Intestinal Obstruction

Signs & Symptoms
1. Large Intestine
  1. Low grade Cramping Abdominal Pain
  2. Absolute Constipation
  3. Gradual onset
  4. Abdominal Distention
  5. Lack of Flatus
2. Small Intestine
  1. Metabolic Alkalosis (vomiting Stomach Acids)
    1. Bile Color Emesis
    2. Distal Small intestine more Gradual & may even smell like feces
      1. Needs Surgery Immediately
  2. Rapid Dehydration
  3. Colicky & Cramp Like Pain (Intermittent)
  4. Feces (for short time)
  5. Minimal Distention
3. Bowel Sounds High Pitched Above Obstructure
  1. Borborgymi (Hyperactive)
4. Nonmechanical Absent Bowel Sounds
5. Paralytic Ileus (Constant pain
6. Mechanical (Pain in Waves0
Intervention
1. NG tube
  1. Check q 4hrs
2. NPO
3. IV Fluids
  1. Lactated Ringers or NS (GI losses Isotonic)
4. Surgery if Intestines are Strangulated
5. Analgesic (pain)
6. Monitor BUN, Creatinine, Electrolytes, Dehydration, Metabolic Alkalosis
  1. Rising BUN & Creatinine is indicator of Acute Kidney Injury
7. Immediately report if output is less than 0.5kg/ml per hour
8. Low obstruction (Metabolic Acidosis) Lossing Bicarb
9. Oral Care (Mouthwash Frequently) & Water soluble lubricant
Causes
1. Mechanical
  1. hernia
  2. strictures from crohn's disease
  3. Diverticular Disease
  4. Occulusion
  5. Volvolus
2. Nonmechanical
  Anotações:
  - Something Interferes with the parasympathetic nervous System.
  1. Hypokalemia
  2. Spinal Fracture
  3. Anasthesia
  4. Abdominal Surgery
No Passage of Stool
Complications
1. Intraluminal Pressure Increases
  1. Increased Permeability of Capillaries
    1. Content Leaks into Peritoneal Cavity
    2. Hypovolemic Shock
    3. Third Spacing
    4. Hypotension
2. Bowels Can become Extremely distended
  1. Blood Flow stop
    1. Intestinal Strangulation/Intestinal Infarction
    2. Needs to Be corrected Immediately (Septic Shock Risk)
Diagnostics
1. Elevated WBC
  1. Preforation
  2. Strangulation
2. Decreased hct/hgb?
  1. Bleeding
  2. Strangulation/Necrosis
3. CT scans, X Rays, Sigmoidoscopy, Colonoscopy

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	Criado por Ilana Kovach quase 8 anos atrás