ACTIVE LEARNING TEMPLATE: System Disorder
STUDENT NAME _____________________________________
Small Bowel Obstruction
DISORDER/DISEASE PROCESS __________________________________________________________ 51
REVIEW MODULE CHAPTER ___________
Alterations in Pathophysiology Related Health Promotion and
Health (Diagnosis) to Client Problem Disease Prevention
disorder that causes a mechanical results from mechanical (90%)or treatment focuses on fluid and
or functional intestinal obstruction nonmechanical (10%) causes. electrolyte balance, decompressing
Mechanical usually requires surgery. bowel, and relief/removal of obstruction
ASSESSMENT SAFETY
CONSIDERATIONS
Risk Factors Expected Findings
-thirst response is
-mechanical: compression of intestine, postsurgical -F&E imbalance
adhesions, carcinomas, diverticulitis, fecal -metabolic alkalosis decreased in older
impaction, hernia, volvulus (twisting), -visible peristaltic waves adult
-mechanical obstructions: colicky, intermittent pain (mild)
intussusception (telescoping) -F&E imbalance
-nonmechanical obstructions: vague, diffuse, constant
-nonmechanical: result from decreased peristalsis pain with sig. abd distention, projectile vomiting could cause
arrhythmias
Laboratory Tests Diagnostic Procedures
-inc. Hgb, BUN, Cr, Hct (indicate dehydration)
-inc. serum amylase and WBC occur with strangulating -x-ray (evaluate free air & gas patterns)
obstructions -Endoscopy determines cause
-ABGs indicate metabolic imbalance, depending on
obstruction type -CT scan determines cause/location of
-chemistry profiles reveal decreased sodium, chloride, and obstruction
potassium
PATIENT-CENTERED CARE Complications
Nursing Care Medications Client Education -dehydration (due
to persistent
-mechanical: surgery prep, withhold intake
until peristalsis resumes
-Prokinetics: -prevent bowel vomiting)
-nonmechanical: NPO, assess bowel promote gastric obstruction with high fiber -electrolyte
sounds, oral hygiene, adm IV F&E
replacement (K+), pain management, motility diet and hydration
imbalance
encourage ambulation, semi-fowler position -broad spectrum
-metabolic
antibiotics:
alkalosis
especially with
-ruptured intestine
suspected
Therapeutic Procedures Interprofessional Care could lead to
bowel
strangulation infection
-NG tube with a vent (to -gastroenterologist
prevent damage to the -anti-emetics: -dietician
stomach mucosa during relieve
cont. suctioning) is inserted nausea/vomiting
to decompress the bowel
ACTIVE LEARNING TEMPLATES
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