Pediatric Nursing Demystified

Volvulus

What Went Wrong?

Volvulus is a disorder where the intestine twists around itself as a result

of ingesting a foreign substance and adhesion or from unknown causes that

result in blood vessels to compress and an ischemia to that can lead to

necrosis.

Signs and Symptoms

Abdominal pain

Vomiting after feeding

No bowel sounds

Bloody stool

Distended abdomen

Test Results

Abdominal radiograph: Shows distended intestine loops and no gas in

large intestine

Upper GI series: Shows distended intestine loops and no gas in large

intestine

Barium enema: Shows distended intestine loops and no gas in large

intestine

Blood chemistry: Increased potassium and decreased calcium

Treatment

Surgery: Untwisting the intestine and removal of any necrotic tissue.

Administer total parenteral nutrition (TPN) to maintain nutrition until

the intestine heals.

Administer antibiotics to prevent infection.

Administer IV fluids to maintain fluid and electrolyte balance.

Nursing Intervention

Nothing by mouth.

Insert NG tube to decompress the GI tract.

Monitor bowel sounds.

Monitor bowel movements.

Postoperative care:

• Increase dietary fiber and fluid and increase the child’s activity to
  encourage normal bowel movements.
  Explain the disorder and treatment to the family.

Nursing alert Administer stool softeners following surgery because opioid anal-

gesics decrease GI motility.

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(^250) Pediatric Nursing Demystified