Page 980 - Saunders Comprehensive Review For NCLEX-RN

intestine is lateral to the umbilical ring.

2. No membrane covers the exposed bowel.

3. The exposed bowel is covered loosely in saline-

soaked pads, and the abdomen is loosely wrapped in
a plastic drape or or agency approved drape;
wrapping directly around the exposed bowel is
contraindicated, because if the exposed bowel
expands, wrapping could cause pressure and
necrosis.
4. Preoperatively: Care is similar to that for omphalocele;
surgery is performed within several hours after birth
because no membrane is covering the sac.
5. Postoperatively: Most infants develop prolonged ileus,
require mechanical ventilation, and need parenteral
nutrition; otherwise, care is similar to that for
omphalocele.
XIII. Umbilical and Inguinal Hernia and Hydrocele
A. Description
1. An umbilical hernia is a protrusion of the bowel
through an abnormal opening in the abdominal wall.
2. In children, hernias most commonly occur at the
umbilicus and also through the inguinal canal.
3. A hydrocele is the presence of abdominal fluid in the
scrotal sac.
B. Assessment
1. Umbilical hernia: Soft swelling or protrusion around
the umbilicus that is usually reducible with a finger
2. Inguinal hernia
a. Inguinal hernia refers to a painless
inguinal swelling that is reducible.
b. Swelling may disappear during periods
of rest and is most noticeable when the
infant cries or coughs.

3. Incarcerated hernia

a. Incarcerated hernia occurs when the
descended portion of the bowel
becomes tightly caught in the hernial
sac, compromising blood supply.
b. This represents a medical emergency
requiring surgical repair.
c. Assessment findings include irritability,
tenderness at site, anorexia, abdominal
distention, and difficulty defecating.
d. The protrusion cannot be reduced, and

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