1. The client/caregiver has a basic understanding of the anatomy and physiology of the intestines.
   1. The small intestine is approximately 18 feet long and extends from the stomach to the large intestine.
   2. The large intestine, which is much shorter and wider, ascends up the right side of the abdomen, is horizontal across the abdomen, and descends on the left side of the abdomen.
   3. Digestion and absorption occur in the intestines.
2. The client/caregiver can define content obstruction.
   1. A blockage prevents the contents from passing normally through the intestines, and it can occur in either the large or small intestine.
   2. There are two basic types of obstructions:
      1. Mechanical obstruction occurs when something physically stops the passage of fecal contents (may be caused by tumors, adhesions, hernias, etc.).
      2. Paralytic obstruction is the cessation of peristalsis caused by trauma, infection, toxins, surgery, and so forth.
3. The client/caregiver can list factors that increase the risk of bowel obstruction.
   1. Inflammatory disease
   2. Tumor
   3. Hernia
   4. Fecal impaction
   5. Postoperative scar tissue (adhesions)
   6. Foreign bodies (ingested materials that obstruct the intestines)
   7. Congenital strictures
   8. Strictures or scars from radiation therapy
4. The client/caregiver can recognize signs and symptoms.
   1. Paralytic ileus is marked by
      • Abdominal distention
      • Absent bowel sounds
      • Relatively little pain
   2. Mechanical obstruction
   3. Abdominal fullness and distention
   4. Abdominal pain and cramping
   5. Vomiting
   6. Failure to pass gas or stool
   7. Breath odor
5. The client/caregiver can state possible treatment.
   1. Intravenous fluids to replace fluids
   2. Nasogastric tube to drain fluids and gas
   3. Surgery
6. The client/caregiver can list possible complications.
   1. A lack of blood supply to the bowel can cause gangrene and death of the bowel tissue
   2. Perforation (hole) in the intestine
   3. When obstruction occurs, intestinal contents, fluids, and gas accumulate.

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care.
Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott
Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com