Case study of a newborn with necrotizing enterocolitis in an ileostomy state applying the self-care theory of Dorothea E. Orem.

Abstract

Premature newborn of 35 dsg/ 39.5 weeks corrected with Necrotizing Enterocolitis IIIA and postoperative ileostomy by Exploratory Laparotomy, starting trophic stimulation with hydrolyzed milk presenting abdominal distension after feeding, a weight increase less than percentile 10 on the Fenton scale, leakage of effluent from ileostomy. Main diagnoses and interventions: 1. Growth retardation related to increased basal metabolic rate due to stress manifested by crying, difficulty falling asleep, weight gain less than the 10th percentile, and IPAT score 7, 2. Willingness mother to improve knowledge in the care of digestive stomas (ileostomy) manifested by verbal expression of the desire to perform care at home. Among the results obtained are mentioned; Position and containment were provided to reduce stress and decrease energy consumption by managing the environment, light and sound stimuli were decreased, having a weight gain of 80 g in a surveillance time of one week with a score of 11 on the IPAT scale and managed to train the mother in the care of the stoma by making her a participant in the change of collection bag, information was provided on alarm data that could indicate infection data or skin lesion in the peristomal area, as a conclusion; Maintaining a stoma with adequate care is essential to avoid complications that may aggravate the patient, as well as managing the micro and macro environment to reduce stress in the hospitalized newborn.