A patient, recovering from an open cholecystectomy 3 days prior, has not passed any flatus since surgery. Which of the following would suggest to the nurse that the patient may be experiencing a life-threatening condition?

Question

1. falling blood pressure
2. respiratory rate 20
3. anorexia
4. hypoactive bowel sounds

Answer 1

1

Rationale: This patient is experiencing a possible small bowel obstruction. The patient has had abdominal surgery and the lack of flatus indicates that peristalsis has not returned. Hypotension is one characteristic of a "mass effect" that occurs within the intestines. Electrolyte imbalances and abdominal distention are other criteria of the "mass effect" which could lead to cardiovascular collapse and perforation of the intestinal wall. Anorexia and hypoactive bowel sounds are important but are expected with reduced peristalsis within the gastrointestinal tract. A respiratory rate of 20 is considered normal.