- Mechanical obstruction include adhesions and strangulated hernias (Mechanical obstruction usually associated with small-bowel obstruction) chronic, severe constipation or fecal impaction, carcinomas (usually associated with large-bowel obstruction) foreign bodies, such as fruit pits, gallstones, and worms; compression of the bowel wall from stenosis; intussusception; volvulus of the sigmoid or cecum, tumors and atresia.
- Nonmechanical obstruction usually results from paralytic ileus, the most common of all intestinal obstructions. Paralytic ileus is a physiological form of intestinal obstruction that usually develops in the small bowel after abdominal surgery. Other nonmechanical causes of obstruction include electrolyte imbalances, toxicity, such as that associated with uremia or generalized infection; neurogenic abnormalities such as spinal cord lesions; and thrombosis or embolism of mesenteric vessels.
- Abdominal X-rays.
- Barium enema In large-bowel obstruction reveals a distended, air-filled colon or a closed loop of sigmoid with extreme distention
- Serum sodium, chloride, and potassium levels may decrease because of vomiting.
- White blood cell counts may be normal or slightly elevated if necrosis, peritonitis, or strangulation occurs. Serum amylase level may increase, possibly from irritation of the pancreas by a bowel loop.
- Hemoglobin concentration and hematocrit may increase, indicating dehydration.
- Sigmoidoscopy, colonoscopy, or a barium enema may be used to help determine the cause of obstruction.
- Acute pain
- Deficient fluid volume
- Imbalanced nutrition: Less than body requirements
- Ineffective tissue perfusion: GI
- The patient will express feelings of comfort, Report pain is relieved/controlled, Verbalize methods that provide relief.
- The patient’s bowel function will return to normal, Participate in bowel program as indicated.
- The patient’s fluid volume will remain within normal parameters, Maintain fluid volume at a functional level as evidenced by individually adequate urinary output, stable vital signs, moist mucous membranes, good skin turgor.
- The patient will maintain adequate caloric intake. Demonstrate behaviors, lifestyle changes to regain and/or maintain appropriate weight.
- The patient will exhibit signs of adequate GI perfusion.
- Pain Management Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain. Environmental Comfort Management Manipulation of the patient’s surroundings for promotion of optimal comfort
- Constipation/Impaction Management: Prevention and alleviation of constipation/impaction. Bowel Management: Establishment and maintenance of a regular pattern of bowel elimination
- Fluid Management Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels. Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded. Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
- Nutrition Management Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance Facilitating gain of body weight.
- Fluid/Electrolyte Management Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels. Gastrointestinal Intubation: Insertion of a tube into the gastrointestinal tract
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