Presentation on Intestinal obstruction, .pptx

This is presentation on intestinal obstruction included in syllabus of bsn 2nd year.

1. Intestinal obstruction Intestinal obstruction is a blockage of a small intestine or colon that prevents food and fluid from passing through.

2. Pathophysiology Obstruction gives rise to increased intra luminal pressure. Accumulation of gas and fluid occurs in the obstructed segment. There is impairment of blood supply. Bacterial invasion occurs. Peritonitis may occur. Ventilation becomes restricted due to elevation of diaphragm and distention of abdomen.

3. Cont … There may be atelectasis of lung (collapse of lung). Venous return is hampered. There is loss of fluid and electrolytes. There is hypokalemia, and dehydration because of vomitings. There is hemoconcentration, hypovolaemia, renal failure. All this can lead to shock and death.

4. Causes Many conditions can cause intestinal obstruction. Intestinal obstruction can occur as the result of a "mechanical" obstruction — when something, such as a hernia or tumor, is physically blocking intestine. Intestinal obstruction can occur as the result of a condition in which your intestines don't function properly. This type of intestinal obstruction is called paralytic ileus (pseudo-obstruction).

5. Cont …. Chemical, electrolyte or mineral disturbance such is decreased in potassium level. Decreased blood supply to the abdominal area. Injury to abdominal blood supply. Intra abdominal infection. Uses of certain medicine especially narcotics.

6. Sign and Symptoms Signs and symptoms of intestinal obstruction include: Cramps, abdominal pain that comes and goes. Nausea. Vomiting. Diarrhea. Constipation. Inability to have a bowel movement or pass gas. Swelling of the abdomen (distention). Breathing odour.

7. Test and diagnoses Physical exam. Doctor will ask about medical history and symptoms. He or she will also do a physical exam to assess patient's situation. The doctor may suspect intestinal obstruction if abdomen is swollen or tender or if there's a lump in abdomen. Imaging tests. To confirm a diagnosis of intestinal obstruction, Doctor may recommend abdominal X- ray or computerized tomography (CT) scans. These tests also help doctor determine if the obstruction is paralytic ileus or if it's a mechanical obstruction, and if it's a partial or a complete obstruction.

8. Treatment Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal distention and vomiting. Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death. Placing an intravenous (IV) line into a vein in arm so that fluids can be given.

9. Complications If left untreated, intestinal obstruction can cause serious, life- threatening complications, including: Electrolyte imbalances Infection Jaundice Perforation (hole) in the intestine Death of the affected intestine. Infection in the abdominal cavity.

10. Nursing diagnosis Acute pain related to abdominal distention. Imbalanced nutrition less than body requirements related to decreased nutrient intake. Constipation related to intestinal obstruction. Ineffective tissue perfusion (gastrointestinal) related to obstruction. Risk for deficient fluid volume related to intestinal obstruction.

11. Nursing interventions Administer analgesics to relieve pain. Administer laxatives to prevent constipation. Advice the patient to take soft food and fluid to reduce the volume of stool. Avoid the patient from eating hard and spicy food. Teach the patient the dosages, routes, and side effects for all medications.

12. References Peterson MA. Disorders of the large intestine. In: Marx JA, et al. Rosen's Emergency Medicine. 7th ed. Philadelphia, Pa.: Mosby; 2009. http://www.mdconsult.com/book/player/ linkTo?type=bookHome&isbn=978-0-323-05472-0&eid=4- u1.0- B978-0-323-05472-0..X0001-1--TOP&uniq=216142190- 4. Accessed Aug. 24, 2010. Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ ddiseases/pubs/intestinalpo/index.htm. Accessed Aug. 24, 2010. Abdominal adhesions. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/ pubs/intestinaladhesions/index.htm. Accessed Aug. 24, 2010