Hirschsprung's Disease Case Study
RNSG2462 Pediatric
Case Study Template TWO
Student Name___________
Due Date:______02/21/15______________
*Begin typing at the asterisk under each heading. Please see the Grading Rubric for guidelines for writing the case study.
Patient Story
Current Information
*J, a 2 week old Caucasian female, was diagnosed with Hirschsprung’s Disease. Hirschsprung’s Disease is a congenital condition where the large intestine becomes obstructed due to poor muscle movement in the bowel. Failure to pass meconium within the first 36 hours after birth indicated a bowel obstruction, and an exploratory laparotomy with sigmoid colon and ileal biopsy supported evidence of Hirschsprung’s Disease. Her recovery from ileostomy surgery and nutritional status is being evaluated for discharge. An ostomy pouch was used for the drainage of the intestinal waste, and a mucous fistula allowed passing of mucous and gasses from the non-functioning portion of the colon. The patient has no known drug allergies. Bacitracin 500units/g topical ointment is scheduled, and applied generously twice daily to the peristomal erythema surrounding the mucous fistula. Medications as needed include acetaminophen 37.5mg every 6 hours 1 to 3 times daily, and hydrocodone-acetaminophen 0.8ml every 4 hours for pain via nasogastric tube. Lanolin …show more content…
She states that she and the patient’s father will be independently caring for J at home. Family education on normal stoma appearance (red/pink, moist, and shiny), normal effluent consistency and color (liquid, thick, pasty, greenish-yellow), and cleaning the ostomy bag was provided. Advise the family to use special soap for ostomy bag, and to never use deodorant or fragrance inside the bag. Teach family that some foods that may block the stoma are raw pineapple, nuts and seeds, celery, popcorn, corn, dried fruits, mushrooms, chunky relishes, coconut, and some Chinese
Case Study Template TWO
Student Name___________
Due Date:______02/21/15______________
*Begin typing at the asterisk under each heading. Please see the Grading Rubric for guidelines for writing the case study.
Patient Story
Current Information
*J, a 2 week old Caucasian female, was diagnosed with Hirschsprung’s Disease. Hirschsprung’s Disease is a congenital condition where the large intestine becomes obstructed due to poor muscle movement in the bowel. Failure to pass meconium within the first 36 hours after birth indicated a bowel obstruction, and an exploratory laparotomy with sigmoid colon and ileal biopsy supported evidence of Hirschsprung’s Disease. Her recovery from ileostomy surgery and nutritional status is being evaluated for discharge. An ostomy pouch was used for the drainage of the intestinal waste, and a mucous fistula allowed passing of mucous and gasses from the non-functioning portion of the colon. The patient has no known drug allergies. Bacitracin 500units/g topical ointment is scheduled, and applied generously twice daily to the peristomal erythema surrounding the mucous fistula. Medications as needed include acetaminophen 37.5mg every 6 hours 1 to 3 times daily, and hydrocodone-acetaminophen 0.8ml every 4 hours for pain via nasogastric tube. Lanolin …show more content…
She states that she and the patient’s father will be independently caring for J at home. Family education on normal stoma appearance (red/pink, moist, and shiny), normal effluent consistency and color (liquid, thick, pasty, greenish-yellow), and cleaning the ostomy bag was provided. Advise the family to use special soap for ostomy bag, and to never use deodorant or fragrance inside the bag. Teach family that some foods that may block the stoma are raw pineapple, nuts and seeds, celery, popcorn, corn, dried fruits, mushrooms, chunky relishes, coconut, and some Chinese