Clinical Reasoning Questions
1.What is the primary problem and what is the underlying cause/pathophysiology of this problem?
Postoperative paralytic ileus, cause is abdominal surgery with opioid analgesics.
2. What are your top 3 priority assessments?
Abdominal distention, Bowel sounds, pain
3. What are your top 3 lab tests/diagnostics
Abdominal X-ray, Barium enema, Ultrasound
4. What are the top 3 priority potential & actual complications
Necrosis, Dehydration, Electrolyte imbalance, Sepsis
5.What nursing assessments will identify complications EARLY if they develop?
Altered mental status, Bowel sounds, distention in abdomen
6. What are the top 3 priority medications?
Alvimopan; opioid antagonist, Lactulose, Methylnaltrexone
7.What are the top 3 priority education/discharge issues?
Fluid intake, mobility post op, nutrition
Rev. 8/19