Intestinal obstruction occurs when the intestine is blocked, preventing normal movement of its contents. It can be caused by mechanical blockages such as tumors or hernias, or functional issues like neuromuscular problems. Symptoms include abdominal pain, vomiting, distension and constipation. Treatment involves fluid resuscitation, antibiotics, pain management, and sometimes surgery to remove the obstruction. Proper diagnosis and timely treatment are important to prevent complications like perforation and sepsis.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
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A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
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A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
this is a chapter which belongs to fundamentals of nursing subject in first year BSc nursing. this ppt helps you to learn & understand about the normal physiology of bowel elimination, factors affecting bowel elimination, alterations in bowel elimination & its nursing management, procedure related to bowel elimination.
Mr. Sankappa
Definition
Gastro esophageal reflux disease is a chronic and relapsing condition in which prolonged reflux of hydrochloric acid, pepsin and bile salts in the esophagus, oral cavity and respiratory system occurs that leads to esophagitis
Excessive intake of junk foods, coffee, chocolate
Excessive intake of onion, tomato, and beverages
Heavy exercise
Alcoholic and smoking
Medications
Heartburn
Discomfort
Chest pain
Difficulty in respiration
Aspiration pneumonia
After endoscopy the lesions are graded for severity using the Savary Miller grading system;
Grade 1: single or multiple erosions on a single fold.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential or rounded erosions.
Grade 4: ulcer, stenosis or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia (cellular changes on the microscopic level) in the form of circular or non-circular (islands or tongues) extensions.
Pathophysiology
Management
Antacids: An antacid is a substance which neutralizes stomach acidity, used to relieve heartburn, indigestion or an upset stomach (ex: Rantac, Zantac)
H2receptor antagonist: H2 antagonists block histamine-induced gastric acid secretion from the parietal cells of the gastric mucosa. They include cimetidine, famotidine, nizatidine
Proton Pump Inhibitors: Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid (Omeprazole, Rabeprazole, pantoprazole)
Cholinergic drugs:Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter (acetylcholine, carbachol, methacholine)
Cytoprotective drugs: is a process by which chemical compounds provide protection to cells against harmful agents (carbenoxolone, sucralfate, misoprostol)
Prokinetic drugs: prokinetic, is a type of drug which enhances gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. (Benzamide, Cisapride, Domperidone).
Endoscopic intraluminal valvuloplasty
Gastric tissue is utilised to increase the integrity of LES By creating a valve like structure.
his topic - Intestinal Obstruction is very important for final year MBBS - Students & the Medical Officers, as it is one of the commonest causes of Acute Aabdomen. The PPT - contains the classification, common causes, clinical features & management aspects of Intestinal Obstruction. Also, highlights the differentiating features of Plain X-ray abdomen of Small & Large Bowel Obstruction.
Oxygen therapy has been in use for centuries. Oxygen)(O2) is gas used as a drug/medication and a such should be prescribed and administered in the right manner with regards to presenting indications for it's use[1]; which is always in the case of hypoxaemia[2]. It has side effects and specific risks, but, with objective monitoring and administration, it is a potent therapy for the patient with respiratory condition
Other indications include:
Increased work of breathing
Increased myocardial work and/or Myocardial infarction
Pulmonary hypertension[5]
Pre-oxygenation in induction and difficult intubation.
Pre and post suctioning[6]
Postoperative oxygenation especially in abdominal and chest surgeries[7]
Hyperbaric oxygen therapy indicated in decompression sickness, gas embolism, gas gangrene and carbon monoxide poisoning.
Anaemic Hypoxia : it’s benefits is limited due circulatory deficit[8].
In aerosol drug delivery.
GENERAL EXAMINATION
CLINICAL SYMPTOMS
On observation kindly check for symptoms like:
1. Decreased level of consciousness: seen in end-stage renal disease (ESRD).
2. Obvious scars: check previous abdominal surgery.
3. Pallor: Suggestive of underlying anaemia (e.g. erythropoietin deficiency).
4. Shortness of breath: may be due to pulmonary oedema secondary to advanced renal disease.
5. Oedema: typically presents as swelling of the limbs (e.g. pedal oedema) and abdomen (i.e. ascites). In the context of a renal system examination, possible causes could include nephrotic syndrome and end-stage renal disease (due to anuria).
6. Cachexia: muscle loss that is not entirely reversed with nutritional supplementation associated with end-stage renal failure due to protein-energy wasting (PEW).
7. Uraemic complexion: a yellow colour of the skin caused by uraemia in advanced chronic kidney disease.
8. Cushingoid appearance: facial puffiness and weight gain may be due to the use of high dose corticosteroids for renal transplant immunosuppression or glomerulonephritis.
he water to be used for the preparation of haemodialysis fluids needs treatment to achieve the appropriate quality. The water treatment is provided by a water pre-treatment system which may include various components such as sediment filters, water softeners, carbon tanks, micro-filters, ultraviolet disinfection units, reverse osmosis units, ultrafilters and storage tanks. The components of the system will be determined by the quality of feed water and the ability of the overall system to produce and maintain appropriate water quality.
ntubation is a process where a healthcare provider inserts a tube through a person's mouth or nose, then down into their trachea (airway/windpipe). The tube keeps the trachea open so that air can get through. The tube can connect to a machine that delivers air or oxygen.
RAPID SEQUENCE INTUBATION:
Rapid sequence induction (RSI) is a set of actions during induction of anaesthesia in unfasted patients or patients at risk of aspiration/regurgitation of gastric contents.
INDUCTIION AGENT:
Induction agents (sedatives) are integral to the performance of rapid sequence intubation (RSI). They provide amnesia, blunt sympathetic responses, and can improve intubating conditions.
CRICHOID PRESSURE:
Cricoid pressure is applied by an assistant using the thumb and second finger; the first finger stabilizes the thumb and finger on the cricoid ring. press directly backwards at a force of 20-30 newtons against the cervical vertebrae.
endotracheal tube selection
Endotracheal tube selection for male is 8.0 and for female is 7.5
Formula for endotracheal tube children in paediatrics is
[(Age/4) + 4] for uncuffed tubes
[(Age/4) +3.5] for cuffed tubes
Immunization is defined as the procedure in which vaccine is injected into body to produce immunity against specifics diseases or it’s a process of protecting person from diseases by vaccination.
• Vaccine term was coined by Louis pasteur.
• Vaccine is a substance that is introduced into the body to prevent the disease produced by certain pathogens.
• Vaccine consists of dead pathogens or live attenuated (artificially weakened) organisms.
• The vaccine induces immunity against the pathogen, either by production of antibodies or by activation of T lymphocytes.
• Edward Jenner produced first live vaccine. He produced the vaccine for smallpox from cowpox virus.
Ventilator associated pneumonia (VAP) was defined as per the Center of Disease Control (CDC) as a pneumonia that occurs in a patient who was intubated and ventilated at the time of or within 48 h before the onset of the event. Pneumonia was identified using a combination of radiological, clinical, and laboratory criteria
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Deep vein thrombosis (DVT), is the formation of a blood clot in a deep vein, most commonly the legs.[2][a] Symptoms may include pain, swelling, redness, or warmth of the affected area. About half of cases have no symptoms. Complications may include pulmonary embolism, as a result of detachment of a clot which travels to the lungs, and post-thrombotic syndrome.[2][3]
Risk factors include recent surgery, cancer, trauma, lack of movement, obesity, smoking, hormonal birth control, pregnancy and the period following birth, antiphospholipid syndrome, and certain genetic conditions. Genetic factors include deficiencies of antithrombin, protein C, and protein S, and factor V Leiden mutation. The underlying mechanism typically involves some combination of decreased blood flow rate, increased tendency to clot, and injury to the blood vessel wall.
The term inotropic state is most commonly used in reference to various drugs that affect the strength of contraction of heart muscle (myocardial contractility). However, it can also refer to pathological conditions. For example, enlarged heart muscle (ventricular hypertrophy) can increase inotropic state, whereas dead heart muscle (myocardial infarction) can decrease it.
Blood product transfusion and massive transfusionpankaj rana
Blood transfusion
Plastic bag 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
Plastic bag with 0.5–0.7 liters containing packed red blood cells in citrate, phosphate, dextrose, and adenine (CPDA) solution
ICD-9-CM 99.0
MeSH D001803
OPS-301 code 8-80
MedlinePlus 000431
[edit on Wikidata]
Blood transfusion is generally the process of receiving blood or blood products into one's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Malignant hyperthermia (MH) is a disease that causes a fast rise in body temperature and severe muscle contractions when someone with the MH gets general anesthesia. MH is passed down through families. Hyperthermia means high body temperature.
History taking (History of Physical Examination)pankaj rana
A History of Physical Examination Texts and the Conception of Bedside Diagnosis. ... Throughout this paper we construct a difference between a “bedside diagnosis,” made when the physician and patient are in each other's presence, and a “remote diagnosis,” made when the patient and physician are separated.
In hospitals, nursing homes, and other healthcare settings, possible sources of
violence include patients, visitors, intruders, and even coworkers. Examples include
verbal threats or physical attacks by patients, a distraught family member who may
be abusive or even become an active shooter, gang violence in the emergency department,
a domestic dispute that spills over into the workplace, or coworker bullying.
The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale).
Cardiac tamponade
Synonyms Pericardial tamponade
Hemorragic effusion.jpg
A very large pericardial effusion resulting in tamponade as a result of bleeding from cancer as seen on ultrasound. Closed arrow - the heart; open arrow - the effusion
Specialty Cardiac surgery
Symptoms Shortness of breath, weakness, lightheadedness, cough[1]
Usual onset Rapid or more gradual[2]
Causes Cancer, kidney failure, chest trauma, pericarditis, tuberculosis[2][1]
Diagnostic method Symptoms and ultrasound of the heart[2]
Treatment Drainage (pericardiocentesis, pericardial window, pericardiectomy)[2]
Frequency 2 per 10,000 per year (US)[3]
Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium (the sac around the heart) builds up, resulting in compression of the heart.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
2. INTRODUCTTION
▪ Intestinal obstruction means blockage of intestinal pathway
that prevents the normal flow of products of intestine.
▪ It is also known as bowel obstruction.
3. DEFINITION
▪ Intestinal obstruction is a significant or mechanical
blockage of intestine that occurs when food or stool
can not move through the intestine.
▪ These obstruction may be complete or partial.
4. CAUSES
MECHANICAL CAUSES:
An intraluminal obstruction or a mural obstruction from
pressure on the intestinal wall occurs e.g.. Tumour &
neoplasm, stenosis, hernia, abscess.
5. FUNCTIONAL OBSTRUCTION:
The intestinal mass culture can’t propel the contents the bowel.
e.g.. Amyloidosis (It is a group of disease in which abnormal
protein known as amyloid fibrils builds up in tissue, it cause &
change in shape, work & also called organ failure.)
-Muscular dystrophy
-Endocrine disorder such as diabetes
-Neurological disorders
6. CLASSIFICATON
ONTHE BASIS OF CHANGES & MOVEMENTS
Dynamic a dynamic
ONTHE BASIS OF DURATION
Subacute & acute chronic
ONTHE BASIS OF LOCATION
Small bowel obstruction & large bowel obstruction
7. ONTHE BASIS OF CHANGES & MOVEMENTS
DYNAMIC: It occurs when peristalsis is working against a mechanical
obstruction.
8. ADYNAMIC: It may occur in two forms:
1.Where peristalsis may be absent. Occurring secondarily to
neuromuscular failure in the mesentery.
2.Where peristalsis may be present in non-propulsive form (pseudo-
obstruction).
* In both form mechanical elements is absent.
9. ON THE BASIS OF NATURE IT IS
CALSSIFIED INTO
SUBACUTE & ACUTE: It usually occurs in small bowel
obstruction with sudden onset of severe colicky central
abdominal pain distension & early vomiting & constipation.
CHRONIC OBSTRUCTION : Usually seen in large bowel
obstruction with lower abdominal colic and absolute
constipation, followed by distension.
10. ON THE BASIS OF LOCATION
▪ Small bowel obstruction: duodenum, jejunum, and ilium are
the part of the small intestine, when the obstruction occur in
this part of intestine.
▪ High bowel wash: ascending colon, transverse colon,
descending colon, cecum, rectum when the obstruction occur
in this part of intestine.
11. SMALL BOWEL OBSTRUCTION
▪ duodenum, jejunum, and ilium are the part of the small
intestine, when the obstruction occur in this part of
intestine.
17. LARGE BOWEL OBSTRUCTION
▪ Descending colon, sigmoid colon rectum and anal canal
is part of large intestine
▪ Large bowel obstruction occur when if obstruction in
these part of intestine
18. CAUSES
Cancer 60%.
Diverticular disease 15%.
Volvulus 15%.
Others: hernia – fecal impaction - IBD.
Inflammatory bowel disease
Constipation
Adhesion
Faecaloma extreme form of faecal immobilization
Colon atresia- narrowing of colon
19.
20. PATHOPHYSIOLOGY
Due to etiological factor
Impairment of passage of material through bowel
Accumulation of flatus,feaceas and retention of fluid,
reduce the fluid absorption and stimulate more gastric
secretion
21. PATHOPHYSIOLOGY
Distension of proximal intestine with solid fluid and gas
With increasing distension, increase intestinal lumen pressure
Decrease in venous in increase in capillary pressure
22. Oedema, congestion with decrease capillary
pressure
Rapture of perforation of intestine
Peritonitis
23. CLINICAL MANIFESTATION
▪ Initial symptoms is usually crampy pain that is wave like and colicky.
▪ Classical symptoms is nausea vomiting and constipation
▪ Without treatment abdominal pain may increase as a result of
perforation
▪ Ischemia
▪ Absence of passage of flatus abdominal distension
▪ Fever
▪ Tachycardia
24. Difference between High & Low
intestinal obstruction
HIGH LOW
BEGINNING Acute Slow, insidious
GENERAL CONDITION Early compromission preserved
PAIN Crampy pain in paroxism Less intensity
VOMITING Early, profuse, biliary Late, feculent may
be absent
ABDOMINAL
DISTENTION
Moderate, upper
quadrant Early, intense
CONSTIPATION + +++
ELECTOLYTES Cl, K, Na rapid loss Late hydro electrolytic
imbalance
25. COMPLICATION
▪ Intestinal perforation
▪ Peritonitis due to perforation
▪ Sepsis- mostly in which delay in diagnosis or treatment.
▪ Intraabdominal abscess.
▪ Dehydration
▪ Electrolyte disturbance
▪ Multiple organ failure(rarely)
▪ Death
28. LABORATORY FINDINGS
• CBC:
–Increase PCV (dehydration ) and increase in WBC.
• KFT:
–Increase in BUN and creatinine .
• Lactate concentration-amylase-lactic dehydrogenase useful but
not sensitive
–Torule out necrosis
• ABG:
–metabolic alkalosis and respiratory acidosis.
31. SIGMOIDOSCOPY (FLEXIBLE)
▪ it is a minimal invasive endoscopic procedure for large
intestine from the rectum through the last part of the colon
32. COLONOSCOPY
▪ it is the endoscopic procedure for large intestine and
digital part of the small with fibber optic camera on a
flexible tube passed through the anus and it provide
the visual diagnosis show location of obstruction
35. MEDICAL MANAGEMENT
Fluid replacement with aggressive intravenous resuscitation using
isotonic saline or ringer lactate is indicate.
Antibiotic therapy for gram negative bacteria such as cefazolin and
cefotaxime and meropenem
Antiemetic for symptomatic relief of nausea and vomiting such as
ondansetron
Analgesic to relief pain such as morphine, fentanyl and diclofenac.
36. ▪ Diuretics to reduce the fluid retention such as
furosemide.
▪ Stool softener such as duphalac for relief
constipation
37. SURGICAL MANAGEMENT
▪ Bowel resection (enterotomy) - it is a surgical procedure in
which a part of bowel is removed, from either small
intestine or large intestine.
▪ Colostomy
▪ Bypass surgery
38.
39.
40.
41. DIETARY MANAGEMENT
Clear liquid diet- a Clear liquid diet starting with soups and
advancing to half cup to one cup portions.
Food allowed on clear liquid diet, fruit juice after 1 to 2 weeks.
Low fibber diet- temporarily limiting the amount of fibber for
bowel healing
42. Low fibber rich diet such as white bread with outs nuts and seeds
White rice, plain white pasta
Well cooked vegetables and fruits without skin and seeds
Avoid hot spicy and cholesterol rich diet
Avoid alcohol
Avoid smoking
43.
44. Acute pain related to intestinal obstruction as
evidence by patient verbalization.
Goal- resolved the pain
Intervention-
▪ assess level, frequently and type of pain.
▪ Provide comfortable position
▪ Administer the prescribed medication provide diversional
therapy
▪ Provide calm environment
45. Imbalance nutrition less than body requirement related to
altered nutritional absorption as evidence by aversion to
eating
Goal: Enhance the nutritional status
Intervention:
▪ Recommend bed rest before meal
▪ Provide oral hygiene
▪ Avoid food that cause abdominal cramping
▪ Record intake and output
▪ Promote patient participation in dietary planning as possible
46. Risk for deficit fluid volume related to vomiting as
evidence by skin turgidity
Goal: maintain adequate fluid and volume level
Intervention:
▪ Monitor intake and output
▪ Note possible condition that may lead to deficient fluid loss.
▪ Monitor vital sign
▪ Observe the skin condition
▪ Administration preantral fluid
47. Anxiety related to changes in health status as
evidence by somatic complaints
Goal: Patient feel relaxed
Intervention
▪ Review physiological factor such as active medical condition
▪ Observe and note behaviour
▪ Encourage verbalization of feeling
48. A clinical study of intestinal obstruction and its surgical Management in
rural population
Naveen N, Avijeet Mukherjee, Nataraj Y. S, LingeGowda S. N.
The study revealed that Intestinal obstruction is more common in the
age group of 30-60 years. Small bowel obstruction is more common
than large bowel obstruction. Four cardinal features of intestinal
obstruction are pain abdomen, vomiting, distension and constipation.
Most common etiological factor is postoperative adhesions followed
by abdominal hernia. Malignancy as a cause for obstruction is more
common in large bowel than small bowel. Intravenous fluids and
electrolytes, gastrointestinal aspiration, antibiotics and timed
appropriate surgery are still the mainstay of treatment.
49. CONCLUSION
▪ At last in this topic I would like to say intestinal
obstruction is a digestive system disorder that may
affect the intestinal which are responsible for
movement of digestive food particles, faeces, gases.
▪ if they are not passed it will strangulate in intestine and
cause many problem. It may also cause intestinal
perforation that is life threatening condition and if not
treated it will cause death.