Intestinal Obstruction

Description

Paralytic Ileus & Intestinal Obstruction
Ilana Kovach
Mind Map by Ilana Kovach, updated more than 1 year ago
Ilana Kovach
Created by Ilana Kovach almost 8 years ago
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Resource summary

Intestinal Obstruction
  1. Signs & Symptoms
    1. Large Intestine
      1. Low grade Cramping Abdominal Pain
        1. Absolute Constipation
          1. Gradual onset
            1. Abdominal Distention
              1. Lack of Flatus
              2. Small Intestine
                1. Metabolic Alkalosis (vomiting Stomach Acids)
                  1. Bile Color Emesis
                    1. Distal Small intestine more Gradual & may even smell like feces
                      1. Needs Surgery Immediately
                    2. Rapid Dehydration
                      1. Colicky & Cramp Like Pain (Intermittent)
                        1. Feces (for short time)
                          1. Minimal Distention
                          2. Bowel Sounds High Pitched Above Obstructure
                            1. Borborgymi (Hyperactive)
                            2. Nonmechanical Absent Bowel Sounds
                              1. Paralytic Ileus (Constant pain
                                1. Mechanical (Pain in Waves0
                                2. Intervention
                                  1. NG tube
                                    1. Check q 4hrs
                                    2. NPO
                                      1. IV Fluids
                                        1. Lactated Ringers or NS (GI losses Isotonic)
                                        2. Surgery if Intestines are Strangulated
                                          1. Analgesic (pain)
                                            1. Monitor BUN, Creatinine, Electrolytes, Dehydration, Metabolic Alkalosis
                                              1. Rising BUN & Creatinine is indicator of Acute Kidney Injury
                                              2. Immediately report if output is less than 0.5kg/ml per hour
                                                1. Low obstruction (Metabolic Acidosis) Lossing Bicarb
                                                  1. Oral Care (Mouthwash Frequently) & Water soluble lubricant
                                                  2. Causes
                                                    1. Mechanical
                                                      1. hernia
                                                        1. strictures from crohn's disease
                                                          1. Diverticular Disease
                                                            1. Occulusion
                                                              1. Volvolus
                                                              2. Nonmechanical

                                                                Annotations:

                                                                • Something Interferes with the parasympathetic nervous System. 
                                                                1. Hypokalemia
                                                                  1. Spinal Fracture
                                                                    1. Anasthesia
                                                                      1. Abdominal Surgery
                                                                    2. No Passage of Stool
                                                                      1. Complications
                                                                        1. Intraluminal Pressure Increases
                                                                          1. Increased Permeability of Capillaries
                                                                            1. Content Leaks into Peritoneal Cavity
                                                                              1. Hypovolemic Shock
                                                                                1. Third Spacing
                                                                                  1. Hypotension
                                                                                2. Bowels Can become Extremely distended
                                                                                  1. Blood Flow stop
                                                                                    1. Intestinal Strangulation/Intestinal Infarction
                                                                                      1. Needs to Be corrected Immediately (Septic Shock Risk)
                                                                                  2. Diagnostics
                                                                                    1. Elevated WBC
                                                                                      1. Preforation
                                                                                        1. Strangulation
                                                                                        2. Decreased hct/hgb?
                                                                                          1. Bleeding
                                                                                            1. Strangulation/Necrosis
                                                                                            2. CT scans, X Rays, Sigmoidoscopy, Colonoscopy
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