Small Bowel Obstruction
Med Surg: GI - Gastrointestinal
Pathophysiology
A small bowel obstruction is a blockage in the small intestines.
Non-Mechanical obstruction
Paralytic Ileus RAPID Onset Key point
Mechanical obstruction Frequent vomiting & nausea
Adhesions (scar tissue)
Abdominal distention
from surgery Normal Intussusception
Hernias Colicky “intermittent” abdominal pain
Intussusception Bowel sounds
Tumor (cancer)
Hyperactive = ABOVE obstruction
Volvulus
(twisting of bowel) Adhesions
Hypoactive = Below obstruction
!!!
Peritonitis Medical Emergency!
NCLEX TIP 1
Fever
Tachycardia,Tachypnea
Abdominal distention
...
Common NCLEX Question
Client with a small bowel obstruction Treatment
… suddenly develops tachycardia and
tachypnea with a high fever. What is
most likely the problem?
1. Pulmonary embolism 1. NPO N
2. Bowel perforation notify HCP NPO
2. NGT insertion
3. Pneumonia
4. Atelectasis
(nasogastric tube)
3. IV fluids
Su 4. Semi-Fowler’s position
5. Pain control (non-opioids) N
Patients that fail to improve will need a bowel
resection to cut out the problem area & may AVOID Opioid analgesics: NGT insertion
have an ostomy placed until bowels heal Morphine
Hydrocodone
Hydromorphone
Med Surg: GI - Gastrointestinal
Pathophysiology
A small bowel obstruction is a blockage in the small intestines.
Non-Mechanical obstruction
Paralytic Ileus RAPID Onset Key point
Mechanical obstruction Frequent vomiting & nausea
Adhesions (scar tissue)
Abdominal distention
from surgery Normal Intussusception
Hernias Colicky “intermittent” abdominal pain
Intussusception Bowel sounds
Tumor (cancer)
Hyperactive = ABOVE obstruction
Volvulus
(twisting of bowel) Adhesions
Hypoactive = Below obstruction
!!!
Peritonitis Medical Emergency!
NCLEX TIP 1
Fever
Tachycardia,Tachypnea
Abdominal distention
...
Common NCLEX Question
Client with a small bowel obstruction Treatment
… suddenly develops tachycardia and
tachypnea with a high fever. What is
most likely the problem?
1. Pulmonary embolism 1. NPO N
2. Bowel perforation notify HCP NPO
2. NGT insertion
3. Pneumonia
4. Atelectasis
(nasogastric tube)
3. IV fluids
Su 4. Semi-Fowler’s position
5. Pain control (non-opioids) N
Patients that fail to improve will need a bowel
resection to cut out the problem area & may AVOID Opioid analgesics: NGT insertion
have an ostomy placed until bowels heal Morphine
Hydrocodone
Hydromorphone
