Question

Bowel Obstruction An 80-year-old man comes to the ED reporting acute upper to mid-abdominal, sporadic pain and cramping. Upon assessment, the nurse observes abdominal distention and high-pitched bowel sounds. The physician has ordered flat plate and upright abdominal x-rays that show distention of loops of intestine, with fluid and gas in the small intestine in conjunction with absence of gas in the colon. The physician has diagnosed a bowel obstruction.

1. Based on the findings, identify which type of bowel obstruction this patient most likely has.

2. What other signs and symptoms would the nurse observe for in this patient?

3. Identify the priority nursing interventions needed for this patient.

4. Identify the expected medical management for this patient.

5. Explain the surgical management that may be needed for patients with bowel obstructions. It is found that the patient has a small fecal impaction. Identify the preventive care that the nurse would include in patient/family teaching for this patient.

Answer 1

1. The type of bowel obstruction the patient is having is mechanical ( small intestine is affected ) .

2. The other signs and symptoms the nurse should assess for :-

1. low electrolytes

2. hypovolemia

3. vomiting - poop

4. may turn malodorous with fecal smell

5. abdominal distention

6. constipation with failure to pass flatus

7. Bowel Sounds:

-increased

-high pitched at first

-then go silent

8. PAIN

3. The priority nursing intervention for this patient is to relieve the pain caused by obstruction . It can be sorted by providing analgesics and treating the ultimate cause for pain that is obstruction . Other nursing interventions include :-

Nursing

-npo, iv w/ electrolytes

-frequent vital signs, and urine output

-abx if infection

-analgesics

-bowel decompression

-NG- suction for partial or obstruction high in small bowel

4. The medical management for this patient include the following :-

Analgesic

IV fluid therapy

Antibiotics

Vital sign assessment

Bowel decompression

5. The surgical management for this patient :-

Occasionally mechanical can be fixed per endoscopy

-mechanical usually needs surgery- may have temp or permanent ostomy.