Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 7 Gastrointestinal System^313



  • Not to lie down after eating.

  • Elevate head of bed.

  • Avoid wearing clothing that is tight at waist.

  • Avoid acidic foods (citrus, vinegar, tomato), peppermint, caffeine, alcohol.

  • Stop smoking.

  • Lose weight if overweight.


Intestinal Obstruction and Paralytic Ileus


WHAT WENT WRONG?


An intestinal obstruction occurs when motility through the intestine is blocked.
This may be caused by a mechanical obstruction due to the presence of a tumor,
presence of adhesions from prior surgery, infection or fecal impaction. A paralytic
ileus results when motility through the intestine is blocked without any obstruct-
ing mass. This may occur during the postoperative period following intra-abdominal
surgery, during a severe systemic illness (sepsis), electrolyte imbalance, or because
of a metabolic disorder (diabetic ketoacidosis).


PROGNOSIS


Disruption of intestinal function needs to be reestablished for return to homeostasis.
In most cases the underlying cause must also be corrected in order for the intestinal
function to be restored. Nutritional needs must be met during the treatment period.


HALLMARK SIGNS AND SYMPTOMS



  • Obstruction:

    • Abdominal pain (cramping, intermittent or constant)

    • Abdominal distention

    • Vomiting of gastrointestinal contents (may eventually include stool as GI
      tract backs up)

    • Bowel sounds high-pitched

    • Constipation

    • Abdominal tenderness on palpation




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