Unfolding Case Study- Bowel ObstructionA 69-year-old male client with a history of colorectal cancer arrives at the ED and reports that he hasabdominal pain of 5/10 on a 0 to 10 pain intensity scale. The client reports a history of benign prematureventricular contractions (PVCs) and is taking metoprolol 50 mg twice daily for control. He tells the nursethat he recently completedchemotherapy treatments and since then has had extremefatigue, loss ofappetite, sores in his mouth and diarrhea. He is wondering if his symptoms are due to the effects ofchemotherapy. He reports no allergies.Nursing Assessment findings include:Vital signs: temperature= 99.2ºF (37.3ºC), apical heart rate= 90 beats/min and irregular withand occasional skipped beat, respirations= 24 breaths/ min, blood pressure (BP)= 168/90 mmHg,oxygen saturation= 93% on RA, abdominal pain 5/10 on a 0 to 10 pain intensity scale.Reports loss of appetite, vomiting, constipation with diarrhea containingblood streaks,abdominal distension and tenderness;mass in mid-abdomen palpated, bowel soundsare high-pitched tikling sounds; last bowel movement was during the night; weight is 145 lb (65.8 kg);reports a loss of 10 lb. (4.5 kg) in the last month.Breath sounds are clear bilaterally and client denies dyspnea or chest painSkin is intact, dry, withpoor turgor, sore white patches on mucous membranes in the mouthReportsurine output had decreased over the past week; denies burning or difficulty.
