Can someone help me with a learning need?

if the patient is going to have surgery then there is pre-surgical teaching that needs to be done.

• http://www.surgeryencyclopedia.com/fi-la/intestinal-obstruction-repair.html - intestinal obstruction repair, the surgery
  
• http://www.upmc.com/healthatoz/patienteducation/documents/presurgery.pdf - pre- and postsurgery instruction sheet
  
  • deep breathing and coughing
    
  • leg exercises
    
  • post op pain relief
    
  • wound care
    
  • physical activity
    

by the way, your etiology on the acute pain diagnosis is incorrect. it must be something that is causing injury to the tissues or stimulating the pain receptors. saying "intestinal obstruction" isn't identifying the source of the pain well enough. the pain is because of pressure due to abdominal distension. the etiology of the nausea is quite simply due to gastric irritation because of the gi fluids that have no where to go because peristalsis has halted although the gi fluids that the gi track manufactures and secretes continues. it's why the docs make these patients npo and often order ng tubes for them. how you came to "stimulation of the visceral afferent pathways resulting from inflammation & distention of the intestine" is incorrect pathophysiology for the nausea. also, the patient is beyond a risk for fluid volume deficient due to intestinal obstruction. he would already have a fluid volume deficit or it has been corrected with iv fluid replacement since he has been hospitalized for a week. the fluid would be trapped in his intestinal tract where peristalsis has stopped and fluids are third spacing. see and read about paralytic ileus: http://www.merck.com/mmpe/sec02/ch011/ch011h.html (intestinal obstruction); http://www.merck.com/mmpe/sec02/ch011/ch011g.html (ileus)