Nursing Process of Enterocutaneous Fistula Patient with Severe Acute Malnutrition in Pediatric Surgical Ward

Sari Rahmawati, Fajar Tri Waluyanti


Objective: This case study aims to prove the effectiveness of nursing intervention, particularly management of nutrition, fluid and electrolyte, ostomy care, and risk for infection management, at managing enterocutaneous fistula patient with severe acute malnutrition in pediatric surgical ward.

Methods: This case study was performed by giving nursing care of enterocutaneous fistula patient with severe acute malnutrition for about 13 days based on the patient’s length of stay.

Results: The target for weight gain in malnourished children was ≥ 50 grams/kg/week. Within thirteen days, weight of the patient rose 450 grams from 4700 grams to 5150 grams. Patient’s weight gain target was 470 grams in 14 days, this condition showed that increase in body weight was quite appropriate. Fistula output was decreased day by day and feces that came out from from anus has better solid consistency than before.

Conclusion: Nutrition management aims to increase body weight during the preoperative period of the client. Hospital treatment managed to increase weight, the child did not experience vomiting and diarrhea from the first day of treatment, and appetite continued to increase every day. This is in accordance with the outcome criteria that has been established for the main problem of imbalanced nutrition: less than the body requirement. Furthermore, children are advised to get follow up care with regular weekly control obligations.


Keywords: child; enterocutaneous; fistula; malnutrition; nursing

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