Case Study Paralytic Ileus

[boskampm15]

Hello everyone! I'm looking for help with a case study. It reads as follows:

You are caring for a patient who had abdominal surgery yesterday. The patient is restless and anxious and tells you that the pain is getting worse despite the pain medication. Physical assessment findings: VS- 140/90, 110, 24, 100.3F, abdomen is rigid and tender to touch. Bowel sounds are hypoactive. PCA with morphine is infusing.

The case study wants me to determine possible causes of the above situation. I'm thinking paralytic ileus but I can't find anywhere that describes how the vitals relate to that diagnosis.

[RainMom]

"...abdomen is rigid..." within 24 hrs of abdominal surgery leads me to think in a different direction which would account for the VS.

[Kuriin, BSN, RN]

Any time you hear "RIGID ABDOMEN", you need to think of a medical emergency.

[bgxyrnf, MSN, RN]

Hello everyone! I'm looking for help with a case study. It reads as follows:

You are caring for a patient who had abdominal surgery yesterday. The patient is restless and anxious and tells you that the pain is getting worse despite the pain medication. Physical assessment findings: VS- 140/90, 110, 24, 100.3F, abdomen is rigid and tender to touch. Bowel sounds are hypoactive. PCA with morphine is infusing.

The case study wants me to determine possible causes of the above situation. I'm thinking paralytic ileus but I can't find anywhere that describes how the vitals relate to that diagnosis.

Start with "rigid and tender" and the vital signs... this person is concerning for much bigger issues than an ileus... and is at risk for being dead in 24 hours.

What could make an abdomen rigid?

What could make a person tachycardic and tachypneic... and perhaps febrile (depending on antipyretics)?

Why might a patient's pain be getting worse and worse even with a PCA?

Also, "restless and anxious" in a person like this if concerning... why might that be?