Nursing Care Bowel Obstruction Diagnosis and Intervention

Sign and Symptoms of Bowel Obstruction

• Vomiting with or without nausea, nausea often relieved by vomiting
• Constipation with or without overflow diarrhoea
• Onset of obstruction is rarely an acute event
• Partial obstruction may occur intermittently and resolve spontaneously
• Symptoms may worsen until they become constant
• Gaseous abdominal distension, +/- ascites
• Intestinal Colic
• Continuous abdominal pain
• Bowel sounds may be altered

Nursing Diagnosis for Bowel Obstruction

• alteration of fluid and electrolytes related to NG
• alteration of nutrition

 Nursing Intervention for Bowel Obstruction client

• Focus on treating the predominant symptom(s)
• Review treatment regularly as symptoms may change
• Drugs used for symptom management will usually have to be delivered via a syringe driver as the oral route is often unreliable
• Good and regular oral hygiene
• Provide ongoing information and psychological support for patients and family
• Exclude other causes of nausea and vomiting, constipation,
• abdominal distension (ascites), intestinal colic (laxatives) and treat accordingly.
• If obstruction present and complete – stop all laxatives – clear bowel with phosphate enema.
• SC/IV fluids may be required for hydration and electrolyte balance and comfort

Refrence
HARDY, J.R., (2000), Medical Management of Bowel Obstruction, British Journal of Surgery, 87, p1281 – 1283
WOOLFSON, R.G., JENNINGS, K., WHALEN, G., (1997), Management of Bowel Obstruction in Patients with Abdominal Cancer, Archives of Surgery, Vol. 132 (10), p1093 – 1097
RIPAMONTE, C., MERCANDANTE, S., (2004), Pathophysiology and Management of Malignant Bowel Obstruction in Doyle, D., Hanks, G., Cherny, N., Calman, K. (Eds.), Oxford Textbook of Palliative Medicine, 3rd Edition, Oxford, Oxford University Press, p496 – 507.