Bowel Sounds - HELP!

[nursinghealth]

Hello:

I am a new grad working on a surgical unit in a hospital setting.

I had a patient yesterday recovering from a bowel resection. She was started on full fluids POD1 and advanced to a regular diet by POD2.

I documented BS as hypoactive as I heard very light tinkering approx 1-2 min apart . It was dicey though - as a new grad, I don't feel completely confident in my ability to differentiate between absent and hypoactive BS. Was that a BS, or was it the sound of the tubing on my stethoscope?

My patient had not produced flatus by POD2, and I was concerned about the fact that she was on a regular diet. I thought food was not to be introduced until BS and flatus were confirmed. I ran this by another nurse and was told it was fine; this is the way it is normally done.

My patient's abdomen has since become distended and her diet was reversed back to clear fluids. If she vomits, an NG tube is going in.

Was I correct to think a regular meal was inconsistent with her presentation? The MD ordered it, a co-worker confirmed it was acceptable... yet still I'm not sure. Am I wrong?

[nursej22, MSN, RN]

Relying on bowel tones to determine when start feeding has been found to be unreliable. Diet usually begins with clears and advances as tolerated. Withholding solid food has not been shown to decrease frequency of postop ileus.

Postoperative diet advancement: surgical dogma vs evidence-based medicine. - PubMed - NCBI

[nursinghealth]

Thank you!