The nurse caring for a client with small bowel obstruction would plan to implement which nursing intervention first?
A. Administering pain medication
B. Obtaining a blood sample for laboratory studies
C. Preparing to insert a nasogastric (NG) tube
D. Administering I.V. fluids
Correct Answer: D. Administering I.V. fluids.
I.V. infusions containing normal saline solution and potassium should be given first to maintain fluid and electrolyte balance. Maintenance of bowel rest requires alternative fluid replacement to correct losses and anemia. Fluids containing sodium may be restricted in presence of regional enteritis.
Option A: Pain medication often is withheld until the obstruction is diagnosed because analgesics can decrease intestinal motility. Provide comfort measures (back rub, reposition) and diversional activities. Promotes relaxation, refocuses attention, and may enhance coping abilities.
Option B: A blood sample is then obtained for laboratory studies to aid in the diagnosis of bowel obstruction and guide treatment. Blood studies usually include a complete blood count, serum electrolyte levels, and blood urea nitrogen level.
Option C: For the client’s comfort and to assist in bowel decompression, the nurse should prepare to insert an NG tube next. Resume or advance diet as indicated (clear liquids progressing to bland, low residue; then high-protein, high-calorie, caffeine-free, non-spicy, and low-fiber as indicated).
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