Med Surge Success book (found in library)= ch 7 # 13-24,37-144, ch 8 # all questions

*The exam questions are not limited to only what is listed on this guide. Please refer to your chapter

readings, recordings, and module materials. ATI has additional practice questions for review in Learning

Systems RN 3.0.

Ch. 56 – Care of Patients with Noninflammatory Intestinal Disorders

● Nonmechanical (ileus) vs. mechanical obstruction (intussusception, volvulus, etc.)

o Non-mechanical: results from neurological disturbances that affect the muscles.

Can be primary or secondary (often based on anesthesia medications).

Remember to assess the patient's bowel tones for complications from this!

▪ Paralytic Ileus: the bowel is not impacted by a physical obstruction, but

because of a lack of peristalsis as a result of neuromuscular disturbance,

causing backup of fecal contents and abdominal distention and potentially

leakage of stool contents into the peritoneum space can occur, causing

inflammation and infection, decreased electrolyte levels and reduced

blood volume.

o Mechanical: from a structural disturbance of the bowel.

▪ Adhesions: scar tissue from surgery that builds up and causes obstruction

▪ Benign or malignant tumors

▪ Appendicitis complications: if the appendix bursts, often the contents will

cause disruptions in fecal matter flow.

▪ Hernia: protrusion of the bowel through an opening that should not be

there, causing pain and blockages.

▪ Fecal impactions: from constipation

▪ Strictures: from crohns or radiation

▪ Intussusception: telescoping of the bowel into itself.

▪ Volvulus: twisting of the bowels, allowing nothing to go through.

o Physical Assessment

▪ Obstipation: severe constipation that may last for days without any

passage of stools. Diarrhea may be present in partial obstructions

▪ Failure to pass gas

▪ Vomiting that may be foul smelling or coffee ground like.