A nurse is caring for a client who developed paralytic ileus after a stroke. The client reports nausea, abdominal discomfort, and distension; bowel sounds are absent. Which prescription does the nurse question?

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Paralytic ileus is characterized by temporary paralysis of a portion of the bowel, which affects peristalsis and bowel motility. Signs and symptoms include abdominal discomfort, distension, and nausea/vomiting. Risk factors for paralytic ileus include: Abdominal surgery Perioperative medications (eg, anesthesia, analgesics) Immobility (eg, stroke) To prevent further abdominal distension and resulting nausea, the client should remain NPO. Nasogastric tube to wall suction may be necessary to decompress the stomach (Option C). IV fluid and electrolyte replacement (eg, normal saline) may be necessary to correct losses that occur from nasogastric suction (Option B). Nausea can be treated with prescribed antiemetics (eg, ondansetron, promethazine) (Option D). (Option A) The client should not take medications by mouth (due to NPO status), and opioid medications should be avoided as they prolong paralytic ileus. Instead, non-opioid IV analgesics (eg, ketorolac, ibuprofen, acetaminophen) should be administered as prescribed if the client is in pain. Educational objective: Opioid medications can worsen constipation and paralytic ileus and therefore should be avoided in high-risk clients (eg, stroke, post abdominal surgery).

A Nurse Is Caring for a Client Who Developed Paralytic