- Acute Pain related to Inflammation of scar tissue and Constipation as evidenced by Reports of cramping and facial grimacing
- Constipation related to Inflammation within the bowels and narrowing of the lumen as evidenced by Abdominal distention and Infrequent passage of stool
- Dysfunctional Gastrointestinal Motility related to Partial or complete obstruction and
Inflammatory bowel conditions as evidenced by Abdominal bloating and Altered bowel sounds
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain related to Inflammation of scar tissue and Constipation as evidenced by Reports of cramping and facial grimacing | Patient will report a decrease or relief in cramping and pain. Patient will display a relaxed appearance with vital signs within normal limits. | 1. Administer pain medications as ordered. Managing pain is better achieved when pain medications are given routinely. Pain medication will likely be administered IV as the patient with an SBO will likely not be able to tolerate oral medications and will be prescribed NPO status for bowel rest. 2. Provide comfort measures. Comfort measures such as massage, deep breathing, and guided imagery can help ease a patient’s pain. Additionally, distraction activities such as watching TV, playing games, or reading can help focus their mind on something else as a way of coping with the pain. 3. Cluster nursing care with pain medication. Perform nursing care when the pain medication is at its peak therapeutic level. Anticipate administering pain medication before pain is severe, and then waiting until the relief is at its highest, so the patient is most comfortable and in the least amount of pain before tasks such as repositioning, ambulating, or bathing. 4. Place nasogastric tube. A patient with small bowel obstruction will need a nasogastric tube to help decompress the stomach. The decompression will relieve abdominal distention and help decrease the patient’s pain. | Patient reported a decrease or relief in cramping and pain. Patient displayed a relaxed appearance with vital signs within normal limits. |
| Subjective data: -Less than three bowel movements per week -Hard, dry stool -Lumpy stool -Difficulty/straining to pass stool, painful -Stomach pain, aches, or cramps -Sensation of feeling bloated or nauseous Objective data: -Assess medical history related to potential constipation (history of constipation, activity level, medications used routinely for constipation) -Assess stool characteristics per patient Color, consistency, amount | Constipation related to Inflammation within the bowels and narrowing of the lumen as evidenced by Abdominal distention and Infrequent passage of stool | Patient will verbalize having a bowel movement without straining. Patient will implement two strategies to relieve constipation. Patient will have a bowel movement at least every 2-3 days. | 1. Provide a warm sitz bath as appropriate. The warm water of a sitz bath can help relieve pain and discomfort for a patient experiencing constipation related to an SBO or hemorrhoids. 2. Encourage hydration. Once the patient is allowed to consume fluids, encourage hydration. Discourage them from drinking alcohol or caffeine, and educate these fluids can dehydrate them. Adequate fluid intake helps soften the stool, making it easier to pass through the intestines and rectum. 3. Encourage fiber when appropriate. Fiber should be encouraged to help with constipation but needs to be introduced very slowly. Too much fiber too quickly can cause abdominal distress or diarrhea. The patient may need education on fibrous foods or supplements at discharge. 4. Encourage physical activity. A sedentary lifestyle can contribute to constipation. Encourage walking in the hospital and once discharged as this increases gastric motility and emptying. | Patient verbalized having a bowel movement without straining. Patient implemented two strategies to relieve constipation. Patient had bowel movement improved. |
| Subjective data: Expressions of pain, Unpleasant feeling Objective data: -Abdominal bloating -Abdominal cramping or pain -Absence of flatus -Altered bowel sounds -Constipation -Nausea -Vomiting -Lack of appetite | Dysfunctional Gastrointestinal Motility related to Partial or complete obstruction and Inflammatory bowel conditions as evidenced by Abdominal bloating and Altered bowel sounds | Patient will be free from abdominal pain, bloating, and distension. Patient will demonstrate active bowel sounds and the passage of flatus. | 1. Insert a nasogastric tube. NG tubes are recommended for simple or partial obstructions to decompress the stomach. 2. Prepare and assist in surgical intervention. Surgery is indicated for SBO if the small intestine is strangulated or completely blocked to treat the underlying cause of decreased gastrointestinal motility. 3. Keep the patient NPO. NPO status ensures adequate bowel rest allowing ample time for recovery from a bowel obstruction. 4. Assist with ambulation. Ambulation post-surgery is necessary to restart bowel motility and prevent further complications. | Patient will be free from abdominal pain, bloating, and distension. Patient will demonstrate active bowel sounds and the passage of flatus. |