Page 977 - Saunders Comprehensive Review For NCLEX-RN

B. Assessment

1. Newborns
a. Failure to pass meconium stool
b. Refusal to suck
c. Abdominal distention
d. Bile-stained vomitus
2. Children
a. Failure to gain weight and delayed
growth
b. Abdominal distention
c. Vomiting
d. Constipation alternating with diarrhea
e. Ribbon-like and foul-smelling stools
C. Interventions: Medical management

1. Maintain a low-fiber, high-calorie, high-protein

diet; parenteral nutrition may be necessary in extreme
situations.
2. Administer stool softeners as prescribed.
3. Administer daily rectal irrigations with normal saline
to promote adequate elimination and prevent
obstruction as prescribed.
D. Surgical management: Preoperative interventions
1. Assess bowel function.
2. Administer bowel preparation as prescribed.
3. Maintain NPO status.
4. Monitor hydration and fluid and electrolyte status;
provide fluids intravenously as prescribed for
hydration.
5. Administer antibiotics or colonic irrigations with an
antibiotic solution as prescribed to clear the bowel of
bacteria.
6. Monitor strict intake and output.
7. Obtain daily weight.
8. Measure abdominal girth daily.
9. Avoid taking the temperature rectally.
10. Monitor for respiratory distress associated with
abdominal distention.

E. Surgical management: Postoperative interventions

1. Monitor vital signs, avoiding taking the temperature
rectally.
2. Measure abdominal girth daily and PRN (as needed).
3. Assess the surgical site for redness, swelling, and
drainage.
4. Assess the stoma if present for bleeding or skin

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