Intestinal Obstruction

Definition:

Any factor either narrows intestinal passage way or interfere with peristalsis can result in bowel obstruction.

Intestinal obstruction occurs when intestinal contents can not pass through GI tract, and it requires prompt treatment. The obstruction may either be partial or complete.

Etiology:

Classification of Etiology:

Mechanical Obstruction:

  1. Adhesion
  2. Hernia (Inguinal/ Umbilical Hernia)
  3. Tumor
  4. Volvulus
  5. Intussusceptions

Non-mechanical obstruction may result from a neuro-muscular or vascular disorder

  1. Paralytic ileus
  2. Vascular distention
  3. Clinical features:
  4. Nausea
  5. Vomiting (orange-brown, foul smelling due to bacterial growth)
  6. Abdominal pain (Universal pain)
  7. Abdominal distension
  8. Constipation
  9. High pitched bowel sounds
  10. Decrease urine out put
  11. Hypokalaemia
  12. Hyponatraemia

Complication:

  1. Shock
  2. Dehydration
  3. Necrosis of tissue
  4. Perforation
  5. Aspiration Pneumonia

Investigation:

  1. X-ray
  2. Barium enema
  3. CBC
  4. Serum electrolyte
  5. Amylase test

Medical Management:

  1. NG insertion before surgery
  2. Analgesic

Nursing Management:

  1. Observe for color, odor & amount of vomiting
  2. Patient should be monitor for dehydration & electrolyte imbalance
  3. Nurse should provide comfort measures to promote a restful environment
  4. Keep visitors to minimize
  5. Record TPR & BP
  6. Record for any complication

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