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Partial Obstruction of Small Intestine - Coggle Diagram
Partial Obstruction of Small Intestine
Nursing Diagnosis: Constipation
Medications:
Lactulose enema - used to soften stool and promote bowel motility
Polyethylene glycol (MiraLAX) - laxative that helps draw water into intestines which softens stool
Morphine - used for pain management
Signs and Symptoms: Changes in bowel movement pattern (less occurrences), straining when defecating, hard and dry stools, abdominal distention, cramping, nausea, and loss of appetite
Constipation related to decreased gastrointestinal motility secondary to partial bowel obstruction or use of opioid analgesics (e.g., morphine).
Expected Outcome
Short-Term Outcome: Patient will pass stool that is soft and formed, within 48 hours of starting treatment
Long-Term Outcome: Patient will have regular, comfortable, soft bowel movements, and will maintain adequate hydration to prevent further complications related to partial bowel obstruction
Nursing Interventions
Monitor for signs of increased constipation or obstruction such as abdominal distention, and N/V because these symptoms can mean that the patient needs surgical intervention
Encourage fluid intake to soften stool and promote bowel motility
Auscultate and monitor bowel sounds in abdominal quadrants to monitor status of peristalsis or worsening of obstruction
Administer stool softeners such as lactulose enema or laxatives as prescribed to help soften stool and promote bowel movements
Educate patient on changing their diet after bowel status improves such as increasing fiber intake to make stool easier to pass and prevent another bowel obstruction
Assess patient's bowel movement schedule and symptoms of constipation to establish patient's baseline and helps identify if interventions are effective
Administer opioid analgesics at lowest effective dose to ensure minimal impairment of gastrointestinal motility
Evaluation
Patient reports decreased abdominal pain and discomfort demonstrating effective treatment for constipation
Patient maintains adequate hydration and has not had complications related to worsening of bowel obstruction
Patient reports passing stool that is soft and formed without straining which demonstrates improvement in bowel motility
Patient verbalizes techniques to prevent future bowel obstruction and constipation using the teach back method