Small Bowel Obstruction

Question 1

Types of intestinal obstruction

Answer 1

Mechanical
Nonmechanical

A, Adhesions. B, Strangulated inguinal hernia. C, Ileocecal intussusception. D, Intussusception from polyps. E, Mesenteric occlusion. F, Neoplasm. G, Volvulus of the sigmoid colon.

Question 2

Clinical Presentation of Intestinal Obstruction

Answer 2

Abdominal pain with bloating or distention
Nausea and vomiting
Fever
hypoactive or hyperactive bowel sounds
constipation.
Absence of the passage of flatus or feces (obstipation)
Any signs of dehydration will also support the diagnosis of bowel obstruction

Question 3

Causes of Intestinal Obstructions

Answer 3

Adhesions
Hernias
Tumors
Volvulus
Intussusception

Question 4

Complications of Intestinal Obstructions

Answer 4

Ischemia
Perforation
Sepsis
*muscle guarding and rebound tenderness on palpation are signs of peritoneal irritation and may indicate strangulation

Question 5

Nursing Management for Intestinal Obstructions

Answer 5

NPO (nothing by mouth) status
Intravenous fluids – fluid and electrolyte replacement of losses **potassium
Nasogastric tube insertion – proper technique, checking placement
Medications – need for pain management, antiemetics etc.
*laxatives are contraindicated
Continuous monitoring – vital signs, measuring input/output, replacing fluid losses, bloodwork (i.e. electrolytes, albumin, protein, BUN, creatinine etc)