Question

You are a nurse in a medical–surgical hospital unit caring for a patient who had an open   cholecystectomy 3 days earlier. Subsequently, the patient developed a parlay tic ileus.   Additional complications require continued postoperative antibiotic infusions.  

a. What nursing assessment finding could indicate the presence of a paralytic ileus?

b. Which medical interventions could have contributed to the development of your patient’s         paralytic ileus?

c. How long would you expect the paralytic ileus to last?

d. In what ways would you expect a paralytic ileus to resolve?

e. List possible nursing diagnoses for this patient related to the surgical procedure and      postoperative complications.

Answer 1

An ileus occurs when the intestines do not move food through in the normal way. It often occurs after abdominal surgery.This is a severe condition because, if left untreated, an ileus can cut off blood supply to the intestines and cause tissue death. This can result in an intestinal tear or life-threatening infection of the abdominal cavity.Open cholecystectomy (removal of gall bladder) is a major surgical procedure.

A nurse can acess the patient if he devolops symptoms like distended abdomen, fullness, gas, abdominal spasms, constipation, diarrhea, nausea with or without vomiting, and foul-smelling breath, bilious vomiting

In some conditions medications can also lead to paralytic ileus. Some medications can cause electrolyte imbalance, which may cause intestinal mortility. which may result in paralytic ileus. For example hypokalemia can cause paralytic ileus.

Treatment options for an ileus include waiting for the ileus to resolve, making dietary changes, or adjusting medication use. Sometimes, surgery is necessary. The treatment will depend on the severity of the ileus and its underlying cause.Possible treatments for an ileus include.

• Intravenous fluids to prevent dehydration
• Nasogastric decompression, which uses a tube to suction out materials that a person might otherwise vomit up
• Pain relief
• Dietary changes
• Medication changes
• Surgery

Nursing diagnoses for this patient related to the surgical procedure and postoperative complications are

• Deficient Knowledge
• Fear/Anxiety
• Risk for Injury
• Risk for Infection
• Risk for deficient Fluid Volume
• Acute Pain
• Impaired Skin Integrity
• Disturbed sleep pattern
• Bathing/hygiene self-care deficit