Management of the Infant With Gastroschisis: A Comprehensive Review of the Literature

Tracey Williams, MSN, RN, NNP, Rachel Butler, MSN, RN, NNP, Tara Sundem, MSN, RN, NNP


NAINR. 2003;3(2) 

In This Article

Family Management

One of the most significant roles for the newborn and infant nurse is care of the family of the newborn with gastroschisis. Throughout the NICU stay, parents need basic information regarding the environment, equipment, treatment, prognosis, and process of recovery for their infant. Because of the anticipated lengthy hospitalization and the involvement of multiple medical services, consistency in care and communication are essential. This consistency can be facilitated through the use of primary caregivers including bedside nurses, nurse practitioners, and physicians. Supportive resources such as social services and hospital chaplains may help the family cope with the various stresses of the infant's illness and hospitalization. Parents should be encouraged to interact with their newborn before and after surgery. They need to be encouraged to express concerns and feelings. It is also essential that parents be involved in important decisions and participate in daily care activities as appropriate.[3]

Before discharge, parents must be taught to recognize signs and symptoms of possible late complications such as strictures, bowel obstruction, and GER. Instruction should include the significance of bilious vomiting as it relates to possible bowel obstruction and/or midgut volvulus. Parents should also be aware that GER may require further medical treatment after discharge from the NICU. Because intestinal complications increase the risk for feeding intolerance and failure to thrive, follow-up visits must include assessment of adequate growth and weight gain.[4,43] In addition to the special needs associated with gastroschisis, these infants also require routine infant care such as immunizations and development evaluations. Parents should be informed about the number of follow-up appointments and the importance of keeping their appointments. Every effort should be made to coordinate appointments on the same day to facilitate parental compliance.


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