Imperforate Anus - 3 Nursing Diagnosis and Treatment

Imperforate anus of anorectal malformations (ARMs) is congenital defect in which the opening to the anus is missing or blocked. The cause of anorectal malformations is unknown, the genetic basis of these anomalies is very complex because of their anatomical variability, in an 8% of patients genetic factors are clearly associated with ARMs.

Imperforate anus occurs in about one of every 5,000 newborns. It is somewhat more common in boys than girls. If the anus is missing, there is no outlet to release stool after birth. The intestine ends in a blind pouch, so your infant's stool, called meconium, remains in the intestine.

Treatmentof Imperforate Anus

Imperforate anus usually requires immediate surgery to open a passage for feces unless a fistula can be relied on until corrective surgery takes place. Depending on the severity of the imperforate, it is treated either with a perineal anoplasty or with a colostomy.

The infant is allowed to develop for several months before more intricate repairs are attempted. Surgery for a low-type imperforate anus includes closing any little tube-like openings (fistulas), creating an anal opening, and putting the rectal pouch into the anal opening.

This can cause vomiting and an enlarged or swollen abdomen. In some cases, the rectum may end high in the pelvis or it can end low, closer to the correct position.

1. Fluid Volume Deficit
related to:

• excessive loss: vomiting

Evidenced by:

• Skin dry mucous membranes.
• Decrease in skin turgor.
• Increase in pulse rate and temperature.
• Decrease in blood pressure.
• Output is more than fluid intake
• Hemo-concentration
• Electrolyte imbalance

Goal:

• After the act of nursing, lack of fluid volume can be resolved

Outcomes:

• Maintaining adequate hydration with moist mucous membranes,
• Skin turgor and capillary refill good,
• Stable vital signs,
• Adequate output of urine.

2. Impaired skin integrity
related to:

• colostomy

Evidenced by:

• Drain any stitches.
• The existence of the incision.
• The existence of skin irritation.
• There is swelling and redness.
• Skin around the colostomy wet and no drainage.

Goal:

• After the act of nursing, impaired skin integrity can be resolved.

Outcomes:

• Area of skin around the colostomy will be colored pink,
• Dry and free from skin damage,
• Incision free of redness,
• No swelling and drainage.

3. Risk for infection
related to:

• surgical procedures

Evidenced by the risk factors:

• Exposure presence of surgical wounds with the outside air.
• Wound care was not using sterile technique.
• The existence of materials that could contaminate the surgical incision.

Goal:

• After the act of nursing, infection does not occur.

Outcomes:

• Infection does not occur.
• There are no signs of infection.
• Watch the signs often.