Bowel Care sp C/S

[whiterobin]

After a duramorph C/S how long do you wait to start bowel care? If no flatus within 24 hours, what do you start with and in what order do you proceed and with what time frame, especially if pt needs a BM to be D/C'd at 48 to 72 hours-Pericolace/Colace, MOM, Dulcolax supp/tabs, Prune juice. Have you heard of increased risk of ileus or slower bowel recovery with cold/iced water/drinks verses room temp water/drinks-this would affect our choice of ice chips only after surgery?

[mark_LD_RN]

our patient recieve colace bid, and may have dulcolax if no flatus in 24 hours if gas and abdominal pain or distention is a problem. we do not require a bowel movement for patient to be discharged.and have seen no difference in warm or cold liquids. even though a couple nurses here swear by warm prune juice uck:)

by the way what area of the country or you from and how old are theses docs, we stopped requiring bowel movement to be able to go home a long time ago:)

[SmilingBluEyes]

Same as Mark, here. BID colace, encourage fluids and fruit juices and ambulate, ambulate, ambulate! (did I say ambulate? haha). We want to have her passing flatus but not necessarily have a BM before discharge.

[whiterobin]

Thank you for all of your replies. I have a concern that at 24 hours if no flatus, I have seen a practice of Dulcolax Supp q 2 hours X 2 with MOM 45cc with the first supp. This is along with Pericolace BID. This seems a bit much, but will it hurt? My practice is in Arizona and California. (Yes, the Doctors are a bit of "good ol' boys" :roll ) Kathy RNC

[SmilingBluEyes]

seems like overkill to me.