Bowel obstructions Flashcards
What is a bowel obstruction?
When bowel contents cannot pass through the GI tract
What is the difference between a partial and a complete bowel obstruction?
Partial obstructions can be resolved with conservative treatment while complete obstructions require surgical intervention
What is the difference between a simple and a strangulated bowel obstruction?
Simple obstructions still have a blood supply while strangulated obstruction does not
Does the bowel proximal to the obstruction distend or collapse?
What is the consequence of this?
The bowel proximal to the obstruction distends and intraluminal pressure increases
The increase of intraluminal pressure results in fluid leakage into peritoneal cavity
What is a consequence fluid retention in the bowel and fluid leakage into the peritoneal cavity?
Reduction in circulating blood volume, resulting in hypotension and potential hypovolaemic shock
What is a mechanical obstruction?
What is the most common cause of a mechanical obstruction?
A detectable occlusion of the intestinal bowel/lumen, most often in the small bowel
The most common cause is surgical adhesions
What is a non-mechanical obstruction?
What is the most common form?
A lack of peristalsis as a result of a neuromuscular or vascular disorder
The most common form is a paralytic ileus
What is intussusception?
Where is a commmon place for intussusception to occur?
The prolapse of one segment of bowel into the lumen of another segment
The junction between the ileum and the caecum
What are the signs and symptoms of a SMALL BOWEL OBSTRUCTION?
Rapid onset:
- Frequent and copious vomiting
- Colicky, cramp-like intermittent pain
- Faeces for a short time
- Greatly increased abdominal distension
What are the signs and symptoms of a LARGE BOWEL OBSTRUCTION?
Gradual onset:
- Low-grade cramping abdominal pain
- Acute constipation
- Increased abdominal distension
- Rarely vomiting
What are the gold standard tests for detecting bowel obstructions?
Ultrasound and X-ray
What major concerns are there with regards to bowel obstruction?
What are the nursing management steps that can be taken to treat a bowel obstruction?
Major concerns
- Hypovolaemic shock
- Bowel strangulation
Nursing management
- Vital observations to watch for hypovolaemic shock
- Monitor fluid input/output
- IV fluids: Third spacing of fluid may lead to hypovolaemic shock
- Nasogastric tube drainage
- Analgesia
- Oral and nasal cares
- Support Pt and family (anxiety, fear, etc.)
- Communication with Pt and family
What are the planning goals in dealing with a bowel obstruction?
Relieve the obstruction and return to normal bowel function
Reduce pain and discomfort
Return to normal fluid and electrolyte status
