‫‪Intestinal obstruction‬‬

‫محمد عادل شبل ابو سليمان‬ ‫محمود محمد احمد‬

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‫محمد عبدالرحمن عبدالمجيد‬
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‫مؤمن محمد منصور‬
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‫محمد جمعه محمد بسيون‬
‫‪222605000061‬‬
‫محمد بكر محمد القشاش‬
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‫محمد جمعه شاهي‬
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‫‪192605000076‬‬
‫مصطفى مسعود عبد الستار‬
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‫يوسف احمد علي‬
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‫محمد ابراهيم عبد الحميد‬
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‫محمد علي فرج‬
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‫‪Under Supervision‬‬
‫‪Dr. Noura Elrefaey‬‬
‫‪Dr. Amira Mohamed‬‬
 Outlines
Definition
Classification
Definition,Causes,Most Common Site,S&S
Nursing Care Plan
Definition
Intestinal obstruction, also known as bowel obstruction, is a
medical condition characterized by a partial or complete
blockage of the normal flow of contents through the small
intestine or large intestine (colon). This blockage can prevent
the passage of food, fluids, gas, and stool through the digestive
track

Classification
Small intestine
Large intestine
Small intestine
Defintion
Small intestine obstruction, also known as small bowel obstruction, occurs when
there is a partial or complete blockage of the normal flow of contents through the
small intestine. The small intestine is a long and coiled tube that plays a crucial
role in the digestion and absorption of nutrients from the food we eat. When
there's an obstruction in the small intestine, it can lead to the accumulation of
fluids, food, and gas upstream from the blockage, causing symptoms such as
severe abdominal pain, nausea, vomiting, abdominal distension, and the inability
to pass gas or have bowel movements.
Causes
Adhesions: Scar tissue that forms in the abdominal cavity, often as a result of
prior abdominal surgeries, can cause the small intestine to become twisted or
kinked, leading to obstruction.
Hernias: Inguinal hernias, femoral hernias, and incisional hernias can trap a loop
of the small intestine, causing obstruction.
Intussusception: This occurs when one section of the small intestine telescopes
into another section, leading to blockage.
Tumors: Benign or malignant growths in the small intestine can physically
obstruct the passage of intestinal contents.
Strictures: Narrowing of the small intestine due to conditions like Crohn's disease
can result in partial obstruction.
Meconium Ileus: In newborns, a thick, sticky substance called meconium can
block the small intestine.
Foreign Bodies: Ingested foreign objects, such as toys or bezoars (agglomerations
of indigestible material), can block the small intestine

Most Common Site

The most common site for a small intestine obstruction is the junction between
the small intestine and the large intestine, known as the ileocecal valve. This is
where the small intestine meets the beginning of the large intestine (the cecum).
Small intestine obstructions can occur at this point due to various factors,
including adhesions, hernias, and intussusception.

Signs & symptoms

 Abdominal Pain
 Abdominal Distension
 Nausea and Vomiting
 Inability to Pass Gas or Stool
 Dehydration and Electrolyte Imbalance
Large intestine
Defintion
Large intestine obstruction, also known as colonic obstruction, occurs when there
is a partial or complete blockage in the large intestine (colon). The large intestine
is responsible for further absorption of water and electrolytes from undigested
food, as well as the formation and elimination of stool. When an obstruction
occurs in the large intestine, it can lead to symptoms such as abdominal pain,
distension, constipation, and the inability to pass stool, while liquid or gas may
still be able to pass around the obstruction.

Causes
Colorectal Cancer: Malignant tumors in the colon or rectum can obstruct the
passage of stool.
Diverticulitis: Inflammation or infection of diverticula (small pouches in the colon)
can lead to an obstruction.
Fecal Impaction: A hardened mass of stool can become lodged in the colon,
leading to a blockage.
Strictures: Narrowing of the colon due to conditions like inflammatory bowel
disease (IBD) can result in obstruction.
Colonic Pseudo-obstruction: Also known as Ogilvie's syndrome, this is a condition
where the colon dilates excessively and fails to function properly, mimicking an
obstruction.
Endometriosis: In rare cases, endometriosis can lead to adhesions and blockages
in the colon.
Most Common Site
The most common site for a large intestine (colon) obstruction is the sigmoid
colon. The sigmoid colon is the S-shaped portion of the colon located in the lower
left side of the abdomen, just before the rectum. It is a common site for
obstructions, particularly due to conditions like colorectal cancer, diverticulitis,
and volvulus (twisting of the colon). Obstructions in the sigmoid colon can lead to
symptoms such as abdominal pain, distension, and difficulty passing stool.

Signs & symptoms

 Abdominal Pain
 Abdominal Distension
 Abdominal Tenderness
 Inability to Pass Gas or Stool
 Dehydration and Electrolyte Imbalance
 Nursing Care Plan
Nursing Diagnosis
Acute Pain
Characteristics
1. Crampy and Colicky
2. Intermittent
3. Relieved by Vomiting or
Passage of Gas/Stool
Related to:
-Inflammation of scar tissue
-Constipation
Goal Intervention
-Patient will report a 1. Assess the patient’s pain
decrease or relief in level.
cramping and pain. 2. Assess nonverbal pain cues.
3. Administer pain medications
-Patient will display a as ordered.
relaxed appearance 4. Provide comfort measures.
with vital signs within 5. Cluster nursing care with
normal limits. pain medication.
6. Place nasogastric tube.
7. Reassess Pain level.

As evidenced by:
-Reports of cramping
-Restlessness
-Guarding behaviors
-Facial grimacing
Nursing Diagnosis Goal Intervention
Constipation Patient will have a Provide a warm sits bath as
bowel movement appropriate.
at least every 2-3
Related to:
days Encourage hydration. Once the
Inflammation within the
patient is allowed to consume
bowels
fluids, encourage hydration.
Malabsorption
Narrowing of the lumen
Discourage them from drinking
alcohol or caffeine, and educate
As evidenced by:
these fluids can dehydrate them.
Abdominal distention.
Abdominal pain.
Encourage fiber when
Infrequent passage of stool
appropriate. Fiber should be
Straining and discomfort
encouraged to help with
with defecation.
constipation but needs to be
Verbalizes feeling bloated.
introduced very slowly.

Encourage physical activity.

Nursing Diagnosis Goal Intervention
Dysfunction of The patient will 1- Assess the extent of nausea,
gastrointestinal motility practice vomiting, and limited food and
appropriate fluid intake.
Related to: behaviors to assist 2- Diet modification: small
gastroesophageal reflux with resolution of frequent feedings, bland
disease condition. meals, avoidance of caffeine,
spicy, citrus, dairy products,
As evidenced by: and carbonated products.
Nausea and vomiting 3- Administer fluids and
Abdominal cramping electrolytes as ordered.
Regurgitation 4- Advise patient to eat slowly
and chew food well.
5- Positioning: maintain an
upright position at least 2
hours after meals.
6- Recommend patient to
maintain a normal weight, or
to lose weight if needed.
7- Prepare patient for possible
diagnostic tests.
 Nursing Goal Intervention
Diagnosis
imbalanced nutrition less he patient will  Monitor food intake and
than body requirements achieve a gradual, record dietary preferences
sustainable weight and aversions.
Related to: gain, attain a BMI  Provide information on
inadequate intake of within the normal calorie and protein
nutrients range, and exhibit requirements and the role
improved of each nutrient in healing
As evidenced by: laboratory values and recovery.
weight loss of 5% in the within the next  Encourage small, frequent
past month, BMI of 18.5, three months. meals if the patient has a
and decreased serum poor appetite.
albumin levels.  Maintain good oral hygiene
to ensure the patient's
comfort and encourage
appetite.
 Measure weight, BMI, and
nutritional laboratory
results.
Nursing Diagnosis Goal Intervention
High risk for ineffective The patient will  Regularly assess skin color,
temperature, and capillary refill time.
tissue perfusion maintain adequate  Promote frequent position changes
tissue perfusion, as to prevent pressure ulcers and
Related to: evidenced by promote circulation.
 Collaborate with the healthcare team
altered cardiovascular normal vital signs, to manage modifiable risk factors
function intact skin and (e.g., hypertension, obesity, smoking)
tissue, and through medication, diet, and
exercise.
absence of
 Administer medications as prescribed
symptoms related to manage conditions that can affect
to poor perfusion. tissue perfusion (e.g.,
antihypertensive medications).
 For patients at risk of peripheral
vascular disease, emphasize foot care
and the importance of regular
podiatric assessments.
 For patients at risk of peripheral
vascular disease, emphasize foot care
and the importance of regular
podiatric assessments.
Nursing Diagnosis Goal Intervention
High risk for fluid volume Prevent  Monitor intake and output
accurately.
deficit complications  Record the color, amount, and
related to fluid consistency of urine.
Related to: volume deficit.  Administer IV fluids as prescribed
based on the patient's needs.
 Encourage the patient to drink water
or other oral fluids as tolerated.
 Assess the patient's dietary habits
and recommend a balanced diet.
 Review the patient's medication list
and assess for medications that can
exacerbate fluid loss (e.g., diuretics).
 Collaborate with the healthcare
provider to adjust or discontinue
medications if necessary.
 Educate the patient and family on
the importance of fluid intake and
recognizing signs of dehydration.
 Assess the patient's fluid intake and
output to ensure balance.
 Review the patient's understanding
of fluid management and self-care.