A patient reports gas pains and abdominal distention 2 days after a small bowel resection. Which nursing action should the nurse take?
A.
Administer morphine sulfate.
B.
Encourage the patient to ambulate.
C.
Offer the prescribed promethazine.
D.
Instill a mineral oil retention enema.
The Correct Answer and Explanation is:
The correct answer is B. Encourage the patient to ambulate.
Explanation:
Abdominal Distention and Gas Pains Post-Small Bowel Resection: After a small bowel resection, it is common for patients to experience gas pains and abdominal distention due to postoperative changes in bowel function. These symptoms are often related to the accumulation of gas in the gastrointestinal tract and can be exacerbated by the inactivity following surgery.
Nursing Actions and Rationale:
A. Administer morphine sulfate: Morphine sulfate is an opioid analgesic that can be used to manage pain; however, opioids can also contribute to constipation and decreased bowel motility, which can worsen abdominal distention and gas pains. Thus, while morphine might be prescribed for pain management, it is not the best choice for addressing gas pains and distention specifically.
B. Encourage the patient to ambulate: Encouraging the patient to ambulate is the most effective action for managing postoperative gas pains and abdominal distention. Ambulation helps to stimulate bowel activity and promotes the passage of gas through the intestines. Physical activity facilitates peristalsis and reduces the accumulation of gas, which in turn alleviates abdominal discomfort and distention. Early ambulation is a critical aspect of postoperative care, as it also helps prevent complications such as deep vein thrombosis (DVT) and pulmonary embolism.
C. Offer the prescribed promethazine: Promethazine is an antihistamine with antiemetic properties used to prevent nausea and vomiting. While it can be helpful in managing postoperative nausea, it does not directly address gas pains or abdominal distention and is not the primary intervention for these symptoms.
D. Instill a mineral oil retention enema: Mineral oil enemas are used to soften stool and facilitate bowel movements. However, in the immediate postoperative period following a small bowel resection, using an enema might not be appropriate without specific medical orders. It is generally more prudent to focus on non-invasive methods, such as ambulation, to manage postoperative bowel issues initially.
In summary, encouraging ambulation is a practical and effective way to address gas pains and abdominal distention after surgery, supporting bowel function and overall recovery.