Bowel obstruction is a serious medical condition that requires prompt diagnosis and treatment to prevent serious health complications. A nursing care plan (NCP) is an essential tool for the healthcare team in managing this condition, helping them identify the patient’s needs and how best to meet them.
In this post, we’ll discuss what you need to know about NCPs for bowel obstruction, including the signs and symptoms of the condition, considerations for developing tailored plans according to each patient’s needs, and practical strategies for monitoring progress. Read more about caring for patients with bowel obstruction through comprehensive nursing care planning.
Table of Contents
What is a Bowel Obstruction?
Bowel obstruction is a blockage in the intestine that prevents the normal flow of stool. Scar tissue, tumors, hernias, twisted or abnormal segments of the intestine, or foreign bodies can cause this. Bowel obstructions can be partial or complete and produce a wide range of symptoms depending on their severity and location in the bowels.
If your digestive system stops working correctly, you may experience difficulty with bowel movements and passing gas. Additionally, stomach pain and bloating might occur. Fecal impaction is one type of blockage that happens when a large mass of hard stool gets stuck in the digestive tract. If something other than solid waste causes the obstruction, medical professionals refer to it as a bowel obstruction.
Symptoms of bowel obstruction
The most common symptoms of bowel obstruction are
- abdominal pain
- constipation
- nausea and vomiting
- cramping
- bloating
- changes in the stool.
There may also be signs of dehydration, such as thirst, dry mouth, dark urine, and decreased urination. If left untreated, bowel obstructions can cause serious complications, including infection or tissue death (gangrene) if the block cuts the blood supply.
Causes of intestinal obstruction
The most common causes of intestinal obstruction are
- scar tissue
- tumors
- hernias
- volvulus (a twisted section of the intestine),
- foreign bodies.
Other less common causes include adhesions (bands of fibrous tissue that form between abdominal organs), strictures (narrowing in the intestines), radiation enteritis (inflammation caused by radiation therapy), and endometriosis (abnormal growth of uterine tissue outside the uterus).
Types of Bowel Obstructions
The severity of a bowel obstruction can affect how it presents itself.
Complete obstructions
A complete obstruction can block off a portion of the intestine, making it difficult or impossible to pass stool or gas.
Partial obstructions
Partial obstructions are typically less severe as they only partially block the intestine, causing some slowdown in the progress of solids, liquids, and gases through the digestive system. Symptoms of such an obstruction include discomfort, bloating, and diarrhea.
Pseudo-obstruction
This is a rare condition where the symptoms of bowel obstruction are present without there being any blockage. It usually happens when nerve or muscle issues prevent food, liquids, and gas from passing through the intestines.
Risk factors
- Risk factors for bowel obstruction include
- past abdominal surgery or other abdominal operations
- inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis
- being older than 65 years of age,
- obesity, and pregnancy.
Diagnosis
To diagnose a bowel obstruction, your doctor may order imaging tests such as X-rays, CT scans, or MRIs. They may also order blood tests to check for infection and electrolyte levels or do an endoscopy to examine the lining of the intestines.
Treatment
The main goal of treatment is to remove the obstruction and restore normal bowel function. Depending on the cause and severity of the obstruction, this can be done with medications, surgery, endoscopy, or other methods. In some cases, a tube may need to be inserted through the nose into the stomach to help relieve pressure in the abdomen and allow for the passing of stool or gas.
Complications
Untreated bowel obstruction can cause serious complications, including dehydration, infection, and tissue death (gangrene). A ruptured intestine may occur if the blockage is not addressed quickly. Surgery is sometimes required to repair the damage.
What is Small Bowel Obstruction?
Small bowel obstruction is a blockage in the small intestine caused by an external or internal force, such as scar tissue from previous surgery or a tumor. The obstruction can be partial or complete and may require immediate medical attention.
There are two types of small bowel obstruction.
1. Mechanical obstruction: This obstruction is caused by a physical blockage that prevents the passage of solids, liquids, and gases. Adhesions, tumors, or foreign bodies can cause it.
2. Functional obstruction: This type of obstruction occurs when there is no physical blockage but a disruption in the normal functioning of the intestine, such as an inflammation or infection.
- Symptoms of small bowel obstruction include abdominal pain, nausea, vomiting, bloating, cramps, and constipation. It is essential to seek medical attention if these symptoms occur, as a blockage in the small intestine can cause serious complications.
- Treatment of small bowel obstruction will depend on the severity and cause of the obstruction but may involve medication, surgery, or other intervention.
It is important to seek medical advice to prevent the recurrence of this problem and for proper management. With prompt treatment, most people fully recover from small bowel obstruction and can return to normal activities.
Small Bowel Obstruction Nursing Care Plan
A small bowel obstruction care plan is essential for patients with bowel obstruction. This plan should include the following components:
Assessment
The nurse should assess the patient for any signs and symptoms of bowel obstruction. This may include:
- abdominal pain
- nausea and vomiting, bloating,
- constipation
- changes in stool consistency or color
- dark urine,
- decreased urination or thirst.
Goals of Care
The goal of care should be to reduce symptoms’ severity and relieve discomfort. This may include administering medications as prescribed, providing nutritional support, and educating the patient about their condition.
Nursing Diagnosis For Small Bowel Obstruction
The nurse should assess the patient for any signs and symptoms of bowel obstruction. This may include:
- Altered nutrition Less than body requirements related to decreased absorption of nutrients due to small bowel obstruction.
- Risk for impaired skin integrity related to abdominal distention, pain, and decreased mobility due to small bowel obstruction.
- Pain related to inflammation and peristalsis due to small bowel obstruction.
Interventions
- Monitor vital signs regularly.
- Provide adequate nutritional support with clear liquids or a low-residue diet, as tolerated by the patient.
- Encourage bed rest to decrease abdominal discomfort
- Administer medications such as laxatives, pain relievers, and antispasmodic medications as prescribed.
- Monitor the patient for signs of infection, such as fever, chills, or abdominal pain.
- Promote skin hygiene to prevent breakdown and ulceration due to pressure from bloating and constipation.
- Educate the patient about diet modifications, lifestyle changes, activity restrictions, and follow-up care to prevent further episodes of small bowel obstruction.
Evaluation
The nurse should evaluate the patient’s response to treatment and progress toward meeting goals. This includes monitoring vital signs, assessing symptoms, evaluating the effectiveness of medications and diet changes in relieving discomfort, monitoring skin integrity, and providing education regarding lifestyle modifications necessary to reduce future episodes of obstruction. If the patient’s condition does not improve, the nurse should notify the healthcare provider for further evaluation and treatment.
Final Words
Bowel obstruction can be a life-threatening condition, so patients and their caregivers must understand the symptoms, risk factors, treatments, and follow-up care associated with this condition.
With proper management, most people fully recover from small bowel obstruction and can return to normal activities. It is also essential to seek medical advice to prevent the recurrence of this problem.
By following these guidelines, you and your healthcare team can work together to ensure that your small bowel obstruction nursing care plan effectively achieves its goals. Thank you for taking the time to learn more about bowel obstruction NCP.
References
- https://www.ncbi.nlm.nih.gov/books/NBK448079/#:~:text=Small%20bowel%20obstruction%20is%20a,world%20is%20intra%2Dabdominal%20adhesions.
- https://my.clevelandclinic.org/health/diseases/15850-small-bowel-obstruction
Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.