Hi all. I have had a few patients recently that have developed ilieus post c-section. I am putting this in the general thread because I know that patients develop it from other surgeries as well.
What I don't understand is what I can do to catch it early and hopefully prevent it. Usually when there is stomach pain, we start with pain meds, warm compresses and ambulation as a means of moving the gas through. Our patients are able to eat as soon as they are up to it, whether they have passed gas or not, which I think contributes to it.
Anyway, if it doesn't help they get softly distended and the normal nursing management is then more ambulation, warm drinks, no straws, simethicone as ordered.
The first patient that I had developed increasingly severe pain in her abdomen that worsened steadily, came and went, was only minimally helped with percocet and prevented her from ambulating. She also vomited from the pain. I ran like a madwoman calling doctors and went up the chain of command as best I could without much luck. I was told to 'continue to monitor'. By the grace of god the patient's attending came, took one look, ordered IV morphine stat and imaging. I found out the next day that the patient had a small ilieus that resolved on its own.
The second patient had some pain, not too much. Was softly distended but able to walk. We did hot packs and warm tea and pain meds and she was made comfortable. She ended up with a big ilieus and an NG tube.
Both patients were passing flatus, both were on percocet q4hprn, ibuprofen q6hprn, colace bid and simethicone pchs.
What on earth did I miss? Is there something that I can do to help prevent this? I admit I don't fully understand the pathology. A nurse I work with said its a blockage in the intestine. Would colace benefit? (Both patients were on it bid anyway). The first patient I had go NPO for a while after vomiting, per standard. The other one, who had a worse case, was eating and drinking fine.
I just feel like I missed something, or I should have done something but I don't know what it was.
