AMS1

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Author:
alyn217
ID:
164566
Filename:
AMS1
Updated:
2012-07-31 12:45:51
Tags:
AMS1T3 bowel obstructions
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Description:
bowel obstruction
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  1. Basic info about intestial obstructions
    • What? Intestinal Contents can’t pass through the GI tract
    • Small Intestine or Colon; Partial or Complete
    • Mechanical Obstruction
    • Non-Mechanical 
    •    (Paralytic Ileus)
    • Pseudo-obstruction
    • Vascular Obstruction
  2. what are some possible pathophys's of bowel obstruction
    • Fluid, gas, stool accumulate proximally
    • Distal bowel collapses
    • Extravasation of fluids and electrolytes into peritoneal cavity
    • Reduced circulating blood-->hypotension, shock
    • Intestinal strangulation (infarction): bowel can become necrotic and rupture=infection, death
    • Metabolic alkalosis=vomiting, NG tube
    • Small bowel=dehydration/electrolyte imbalance
    • Large bowel. No early SnSs.
  3. SnSs of bowel obstruction
    • Nausea/Vomiting
    • Fluid volume deficit-->s/sx hypovolemia!!!
    • Abdominal pain
    • Abdominal distention
    • Inability to pass flatus
    • Auscultation reveals “High Pitched Tinkling Sound” above area of obstruction, usually hypoactive or absent below 
    • Fever (if strangulation or peritonitis)
  4. Diagnostics involved with bowel obstruction
    • Abdominal CT
    • Abdominal X-ray 
    • Colonoscopy
    • Sigmoidoscopy
    • Labs:
    • CBC (WBC, H/H)
    • Lytes (BUN, Creatinine)
    • Occult blood analysis
  5. collaborative care for pt w/bowel obstruction
    • Emergency Surgery (strangulated bowel)
    • NPO (NO ICE OR H2O…Oral Care!). patients can swab mouth with oral sponge, shouldn’t give them water-->e-lyte loss. 
    • NG Tube (patency/obstruction)
    • IV fluids (0.9% NS or LR) 
    • --Electrolytes
    • Analgesics
    • Parenteral Nutrition

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