Care plan help. Vomiting

Just because he was NPO does not mean he wouldn't be getting fluids....

Good luck to you. I absolutely hate care plans!

You can still assess bowel sounds. His clinical pathway is GI so that should be your point of care. If he is NPO he will have things such as altered nutrition intake, dry mucous membranes, you would need to assess bowel sounds for hyper or hypoactive sounds also palpate the abdomen as (peritonitis) can develop. Assess skin tugor, pain level etc.

My nursing Dx for this scenario would be:

1. Imbalanced nutrion less than body requirements

2. Impaired oral mucous membranes

3. Dysfunction gastrointestonal motility

Good Luck!

Manage pain

Administer meds

Assess vitals

Assess bowel sounds

educate patient on NPO status and additional s/s that may cause additional problems

I was thinking imbalanced nutrition as well. Just stuck on interventions. Obviously can't give him food, liquids, supplements.

It's the end of the quarter and my brain is fried or something. Here is what I have: 82 yo male, 7 days post op from a hemicolectomy, discharged and then returns to the ER complaining of vomiting and inabilty to eat. Turns out he had a small bowel obstruction. My problem is, I need an "anticipated nursing diagnosis" and one anticipated body system to assess. I'm thinking the GI system, but honestly, how do you assess that? listen for bowel tones? He was NPO so I can't use increase fluids as an intervention. Help, Please!!

What is your major concern in someone with a small bowel obstruction? What do you expect he will need once admitted?

Once again, you can't make a nursing diagnosis without a nursing assessment merely because you have a medical diagnosis.

Also, "administer meds" is not part of a nursing plan of care, it's one part of the medical plan of care that nurses implement. Difference. I know it's hard for students (and some nurses) to wrap their minds around this concept, but try. NCLEX is not interested in what physicians order, they're interested in nursing assessment and nursing decisions about nursing care. "Assessment" is not an intervention either-- you can assess until the cows come home, but if you aren't doing anything, you aren't doing anything. You can use assessment as a nursing order, and follow it with, "If... is found, then do this..." statements, though, because that requires some nursing judgment for you to order as part of the nursing plan of care, which you might be delegating.

I realize the OP has been asked to guess about what she might be seeing (presumably to get ready to do a focused assessment) based on the medical diagnosis. OP, think about what else happens to an old man with a bowel obstruction. He is much more than his GI tract. He'll have NG suction, so he's stuck in bed. Then what? What does an NG tube put him at risk for? If he has pain, what will pain meds do to his gut after he gets them? If he's not taking anything po, what's maintaining his BP and UO, and how do you know? Is he afraid, uncomfortable, unable to care for himself? Lots of things could be going on here. Look at the biggest picture from a nursing standpoint.