bowel sounds vs no bowel sounds

[fairyluv]

I have a res. who is on continuous tube feedings. lately she has been so full that she has been vomiting and we have had to turn off her tube feeding. She has not had a BM in quite a few days, I was reading the nurses notes and seen where it was charted that this res did not have bowel sounds. I thought for sure she did, cause I heard them the other day. So I listened to her again and even had another nurse listen just to make sure we were hearing the same thing. So i charted that she had bowel sounds. they are not hyperactive bowel sounds but they are still active. So how would you approach this ? apperantly it had been reported to the doc that she had no bowel sounds. I figure she might have an impaction, but her family doesn't want anything done. What would you do if this were your res ??

[savoytruffle, BSN, RN]

One surgeon taught me that you need to listen to bowel sounds for five minutes per quad to finally determine/chart "no active bowel sounds". If nurses called this surgeon for no bowels sounds they better have spent a full twenty minutes listening to the patient's abdomen. If the assessment is done too quickly, they may not hear them. I would call listening after a few minutes "hypo active" but you may want to run that by your overseeing nurse or medical director to verify what your facilities policy is on this.

[CapeCodMermaid, RN]

A fecal impaction is a sentinel event and in Massachusetts must be reported to the DPH. Despite code status, something should be done for this poor woman. She is probably in pain. Does she have a bowel protocol? I've had many new nurses tell me a resident has no bowel sounds only to go listen for myself. Sometimes it takes a while to hear them. In the absence of all bowel sounds or hypo active sounds, notify the MD.