Intestinal Obstruction Flashcards
Intestinal obstruction
i. Small bowel (SBO) or large bowel (LBO)
ii. Partial—some contents get through
iii. Complete—total occlusion; surgery
iv. Simple—intact blood supply
v. Strangulated—no blood supply
surgical adhesions, hernias, cancer, strictures from Crohn’s disease, intussusception (where intestine telescopes into itself)
SBO
LBO
colorectal cancer, diverticular disease
Etiology of bowel obstruction
- distal bowel & proximal bowel
2. inadequate blood flow
Manifestations: four hallmark signs of bowel obstruction
b. Abdominal pain
c. Nausea and vomiting
d. Distention—LBO
e. Constipation
Emergency surgery for what?
strangulation or perforation
Partial or total colectomy or ileostomy (removal)—
obstruction or necrosis
Colonoscopy
remove polyps, dilate strictures, laser destruction and removal of tumors
Initial treatment of obstruction (7 things)
i. NPO
ii. IV fluids
iii. IV antiemetics
1. For nausea/vomiting
iv. NG tube
v. Obtain cultures; IV antibiotics
vi. Parenteral nutrition
nursing implication of bowel obstruction
a. Monitor fluid and electrolytes and acid-base balance
b. Pain management; analgesia and positioning
c. Restful environment
d. Postoperative care—similar to laparotomy
e. NG tube care
f. Oral care
a. Protrusion of intestine through an opening or weakened area in the cavity wall
i. Most occur in abdomen; men more than women
Hernias
Manifestations of hernias
pain; increased with activites-intraabdominal pressure
Postoperative care hernias
a. Monitor voiding; I & O
b. Scrotal edema—ice and elevation
c. Encourage deep breathing
d. Splinting
e. Cough or sneeze with open mouth
f. No heavy lifting (greater than 10 pounds) 6 to 8 weeks
Reduced or absent peristalsis due to altered neuromuscular parasympathetic innervation
Non-mechanical obstruction
small intestine–what happens quickly
dehydration
