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Imperforate Anus (Picmonic)
Example Care Plan_Imperforate Anus (Cheat Sheet)
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Let's work on the following nursing care plan for imperforate anus. So imperforate anus, also known as anorectal malformation, is a birth defect in which the anus and the rectum are not properly developed. And the patient is born without an anal opening or the opening is in the wrong place. Nursing considerations: so we want to assess for meconium in the stool. If you recall, the meconium stool is that first stool that has passed at birth. We want to assess heart sounds for other congenital defects. And we want to confirm the presence of the anus. The desired outcome is that the patient will have a normal fluid balance. The patient will be free from infection and the patient will have a normal elimination pattern.
So because this typically happens in newborns, a lot of the subjective data is going to come from the parents. So some things that the parent may report is there may be a passing of stool from the vagina, the scrotum, or other abnormal location. This may indicate that a fistula has formed. And remember a fistula is just an opening between two areas. And there also may be a report of no bowel movement after birth. Some things that we are going to observe as nurses during our assessment is we are going to assess the patient. So there's going to be no anal opening. The anal opening may be in the wrong place. The patient may have some abdominal distension and there may be a failure to pass their first stool. And again, that is called meconium. So we're going to do a full physical assessment.
That's most important. We're going to use our assessment skills and we are going to do a full physical assessment. We're going to make sure that this condition is diagnosed and it's usually diagnosed within the first 24 hours of life. Please know that if the patient has an anal opening, makes sure that it appears to be located in atomically in the correct location. We're going to observe for meconium passage. We're going to make sure that patients actually have a stool. So patients with imperforate anus are either unable to pass the meconium or it's passed from an inappropriate location. For female infants, carefully know if it has passed from anus, vagina, or urethra. For male patients the opening may be located below the penis or the scrotum.
So we want to prepare the patient for diagnostic tests and surgery. So let's write that here. Prepare for surgery. This patient will undergo a lot of diagnostic tests and surgery more than likely. They will have some imaging and labs prior to the determination for surgery. Ultimately, the patient may require a colostomy to be placed. We want to provide colostomy care if appropriate; this is very important. This patient will have a colostomy placed based on the area of the valve that is resected. We want to make sure that we educate parents for the care of the patient of the colostomy. We want to make sure we assess the stoma of the opening of the colostomy for bleeding or any signs of infection. And we also want to make sure that we provide education to the parents. It's very important to educate the parents on how to take care of the patient post-operatively and how to care for the colostomy at home.
The key points, remember that this is a birth defect in which the anus and rectum are not properly developed. It can be in an incorrect location or not there at all. Some of the subjective data that we are going to get from the patient or the family is that the stool is going to come from an unusual location, such as the vagina, the scrotum, or the urethra or other abnormal location. There's going to be a report of no bowel movement after birth or no meconium. The objective data that we're going to see is that there's going to be no anal opening, or it's going to be in the wrong place. Upon our physical assessment. The patient is going to have a failure to pass that first stool, the meconium. So the things that we are going to really focus on is we are going to check for meconium because remember this store should be passed within the first 24 hours of life. So failure to pass meconium indicates that surgery is needed and more than likely they're going to have a colostomy. So colostomy care is also very important. We want to make sure we provide really detailed colostomy care education for the parents. We want to do a demonstration for the parents and we'll have the parent demonstrate back to us on how to properly care for the patient at home. We love you guys. Remember, go out and be your best self today, and, as always, happy nursing.
So because this typically happens in newborns, a lot of the subjective data is going to come from the parents. So some things that the parent may report is there may be a passing of stool from the vagina, the scrotum, or other abnormal location. This may indicate that a fistula has formed. And remember a fistula is just an opening between two areas. And there also may be a report of no bowel movement after birth. Some things that we are going to observe as nurses during our assessment is we are going to assess the patient. So there's going to be no anal opening. The anal opening may be in the wrong place. The patient may have some abdominal distension and there may be a failure to pass their first stool. And again, that is called meconium. So we're going to do a full physical assessment.
That's most important. We're going to use our assessment skills and we are going to do a full physical assessment. We're going to make sure that this condition is diagnosed and it's usually diagnosed within the first 24 hours of life. Please know that if the patient has an anal opening, makes sure that it appears to be located in atomically in the correct location. We're going to observe for meconium passage. We're going to make sure that patients actually have a stool. So patients with imperforate anus are either unable to pass the meconium or it's passed from an inappropriate location. For female infants, carefully know if it has passed from anus, vagina, or urethra. For male patients the opening may be located below the penis or the scrotum.
So we want to prepare the patient for diagnostic tests and surgery. So let's write that here. Prepare for surgery. This patient will undergo a lot of diagnostic tests and surgery more than likely. They will have some imaging and labs prior to the determination for surgery. Ultimately, the patient may require a colostomy to be placed. We want to provide colostomy care if appropriate; this is very important. This patient will have a colostomy placed based on the area of the valve that is resected. We want to make sure that we educate parents for the care of the patient of the colostomy. We want to make sure we assess the stoma of the opening of the colostomy for bleeding or any signs of infection. And we also want to make sure that we provide education to the parents. It's very important to educate the parents on how to take care of the patient post-operatively and how to care for the colostomy at home.
The key points, remember that this is a birth defect in which the anus and rectum are not properly developed. It can be in an incorrect location or not there at all. Some of the subjective data that we are going to get from the patient or the family is that the stool is going to come from an unusual location, such as the vagina, the scrotum, or the urethra or other abnormal location. There's going to be a report of no bowel movement after birth or no meconium. The objective data that we're going to see is that there's going to be no anal opening, or it's going to be in the wrong place. Upon our physical assessment. The patient is going to have a failure to pass that first stool, the meconium. So the things that we are going to really focus on is we are going to check for meconium because remember this store should be passed within the first 24 hours of life. So failure to pass meconium indicates that surgery is needed and more than likely they're going to have a colostomy. So colostomy care is also very important. We want to make sure we provide really detailed colostomy care education for the parents. We want to do a demonstration for the parents and we'll have the parent demonstrate back to us on how to properly care for the patient at home. We love you guys. Remember, go out and be your best self today, and, as always, happy nursing.
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