Nursing Diagnosis for Bowel Obstruction

[Nurse Beth, MSN]

Hannahbanana said:

Students, you don't PICK diagnoses from a list based on a medical diagnosis. You can consider them, assess for them, think about them... but until you do an actual assessment, you cannot write them down as plan faits accomplis.

You are right. These are just possible suggestions.

[londonflo]

Veteran here from a volvulus colon surgery and a 10 year later incarcerated hernia  surgery 7 days of waiting for colon surgeons or general surgeons to take the surgery.   This post relates to my hernia repair. I was returned to my room late afternoon. Slept off and on. I woke more clear headed at midnight and asked to walk. Asked again about every 6 hours, this got me out of the hospital, I ran in to residents in the hall who said "your up!". Had surgery  on Friday, out on Tuesday. Had a BM on Tuesday morning, general surgeon said you 'got your self out of here". My son who is a general surgeon was forecasting doom and gloom but remember: 1) keep them walking 2) deep breathing  3) up in the chair most of the day. 

I was offered one assist with personal hygiene for a stay of 11 days. No change of sheets. 

[Nurse Beth, MSN]

londonflo said:

Veteran here from a volvulus colon surgery and a 10 year later incarcerated hernia  surgery 7 days of waiting for colon surgeons or general surgeons to take the surgery.   This post relates to my hernia repair. I was returned to my room late afternoon. Slept off and on. I woke more clear headed at midnight and asked to walk. Asked again about every 6 hours, this got me out of the hospital, I ran in to residents in the hall who said "your up!". Had surgery  on Friday, out on Tuesday. Had a BM on Tuesday morning, general surgeon said you 'got your self out of here". My son who is a general surgeon was forecasting doom and gloom but remember: 1) keep them walking 2) deep breathing  3) up in the chair most of the day. 

I was offered one assist with personal hygiene for a stay of 11 days. No change of sheets. 

Glad it turned out well. The lack of care is appalling, and I wish I could say I'm surprised.

[Hannahbanana, BSN, MSN]

Nursing diagnosis is not dependent on medical diagnosis. 
Let that sink in. 
I realize that most "nursing diagnosis handbooks" are organized by medical diagnosis, which context is largely responsible for perpetuating the idea that nursing is dependent on and subservient to medicine, forever situated on a lower rung of the hierarchical ladder. This is, tragically for our profession, wrong.

The header for this thread does the same.

There is NO SUCH THING AS A NURSING DIAGNOSIS FOR BOWEL OBSTRUCTION. Sorry to shout. See above. 

[Nurse Beth, MSN]

Hannahbanana said:

Nursing diagnosis is not dependent on medical diagnosis. 
Let that sink in. 
I realize that most "nursing diagnosis handbooks" are organized by medical diagnosis, which context is largely responsible for perpetuating the idea that nursing is dependent on and subservient to medicine, forever situated on a lower rung of the hierarchical ladder. This is, tragically for our profession, wrong.

The header for this thread does the same.

There is NO SUCH THING AS A NURSING DIAGNOSIS FOR BOWEL OBSTRUCTION. Sorry to shout. See above. 

I hear you. You are correct. This thread was started in 2008 and was so named, probably by the OP. I was asked to update it under the same title, so I worked within those constraints. 

[londonflo]

Hannahbanana said:

most "nursing diagnosis handbooks" are organized by medical diagnosis, which context is largely responsible for perpetuating the idea that nursing is dependent on and subservient to medicine, forever situated on a lower rung of the hierarchical ladder. This is, tragically for our profession, wrong.

Trying to get a concept-based format curriculum established is harder than herding cats. Any advice? 

[Nurse Beth, MSN]

Hannahbanana said:

Nursing diagnosis is not dependent on medical diagnosis. 
Let that sink in. 
I realize that most "nursing diagnosis handbooks" are organized by medical diagnosis, which context is largely responsible for perpetuating the idea that nursing is dependent on and subservient to medicine, forever situated on a lower rung of the hierarchical ladder. This is, tragically for our profession, wrong.

 

100% 

[Hannahbanana, BSN, MSN]

londonflo said:

Trying to get a concept-based format curriculum established is harder than herding cats. Any advice? 

Absolutely. Assign them the NANDA-I most current edition before they ever have their first clinical. Have the bookstore stock it. The first chapter or two are written for students (and in my business, for laypersons and anyone else who still thinks all nurses do is "follow doctors orders”). This will get them in the right frame of mind of learning to think like a nurse from the git-go. This is NOT the 80s NANDA that our instructors learned to eyeroll about, or the 2010s one that was still a bit old fashioned. It'll be a revelation. 

Be prepared to spend a bit of time on this; you're doing remedial work here. But it will not be wasted time, believe me. 

The concept is simple: the ANA definition of what nursing IS. Look it up, put it up in the screen, give them a copy to keep in the front if their notebooks or the opening screen on their laptops. Refer to it often. They need to learn what nurses are before you can teach them the tasks they call "skills”— make sure they internalize this before they do anything else.

This will work. I promise you. 

 

 

[subee, MSN, CRNA]

IMHO, the biggest risk for this patient is a rupture in the intestine.  It only has to be a pinhole to cause peritonitis so I would put signs for sepsis at the top of the list.  Pain would be #2 since the patient is losing the will to live.  All this concentration on medical diagnosis is a waste of  time and energy.  What are the most important things you want the next nurse to know when handing this patient over?