Pediatric Nursing Demystified

Monitor intake and output.

Assist patient to plan palatable meals; remember that breakfast is

generally the best tolerated meal.

Avoid smoking areas—intolerance to smoking.

Assess mental status for changes due to encephalopathy.

Explain the disorder and treatment to the family.

Hirschsprung Disease

What Went Wrong?

Hirschsprung disease is a congenital condition where there is the lack of nerve

cells in the colon causing a lack of peristalsis, resulting in stool being unable

to be pushed through the colon.

Nursing alert Hirschsprung disease is common in Down syndrome.

Signs and Symptoms

Failure to pass meconium within the first 48 hours following birth

Failure to pass stool within the first 48 hours following birth

Abdominal distention

Abdominal mass

Ribbon-like or liquid stool

Sunken eyes

Pallor

Dehydration

Irritable

Weight loss

Lethargic

Nursing alert Monitor for fecal vomiting.

Test Results

Abdominal radiograph: Shows distended colon

Rectal biopsy: Absence of ganglion cells in the colon

Full-thickness surgical biopsy: Absence of ganglion cells in the colon

Suction aspiration of rectum: Absence of ganglion cells in the colon

Treatment

Surgery: After 9 months of age, the affected portion of the colon is

removed.

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