Small Bowel Obstruction Nursing Diagnosis & Care Plan: Assessment & Interventions

Small Bowel Obstruction Nursing Diagnosis & Care Plan

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What is Small Bowel Obstruction?
Causes
Signs & Symptoms
Small Bowel Obstruction Nursing Diagnosis
Expected Outcomes & Goals
Small Bowel Obstruction Nursing Interventions
Small Bowel Obstruction Care Plan Examples
Additional Resources

When a small bowel obstruction strikes, nurses are on the front lines, assessing symptoms, managing interventions, and keeping complications in check.

A solid nursing diagnosis for small bowel obstruction (SBO) lays the groundwork for effective treatment, helping to relieve symptoms, restore bowel function, and get patients on the road to recovery.

What is Small Bowel Obstruction?

An SBO requires prompt assessment and intervention to prevent serious complications.

Recognizing its signs and causes is the first step in developing an effective nursing diagnosis for bowel obstruction and care plan. To fully understand how this condition impacts the body, it’s important to explore its pathophysiology and how it differs from a large bowel obstruction (LBO).

Definition and pathophysiology

An SBO occurs when there is a partial or complete blockage of the small intestine, preventing the normal passage of food, fluids, and gas.

If untreated, this results in fluid accumulation, electrolyte imbalances, and possible bowel ischemia.

Difference between small and large bowel obstruction

SBO: More common, typically caused by adhesions, hernias, or tumors, leads to frequent vomiting and severe cramping.

LBO: Often associated with colon cancer, volvulus, or diverticulitis, presents with gradual distension and constipation.

Causes of Small Bowel Obstruction (Related To)

Obstructions can be mechanical — caused by a physical blockage — or non-mechanical, where the intestines lose their ability to function properly.

The most common cause is mechanical obstruction, which occurs when scar tissue, hernias, or tumors physically block the small intestine.

Mechanical obstruction

Adhesions (scar tissue from previous surgery)
Hernias (intestine trapped in abdominal wall)
Tumors or strictures (blockage from growths or scarring)
Intussusception (telescoping of intestine into itself)

Non-mechanical obstruction

Neurological disorders (stroke, spinal cord injury)
Postoperative ileus (temporary paralysis after surgery)
Electrolyte imbalances (hypokalemia, hypocalcemia)

Postoperative complications

Bowel adhesions (most common cause of SBO after surgery)
Peritonitis or infections leading to inflammation

Signs and Symptoms (As Evidenced By)

Catching a small bowel obstruction early is key to avoiding serious complications.

A proper assessment helps shape the nursing diagnosis for intestinal obstruction and guides the best course of action. Keep an eye out for these signs to intervene quickly and keep the condition from getting worse.

Gastrointestinal symptorationms
Abdominal distension and bloating
Severe, cramping abdominal pain (wave-like, colicky)
Nausea and profuse vomiting (bilious or feculent if severe)
Inability to pass gas or stool (complete obstruction)
Physical examination findings
High-pitched bowel sounds (early stage) or absent sounds (late stage, paralytic ileus)
Tenderness or rigidity upon palpation
Signs of dehydration (dry mucous membranes, hypotension)

Nursing Assessment for Small Bowel Obstruction

A solid nursing assessment is the first step in identifying a small bowel obstruction and tracking its progression.

Nurses gather objective findings from exams and subjective symptoms from the patient to guide the nursing diagnosis and determine the best care plan.

Objective (Nurse-Assessed Findings)

Bowel sound assessment: High-pitched sounds initially, then absent in severe cases
Abdominal distension measurement: Measure and document changes
Vital signs: Monitor for tachycardia, hypotension (signs of dehydration)
Fluid and electrolyte balance: Decreased urine output, abnormal lab values

Subjective (Patient-Reported Symptoms)

“I feel sharp, cramping pain in my abdomen.”
“I feel bloated and haven’t had a bowel movement in days.”
“I keep vomiting and can’t keep anything down.”

Laboratory and Imaging Studies

Abdominal X-ray or computed tomography scan – Confirms obstruction and identifies location

Complete blood count – Elevated white blood count if infection present

Electrolyte panel – Monitors dehydration status (sodium, potassium imbalances)

Nursing Diagnosis for Small Bowel Obstruction

A solid nursing diagnosis for small bowel obstruction sets the stage for the right interventions and better patient outcomes.

Identifying key problems early helps prioritize care and prevent complications.

Here are the top nursing diagnoses to focus on:

Acute pain related to bowel distension and obstruction
Dysfunctional gastrointestinal motility related to impaired peristalsis
Risk for deficient fluid volume related to vomiting and NPO (nothing by mouth) status
Imbalanced nutrition: Less than body requirements due to inability to absorb nutrients
Risk for Infection related to potential bowel perforation or sepsis

Expected Outcomes & Nursing Goals

A nursing care plan sets clear goals to keep patients on track and prevent complications.

These short-term and long-term goals help guide care, relieve symptoms, and support recovery.

Short-Term Goals:

Pain relief through appropriate interventions
Bowel decompression to reduce abdominal distension
Maintenance of fluid balance through IV hydration
Prevention of nausea and vomiting

Long-Term Goals:

Restoration of normal bowel function
Patient adherence to dietary and lifestyle modifications
Prevention of complications such as bowel perforation

Nursing Interventions for Small Bowel Obstruction

Managing a small bowel obstruction is all about relieving symptoms, preventing complications, and getting the bowels back to normal.

Nurses play a key role in monitoring changes, keeping patients stable, and choosing the right nursing interventions for a patient with small bowel obstruction. The following steps help guide care and improve patient outcomes.

Monitoring and assessment interventions

Assess bowel sounds and abdominal girth regularly to track changes
Monitor for signs of perforation (fever, rebound tenderness, tachycardia)
Strict intake and output (I&O) monitoring to assess hydration and urine output

Management interventions

Maintain NPO status to allow bowel rest
Insert and manage nasogastric (NG) tube for gastric decompression
Administer IV fluids (normal saline or Lactated Ringer’s) and electrolyte replacement

Pharmacological interventions

Pain management with opioids (use cautiously to avoid worsening ileus)
Antiemetics (Ondansetron, Metoclopramide) for nausea control
Antibiotics if infection is suspected (Ceftriaxone, Metronidazole)

Surgical interventions (if necessary)

Bowel resection for necrosis or strangulation
Lysis of adhesions to remove mechanical blockages

Small Bowel Obstruction Nursing Care Plan Examples

Developing a structured nursing care plan for bowel obstruction helps ensure effective pain management, symptom relief, and patient recovery.

Each care plan focuses on a specific nursing diagnosis and outlines key assessments, expected outcomes, and interventions. The following examples provide a step-by-step approach to managing common complications associated with small bowel obstruction.

Care Plan #1: Acute Pain Related to Bowel Distension

Nursing Diagnosis

Acute pain related to bowel distension as evidenced by severe cramping, facial grimacing, and guarding behavior.

Expected Outcomes

Patient will report a pain score <4/10 after interventions.
Patient will demonstrate improved comfort and relaxation.

Assessment

Monitor pain intensity using the PQRST method.
Assess effectiveness of pain medications.

Interventions

Administer analgesics as prescribed.
Encourage semi-Fowler’s position to relieve pressure.
Provide relaxation techniques (deep breathing, guided imagery).

Care Plan #2: Dysfunctional Gastrointestinal Motility

Nursing Diagnosis

Dysfunctional gastrointestinal motility related to impaired peristalsis as evidenced by absent bowel sounds, bloating, and vomiting.

Expected Outcomes

Patient will regain normal bowel sounds and peristalsis.
Patient will pass gas or stool within 24-48 hours post-intervention.

Assessment

Monitor NG tube output and abdominal distension.
Check for return of bowel function (gas, bowel sounds).

Interventions

Maintain NG tube placement and document drainage.
Encourage early ambulation to stimulate motility.
Monitor for signs of perforation or worsening obstruction.

Care Plan #3: Risk for Deficient Fluid Volume

Nursing Diagnosis

Risk for deficient fluid volume related to vomiting and NPO status.

Expected Outcomes

Patient will maintain stable blood pressure and urine output.
Patient will demonstrate adequate hydration with normal electrolyte levels.

Assessment

Monitor daily weights and urine output.
Check electrolyte levels (sodium, potassium, BUN, creatinine).

Interventions

Administer IV fluids and electrolytes as ordered.
Monitor for dehydration signs (dry mucous membranes, hypotension).
Educate on gradual oral rehydration when bowel function returns.

Prevention of Small Bowel Obstruction and Complications

Preventing a small bowel obstruction starts with proactive care, especially for patients at higher risk due to past surgeries or underlying conditions.

The following strategies help maintain bowel health and prevent future obstructions.

Dietary modifications (high-fiber diet, avoiding gas-forming foods)
Postoperative care (early ambulation, minimizing adhesions)
Hydration and lifestyle strategies to prevent constipation

Patient Education & Discharge Planning

Teaching patients what to watch for after discharge is as important as treating the small bowel obstruction.

Proper education helps prevent complications and keeps them from returning to the hospital.

Here’s what patients need to know to stay on track and manage their condition at home:

Recognizing early symptoms of obstruction (bloating, pain, nausea)
Adopting a bowel-friendly diet
When to seek emergency medical attention (persistent vomiting, severe pain)

Recommended Resources for Small Bowel Obstruction

Need reliable, up-to-date info on small bowel obstruction?

These trusted resources offer the latest guidelines and best practices for assessment, treatment, and prevention.

Nursing Care Plan Resources

Small Bowel Obstruction Nursing Care Made Simple

A well-structured nursing care plan for a patient with small bowel obstruction ensures timely assessment, effective interventions, and proper patient education.

Nurses play a key role in preventing complications by monitoring bowel sounds, maintaining hydration, and managing treatment. Staying proactive and following best practices promotes recovery and reduces the risk of recurrence.

References and Sources

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2022). Nursing care plans: Guidelines for individualizing patient care (11th ed.). F.A. Davis.
Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). Elsevier.
National Institute of Health (NIH). (2024). Digestive Diseases and Intestinal Obstruction.
Schick, M. A., Kashyap, S., Collier, S. A., & et al. (2025). Small bowel obstruction. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK448079/