Anal Atresia Nursing care Plan


Anal atresia is a congenital disorder known as imperforate anus, including the anus, rectum, or both (Betz. Ed 3 in 2002)

Atresia comes from the Greek, "a" means no, "trepis" means nutrition or food. In medical terms "atresia" itself is the absence or closure of a normal body orifice or tubular organ in congenital called Clausura. In other words, the absence of holes in the proper place or a perforated appendix channel or body cavity, it can happen due to a congenital or occur later due to the disease process on the channel. Atresia can occur throughout the body channels, such as anal atresia. Anal atresia is no perforation of the rectum. Anal atresia have another name ie imperforate anus. If atresia occurs it is almost always requires surgery to create a channel like normal state.

According to Ladd and Gross (1966) imperforate anus in 4 categories, namely:

  1. Stenosis of the lower rectum or at the anus.
  2. Persistent anal membrane.
  3. Imperforate anus and rectum ends the impasse lies at various distances from the peritoneum.
  4. Separate anus with the tip.

Atresia can be caused by several factors, among others:
  1. The breakdown of the upper gastrointestinal tract with the anal area so that babies born without anus.
  2. Failure of growth when the baby was 12 weeks / 3 months.
  3. The disruption or cessation of embryological development in the intestine, the distal rectum and urogenital tract, which occurs between the fourth to the sixth week of gestation.
Clinical Manifestations
  1. Meconium did not come out after 24-48 hours.
  2. Neonates vomit green.
  3. The anal membrane.
  4. External fistula in the perineum.

Nursing Care Plan
1. Fluid volume deficit relatd to lose excessive vomiting
Demonstrated by:
  • Skin dry mucous membranes.
  • Decreased skin turgor.
  • Increased pulse and temperature.
  • Decrease in blood pressure.
  • Output more than fluid intake
  • Hemoconcentration.
  • Electrolyte balance disorders.
After implementation, lack of fluid volume can be resolved.
Expected outcomes:
  • Maintaining adequate hydration with moist mucous membranes, skin turgor and capillary refill is good, stable vital signs, adequate urine output.

2. Impaired Skin Integrity related to colostomy
Demonstrated by:
  • There is stitching drain.
  • The existence of the incision.
  • The presence of skin irritation.
  • There is swelling and redness.
  • The skin around the colostomy wet and no drainage.
After implementation impaired skin integrity can be resolved
Expected outcomes:
  • The skin around the stoma area 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
Demonstrated by:
  • The existence of the surgical wound exposure to outside air.
  • Wound care was not using sterile technique.
  • The existence of materials that can contaminate surgical incision.
After implementation, the infection does not occur.
Expected outcomes:
  • Infection does not occur.
  • There are no signs of infection

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