Understanding the physiology of bowel obstruction and its implications for patient assessment and management

2021 ◽  
Vol 19 (7) ◽  
pp. 18-24
Author(s):  
Maddie White

Bowel obstruction causes acute abdominal pain, and, if untreated, leads to strangulation of the bowel and may lead to the patient's death. The aetiology of small bowel obstruction and large bowel obstruction can involve mechanical (dynamic) or non-mechanical (adynamic) causes, as well as pseudo-obstruction, abdominal hernias and postoperative ileus. Assessment techniques include history taking, physical examination, imaging, biochemistry and endoscopic assessment. Intervention options include symptomatic, endoscopic and conservative management, as well as surgical treatment and palliative care. Clinical nurse specialists in colorectal, stoma and palliative care play essential roles in meeting the holistic needs of these patients.

2002 ◽  
Vol 16 (5) ◽  
pp. 386-394 ◽  
Author(s):  
Jane Seymour ◽  
David Clark ◽  
Peter Bath ◽  
Nicola Beech ◽  
Jessica Corner ◽  
...  

2018 ◽  
Vol 29 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Deborah M. Price ◽  
Mary Jo Kocan

2020 ◽  
Vol 25 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Jennifer M Hadley

Clear, sensitive and timely communication with palliative and end-of-life (EoL) patients and their families is important. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) conversations can help patients accept their impending death and achieve a more dignified death. This research explored the experiences and communication strategies of clinical nurse specialists (CNSs) in palliative care when managing DNACPR conversations in the community. Six semi-structured interviews were conducted with community palliative care CNSs, and the results were summarised using autoethnography. Delays in EoL discussions mean that some community palliative care CNSs are having DNACPR conversations at their first meeting with patients. Balancing being clear and sensitive is challenging, especially when patients and families have previously been informed inappropriately or insensitively about DNACPR decisions. DNACPR discussions should be initiated by exploring patient understanding and preferences while emphasising care continuation and a more dignified death.


2019 ◽  
pp. 405-437 ◽  
Author(s):  
Christopher Nutting ◽  
Dorothy Gujral

Chapter 18 covers head and neck cancer emphasising the importance of a multidisciplinary team, comprising specialist surgeons, oncologists, pathologists, radiologists, and palliative care doctors, together with dieticians, speech and language therapists, and clinical nurse specialists. Radiotherapy for tumours of oral cavity, oropharynx, larynx, hypopharynx and nasal sinuses are discussed. .


Author(s):  
Noora O. Rahimuddin ◽  
Fatma A. Al-Fodari ◽  
Laila M. Yatimi ◽  
Ahmed M. Alsaffar ◽  
Basmah K. Kadir ◽  
...  

Patients with pelvic and abdominal cancers usually present with bowel obstruction, especially peritoneal, colorectal, and pancreatic carcinomatosis. A poor prognosis has been reported for patients that suffer from gastrointestinal bowel obstruction secondary to later stage carcinomatosis, although maximal treatment approaches might have been administered. In this context, these patients are suggested to survive for only a few weeks to months, and parenteral nutrition did not enhance the outcomes in these situations. Medical treatment includes the administration of corticosteroids, opioids, anticholinergics, octreotide, and anti-emetics, while surgical outcomes might be more efficacious with more favorable clinical outcomes. However, these operations have been reported with multiple complications that might worsen the prognosis. Stent application is another non-surgical modality with fewer adverse events. Nevertheless, evidence regarding its superiority over the surgical approaches is conflicting among the different studies in the literature. Accordingly, further investigations are still needed for adequate validation.


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