e. Nursing implication for intestinal obstruction.
(1) Abdominal girths should be measured daily. For accuracy of
comparison, follow these suggested guidelines:
(a) Use the same measuring tape each time.
(b) Place the patient in the same position each time.
(c) Ensure that the tape measure is placed in the same position each
time. This can be done by drawing small tic marks on the patient's abdomen to indicate
position for the tape.
(d) Measure the patient at the same time each day.
(2)
Note the color and character of all vomitus. Test for the presence of
occult blood.
(3)
Any stool passed should be tested for the presence of occult blood.
(4) Monitor vital signs closely. Elevations of temperature and pulse may
indicate infection or necrosis.
(5)
Monitor I&O closely. Fluid and electrolyte losses must be replaced.
1-54. DIVERTICULAR DISEASE
a. Definition. Diverticula are bulging dilatations or "out-pouchings" of the
gastrointestinal walls. Common sites are the sigmoid colon, duodenum, and the distal
ileum. However, diverticula can occur anywhere along the GI tract, from the esophagus
to the anus.
b. Diverticulosis. The presence of asymptomatic diverticula is called
diverticulosis. Diverticulosis is sometimes the source of LLQ pain that is relieved by
defecation or flatulence. Constipation or diarrhea may also occur. Diverticulosis
generally requires no treatment other than dietary modification to prevent irritation of the
bowel.
c. Diverticulitis. When diverticula become inflamed or infected, the condition is
referred to as diverticulitis. Food and bacteria lodge and harden in the diverticular sac.
Inflammation results, followed by infection. Complications include abscess, obstruction,
perforation, peritonitis, and hemorrhage.
(1) Symptoms include low grade fever, nausea, gas, abdominal pain, and
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