Question

a patient is admitted with a diagnose of intestinal obstruction.

a. describe the non-surgical management that this patient will require

b. the patient has a nursing diagnose of risk for deficient fluid volume related to impaired fluid intake, vomiting, and diarrhea from intestinal obstruction. what will be your nursing intervention for this patient?

Answer 1

ANSWER :

a)Non surgical management of intestinal obstruction :

• Bowel rest by keeping the patient nil per oral
• Bowel decompression by nasogastric tube
• Intravenous fluid resuscitation with isotonic fluids to maintain fluid balance.
• Correction of electrolyte imbalance
• IV antibiotics(Metronidazole ,carbipenwms etc )for gram negative and anaerobic bacteria to prevent their growth in intestine.
• Catheterize the patient and monitor urine output.
• Antiemetics like cyclizine and prochlorperazine are given for nausea and vomiting.

b)Nursing interventions :

• Close monitoring of vital signs - they may land in hypovolemic shock because of dehydration caused by vomitings and diarrhea
• Monitor fluid balance hourly as hypovolemia can occur quickly.
• Fluid replacement regimens should be started immediately to replace the losses.
• IV infusion of isotonic crystalloid solutions like ringer lactate and 0.9% Nacl done depending on the fluid requirement.
• Fluid and electrolytes requirement of the patient should be assessed by central venous pressure measurement , urine output and interpretation of blood results(blood urea , serum electrolytes etc)
• Monitor fluid input and urine output carefully to assess the fluid balance.Minimum urine output of > 0.5ml/kg/hr indicates adequate fluid balance.