Bowel Obstruction: NCLEX Priorities
SBO vs LBO: pain pattern, vomiting, distention, NG decompression, surgical indications.
Bowel obstruction is partial or complete blockage. NCLEX tests SBO vs LBO and conservative management.
SBO (small bowel)
Crampy periumbilical pain. Early bilious vomiting. Less distention initially. Causes: adhesions (most common), hernias, tumors.
LBO (large bowel)
Lower abdominal pain. Late vomiting (feculent). Marked distention. Causes: cancer, diverticulitis, volvulus.
Recognition
Constipation, no flatus, distention, vomiting. High-pitched then absent bowel sounds. AXR shows dilated loops, air-fluid levels.
Management
NPO, NG decompression, IV fluids. Many partial SBOs resolve conservatively in 48-72h. Surgery for complete obstruction, strangulation signs, or failure to resolve.
Strangulation
Fever, tachycardia, peritonitis, lactic acidosis. Surgical emergency.
Frequently asked
Functional vs mechanical obstruction?
Functional (ileus): post-op, electrolyte imbalance. Treatment: bowel rest, correct cause.
NG to suction or gravity?
Suction (low intermittent) for decompression. Gravity drainage for ongoing decompression after improvement.
Quick check
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