Nursing Care Plans for Intestinal Obstruction.

Definition: Intestinal obstruction is a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.

Etiology: Intestinal obstruction results from mechanical or nonmechanical blockage of the lumen. It can occur as a result of any factor that narrows the lumen of the intestine or interferes with peristalsis. Narrowing of the lumen results in a mechanical obstruction and can be caused by factors such as adhesions, tumors, inflammatory bowel disease, hernias, fecal impaction, intussusception, a volvulus, and strictures. In a nonmechanical obstruction, the bowel lumen remains open but the intestinal contents are not propelled forward. Factors that can cause this paralytic (adynamic) ileus include abdominal surgery, effects of anesthesia and some medications (e.g., narcotic [opioid] analgesics, some antiemetics, anticholinergics, antidiarrheals), electrolyte imbalances such as hypokalemia, decreased blood flow to the intestine (can occur with conditions such as hypovolemia or blockage of mesenteric vessels as a result of an embolus, thrombus, or arteriosclerosis), spinal cord injury, and peritonitis.

Signs & Sx. Crampy abdominal pain that comes and goes Nausea Vomiting Diarrhea Constipation Inability to have a bowel movement or pass gas Swelling of the abdomen (distention) Nursing Dx. Altered tissue perfusion, Risk for fluid volume imbalance, Pain, Constipation, Risk for nutritional imbalance, Nausea, Risk for infection,

Nursing Plan: Nursing interventions Nursing Care Plans for Intestinal Obstruction

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.

Evaluation: Nursing Key outcomes Nursing Care Plans for Intestinal Obstruction

 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.