCLEX
- Integumentary Important Points
- Multisystem
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- Urinary System
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Spinal Cord
- Respiratory System
- Emergency Care of the Respiratory Patient
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- Concepts of Mental Health
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- Health & Stress
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Community Health Overview
- Gastrointestinal Disorders
- Integumentary Disorders
- Respiratory Disorders
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Infectious Disease Disorders
- EENT Disorders
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