Saw my first disempaction yesterday! - page 4

I know this is silly, but I saw my first disempaction yesterday and I nearly lost my lunch (well, the little I'd had time to eat before being called away). How do you handle these things? Strangely... Read More

  1. by   HoustonRN
    The dead bowel story reminds me of when I was a baby nurse-- I had a little old lady from a nursing home who had come in for abd. pain. I assessed her and asked when the last time was she had a BM. She stated, 2 weeks. Well, I thought she was exaagerating. Later that evening I was feeding her clear liquids, and she kept "spitting" and the jello etc was hitting the wall at the foot of the bed. After asking her to stop spitting several times, I became angry and quit feeding her. While I was changing her gown I thought I saw her stomach move, but didn't think anything of it.

    WELL, it turns out she had a twisted gut! She was completely obstructed and what I had seen was visible peristalsis!! Now when they tell me they haven't had a BM for two weeks I believe them.
  2. by   gwenith
    I work with a consultant who regularly orders prune juice 40-100mls bd down the nasogastric to prevent constipation in long term ICU patients. We are also trially "Yokult" a liguid yoghurt acidophillus preparation for diahrrea
  3. by   Retired Nurse
    You can get used to most everything. It is the smells that tops it off. If you can turn and get a fresh breath!!!!! Once when I was holding the basin for a resident vomiting fecal matter, I ask the aide to bring another pan, but then didn't need it. It was worth it when the resident was so thankfull that I hadn't left her. (The least you can do for anyone near death)
  4. by   Streamlined
    This thread went from disimpaction to glass eyes so fast, I couldn't keep up. I'm pretty darn good at disimpacting. I always remember a nursing instructor telling us to think of it as getting tomato paste out of a can. This is not accurate, of course, but I smile imwardly and think of her saying this as I'm doing the deed. Use lots and lots of lube. Wear three or four gloves on your "working" hand to begin the job. You could, say, wear one size small, two size mediums and then a size large or whatever works best for your particular hand. Goes without saying, that you would warn your patient first for what you're about to do to them, along with the promise that they'll feel a helluva lot better. Introduce that digit slowly, aiming for the walls of the rectum as high as your well-protected finger will let you. SLOWLY "around the world" several times, then retract your finger and peel off the first layer of glove. Lube up again, keep repeating the slow spin around , attempting to make contact with the lumen of the rectum. No need to "dig out"--Jeez, I hate that expression--unless there's a very obvious and grabbable chunkette. Let the dig-stim and the lubricant do the work. Be patient. Keep the person warm and covered. Once you've explored the landscape in there, you might come to find out that there's room to tuck a suppository up against the intestinal musosa and then, well-Bob's your uncle! Try not to be grossed out. This is a skill to be proud of because you can offer so much relief in a well-educated and holistic way, thus utilizing all your best gifts. So, to summarize: lube, slow, multiple gloves and the Golden Rule.
  5. by   gizzy76
    Wonderfully put...thanks Streamlined!
  6. by   TiddlDwink
    I've known 'em all... those who couldnt stand phlegm, mucous, feces, vomitus, even blood! I think each of us has something... for me, it's the odor of an infected wound! Truly makes me want to puke!
  7. by   sb22
    I had a patient vomitting stool once. I almost threw up on the patient. The doctor wouldn't even go to the patient's room. He called to have the patient sent out to an acute care hospital (I work in a physical rehab facility) and filled out the transfer form. All I had to do was stay with the patient and not vomit on him. Believe ot or not the patient lived. He had a bowel obstruction.
  8. by   dosamigos76
    Vomiting stool? Oh geesh-I didn't know that was possible. Guess I'll be learning alot once I get in the Nursing Program.
  9. by   Jenni
    Originally posted by PerkyCardiacRN
    I can problem. Worked 4 years with vented/trached pts.

    Just keep the eyeballs away from me...especially the prostetic (sp?) ones.

    Ewww, that has to be the worst. Not much bugs me..but taking out someone's prosthetic eyeball and dropping it in a denture cup for the night just gets me.
  10. by   lrbuck
    My question is: If CNAs,LPNs,RNs,etc have to do the suctioning on trachs, what in the hell do Respiratory Therapists get paid for????