Question

Case Study

Chapter 45: Caring for Clients With Disorders of the Upper Gastrointestinal Tract

Mike Sharp, a 52-year-old male client, is admitted to the medical-surgical unit with a small bowel obstruction confirmed by abdominal X-ray showing abnormal quantities of gas and fluid in the small intestine partially blocking it. The client states that he has colicky pain, nausea, vomiting of stomach contents, and passed mucus and blood but has had no bowel movement. The abdomen is distended, and there are no bowel sounds present. The following orders are noted on the chart:

Admit to medical-surgical unit with small bowel obstruction. No known drug allergies.

Keep NPO; IV: D5 ½ NS at 125 mL/h.

Renal profile, liver profile, CBC with differential; report any abnormal labs

Place a Salem Sump to continuous low suction.

Measure abdominal girth every shift.

Hourly I&O; daily weights

The LPN/LVN needs to insert the Salem Sump and provide nursing management for the client receiving stomach decompression therapy.

a. Explain the nursing management of a client with the Salem Sump for gastric decompression.

b. What is the best way to assess for bowel sounds while the client has a Salem Sump?

Answer 1

a.The nursing management for a patient with Salem Sump are

• Ensure the tube is in position
• Connect it to the appropriate suction method to relieve gastric distension
• Measure the abdominal girth
• The tube has to be advanced by the nurse for about 2_4 "
• The color of the gastric content has to be assessed
• Place patient innrigjt lateral position to encourage draining
• Strictly the patient has to he givtn nothing by mouth
• The tube should bit be secured immediately bevause it is necessary to advance the catheter and empty the stomach content to relieve distension

b.Tue best way to asses bowel sounds when the client is on Salem Simp us by auscultation and hearing for the peristaltic movement.