Question

1. what are signs/ symptoms to look for in a patient with bowel perforations

b. what will be the focus assessment

c. what complications can result from bowel perforation

d. what are the nursing inventions

Answer 1

Sudden and severe abdominal pain,fever,chills, vomitting, swelling and bloating of abdomen,rectal bleeding are the major signs and symptoms of bowel perforation.

A thorough history collection and physical examination needed to find out the cause of symptoms. A chest x-ray shows presence of air in the abdominal cavity. A CT scan is helpful for diagnosis of bowel perforation.

Internal bleeding and sepsis are the major complications of bowel perforation.

Nurses has to check periodic vital signs to assess sign of sepsis. Elevated heart rate,low bp,high temperature are the signs of antibiotics should be given as per doctors order.

Also patients level of consciousness should be assessed and marked periodically. The colour, amount and smell of fluid from any drain should be assessed frequently. Intake output chart should be maintained properly.

Patient complete blood count should be monitored to see presence of infection and to find out anaemia risk. Assess level of pain and pain medication should be given. Assess nutritional status of the patient and replace iv fluids and parenteral or enteral nutrition as per doctors order.