Question

You are a nurse in a medical-surgical hospital unit caring for a patient who had an open cholecystectomy (gallbladder removal) 5 days earlier. The patient has no bowel sounds, is not passing gas, and has developed an incisional infection.

What actions would you take to help the paralytic ileus resolve?

Bowel rest. You'll avoid eating by mouth until your bowel function has returned.

Parenteral nutrition. You may need to have your fluids, electrolytes, and nutrients replaced through an IV.

Nasogastric tube.

What assessment findings would indicate the paralytic ileus is resolving?

Abdominal flat, bowl sounds,

Answer 1

To assist a patient with a paralytic ileus following an open cholecystectomy, interventions include bowel rest, parenteral nutrition, and possibly a nasogastric tube. Recovery is indicated by the return of bowel sounds and the passage of gas. An incisional infection should also be treated with antibiotics and proper wound care.

Step-by-step explanation:

If you are caring for a patient who had an open cholecystectomy 5 days prior and is now exhibiting signs of a paralytic ileus (no bowel sounds, not passing gas) and an incisional infection, certain interventions are necessary to promote recovery. Initially, bowel rest is important, meaning that the patient will avoid oral intake until bowel function resumes. To ensure the patient receives adequate hydration and nutrition during this time, parenteral nutrition and fluid replacement may be administered through an IV. Additionally, a nasogastric tube may be placed to decompress the stomach and remove gastrointestinal secretions, thus relieving distension.

To assess whether the paralytic ileus is resolving, you would look for return of bowel sounds, passage of gas, or a change in abdominal distension. An improvement in these symptoms would indicate a return of intestinal motility, suggesting that the paralytic ileus is resolving.

It's also crucial to address the incisional infection, which could exacerbate the ileus. This would typically involve antibiotic therapy and proper incision care to promote healing and prevent further complications.