VOLVULUS

NORMAL DEVIATION

ABDOMINAL CAVITY Loop and twist in the

colon or intestine

CECUM MIDGUT SIGMOID

VOLVULUS

ALIGNED; NO
MALROTATION CECUM MIDGUT SIGMOID

Predisposing factors: Predisposing factors: Predisposing factors:

Babies and
Middle aged and Young adults
Pregnancy small children
elderly

Fetus can cause Chronic constipation; Abdominal mesentery Abnormal intestinal

displacement and twisting Hirschprung disease; didn't develop normally development in fetus
of colon abdominal adhesions

Colon can flop freely Malrotation in Small

Intestine

Large objects like baby or

stool can act as pivot point
for colon to twist

Portion of intestine or colon twisted

Pinches lumen shut

Bowel obstruction Twisted mesentery

Prevents normal
Breakdown of Infarction (death
passage of food and
intestinal wall of intestinal wall)
water

Release of
bacteria
IMBALANCED
NUTRTION: LESS
THAN BODY
REQUIREMENTS R/T
GASTROINTESTINAL Sepsis and fever
OBSTRUCTION Severe Bloody
Constipation Vomiting Bloating
abdominal pain stool

HYPERTHERMIA R/T DEFICIENT FLUID

ONGOING INFECTION ACUTE PAIN R/T VOLUME R/T
BIOLOGICAL ACTIVE FLUID
INJURY LOSS
CONSTIPATION SECONDARY TO
R/T BOWEL INFARCTION
NURSING INTERVENTIONS: OBSTRUCTION
DX:
1. Monitor VS especially NURSING INTERVENTIONS:
temperature DX:
TX: 1. Monitor VS
1. Eliminate excess clothing or 2. Assess skin turgor
covers 3. Monitor intake and output as
2. Administer antipyretic as ordered
ordered TX:
3. Tepid sponge bath 1. Give oral hygiene
EDX: 2. Administer IV fluid as ordered
1. Encourage to hydrate with 3. Provide fluids
ample amount of fluid as tolerated EDX:
1. Encourage to replenish fluid
loss by increasing fluid intake

NURSING INTERVENTIONS:
NURSING INTERVENTIONS: DX:
DX: 1. Assess usual eating habits
1. Note real, exact weight for age & 2. Assess usual pattern of elimination
height including frequency & consistency NURSING INTERVENTIONS:
2. Assess nutritional history TX: DX:
3. Monitor intake & output 1. Offer fluids as tolerated, if not 1. Monitor VS
TX: contraindicated 2. Observe non-verbal pain cues
1. Provide oral hygiene 2. Provide adequate time & privacy for 3. Assess pain characteristics using
2. Insert NGT as ordered defacation PQRST
3. Collaborate and assist in 3. Collaborate and assist in TX:
sigmoidoscopy or colonoscopy ordered sigmoidoscopy or colonoscopy ordered 1. Help patient assume position of
by physician by physician comfort
4. Offer prescribed diet 4. Offer prescribed diet 2. Provide comfort measures (back rub)
EDX: EDX: & diversional activities
1. Encourage to have diet rich in protein 1. Encourage to increase fluid as 3. Administer analgesics as ordered
and high caloric diet tolerated, if not contraindicated 4. Get rid of additional stressors or
2. Discourage carbonated and 2. Instruct intake of dietary fiber sources of discomfort
caffeinated beverages 3. Encourage regular period for 5. Provide rest periods
elimination & adequate time for EDX:
defacation 1. Encourage to report pain
2. Educate on non-pharmacological
methods for diversional activities

References:
Volvulus. (n.d.). Retrieved from https://www.osmosis.org
Herdman, T and Kamitsuru, S. (2014). NANDA International, Inc. NURSING
DIAGNOSES: Definitions & Classification.UK: John Wiley & Sons