obstructive ileus
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OBSTRUCTIVE ILEUS(Group 2)
By: Group 2Lilis Nur Aida (1301100002)Genta Mahendra (1301100003)Kevian Septian Adi (1301100016)Nurul Qomariah (1301100045)Dyah Ayu Rachmawati (1301100059)
TOPICS
1. Background of obstructive ileus2. Definiton of obstructive ileus3. Etiology of obstructive ileus4. Pathophysiology of obstructive ileus5. Clinic manifestation of obstructive ileus6. Diagnostic examination of obstructive ileus7. Medical management of obstructive ileus8. Nursing care plan of obstructive ileus
BACKGROUND
• Obstructive ileus is a mechanical blockage of the intestine where the blockage completely closes or disrupt the way of intestinal contents. Approximately 20% of patients come to the hospital with complaints of acute abdomen due to obstruction of the gastrointestinal tract, 80% occurred in intestine tenue obstruction.• In Indonesia recorded 7,059 cases of paralytic ileus and obstructive
without hernia who are hospitalized and 7,024 outpatients
DEFINITION OFOBSTRUCTIVE ILEUS
Obstructive ileus is breakdown or disappearance the passage of intestinal contents caused by mechanical obstruction. Barriers in the way of intestinal contents will lead to obstructed intestinal contents and buried in the proximal part of the blockage so that the proximal region will occur or dilated bowel distension.
ETIOLOGY OF OBSTRUCTIVE ILEUS
Abnormality cause of obstruction include:1. Intestinal adhesion
Existence of fibrous tissue in the intestines were found at birth (congenital). However, fibrous tissue is most common after abdominal surgery. Small intestine adhesions are experiencing as a result of this fibrous tissue will blockage the way of food and fluids2. Incarcerated hernia
When it happened narrowing of the intestine can lead to intestinal obstruction
ETIOLOGY OF OBSTRUCTIVE ILEUS
3. Tumors (primary, metastatic):Can lead to obstruction to the entrance of food and fluids
4. Intussusception (entry of the proximal to the distal intestinal)
5. Volvulus (twisted intestinal).
PATHOPHYSIOLOGY OF OBSTRUCTIVE ILEUS
Obstructive Ileus
any mechanical power affects the intestinal
wall
narrowing / blockage of the
bowel lumen
passage disturbed
intestinal lumen
collecting the contents of the
intestinal lumen in the form of gas and
liquid in the proximal
stimulation of the digestive
gland hypersecretion
intestinal distension of
the entire colon at the proximal
occlusion
This blockage causes increased
intestinal movements (hyper
peristalsis) as a natural attempt
CLINICAL MANIFESTATION
OF OBSTRUCTIVE ILEUS
1. Pain on abdomen2. Vomit3. Difficult to defecation4. Feel nauseous5. There’s blood6. Filled with air7. Can’t flatus8. Hyperperistaltik
DIAGNOSTIC EXAMINATION OF OBSTRUCTIVE ILEUS
There are diagnostic examination can do:1. X-ray on thorax: diaphragm will go high because of abdomen
distention2. X-ray on abdomen when the patient lay on bed: to find causes3. X-ray: to see the gas or water in abdomen4. Laboratory examination: like a examination to the blood and
electrolit, it can show if the patient is dehydration, or maybe loss of plasma, or there’s infection
5. Radiogram examination is important to make a diagnostic
MEDICAL MANAGEMENT OF OBSTRUCTIVE ILEUS
Basic treatment of intestinal obstruction are:1. Treatment2. Pharmacology3. Paracentesis4. Surgical actions, which include:
- Colostomy- Stents: surgery for intestinal obstruction
depends on the cause of the obstruction. The most common cause of obstruction such as hernia and adhesions. The surgical action is herniotomy.
NURSING CARE PLAN OF OBSTRUCTIVE ILEUS
• Assessmenta. Identityb. History of present illnessc. Past medical historyd. Family history
e. Activity Daily Lifea) nutritionb) eliminationc) Activityd) Personal Hygiene.
f. Examination a) General condition b) Physical Examination
Nursing Diagnosis
1. Impaired sense of comfort (pain) associated with increased intraluminal pressure
2. Disorders of fluid and electrolyte balance associated with excess fluid loss
3. Nutrition less than body requirements relate to nausea, vomiting
4. The risk of infection associated with peritonitis complications of septicemia
Nursing Intervention
Diagnose 11. Observation level of pain2. Monitor the status of the abdomen every 4 hours3. Encourage early ambulation and avoid sitting long4. Maintain client in semi-Fowler's position5. Maintain fasting until bowel sounds return, reduced abdominal
distension and flatus out6. Teach relaxasi and distraction techniques7. Collaboration: Give analgesics as an indication and evaluation of its
effectiveness
Diagnose 21. Monitor vital sign2. Assess skin turgor and humidity mucous membrane3. Observation intake and output4. Give extra fluids intravenously as indicated5. Collaboration: Parenteral fluids distribution and blood
transfusion
Diagnose 31. Encourage restriction on activities during the acute phase2. Improve oral diet, either a liquid diet or low residu diet3. Consultation with a nutritionist4. Collaboration: Give a drug as indicated
Diagnose 41. Monitor the quality and intensity of pain2. Monitor abdominal distension3. Observation of vital signs4. Prepare patients for surgery if planned5. Collaboration: Give antibiotics as indicated
CONCLUSION
1. Obstruction ileus is damage or loss of the passage of intestinal contents caused by mechanical obstruction.
2. Clinical manifestations in ileus tenderness in the abdomen, vomiting, constipation, abdominal distension, Chapter blood and mucus but no feces and flatus.
3. Diagnostic tests include: X-ray of the thorax, abdomen X-rays, x-rays, laboratory tests), abdominal radiogram examination is essential for diagnosis of intestinal obstruction.
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