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Tuesday, October 27, 2020

Listening for bowel sounds: Nursing guidelines

 Listening for bowel sounds


 The client may feel uncomfortable or embarrassed when discussing bladder or bowel elimination. Be sure to provide privacy and demonstrate understanding.

  • Wash hands and position the client in a supine position. 
    • Positioning the client in this manner the major part of the abdomen to be accessible.
  • Expose the abdomen, but keep other areas of the client's body covered. 
    • This action maintains the client's privacy while allowing access to the abdomen. 
  • Warm the stethoscope in your hands.
    • The shock of a cold stethoscope can temporarily halt bowel sounds. 
  • Imagine the abdomen to be divided into four quadrants or regions. 
  • Place the flat side ( diaphragm ) of the stethoscope against the client's abdomen. 
    • The diaphragm offers coverage of a larger area than the bell and is useful in detecting high-pitched sounds. 
  • Begin in a particular quadrant each time you do this procedure. Continue in a clockwise -fashion around the abdomen. Always use the same pattern. 
    • Following the specific pattern promotes efficiency and helps you to listen to each area. This improves your chances of hearing all bowel sounds. 
  • Listen to peristalsis, which makes bubbling, gurgling, or clicking sounds that vary in intensity, frequency, and pitch. The sounds usually occur about every 5 to 20 seconds.      ( The normal range of bowel sounds is approximately 4 to 32 per minute ).
    • Substance including gas, are formed during normal digestion and peristalsis. The sounds are this substance ( wastes and food products ) moving via peristalsis within intestine. 
  • Continue to listen. If sounds are difficult to hear, listen for at least 5 minutes before concluding that sounds are absent.
    • Sometimes peristaltic movements pause or there is a minimum of gas for a short time.
  • Bowel sounds are described as audible, hypoactive, hyperactive, or inaudible. If you are unable to hear bowel sounds if they are very slow or very fast, this often indicates a serious condition and must be reported immediately. Hyperactive bowel sounds may indicate diarrhoea or early bowel obstruction. Bowel sounds are often hypoactive( or absent )after abdominal surgery or in late bowel obstruction or paralytic ileus and are often affected by spinal cord trauma. 
    • It is important to communicate clearly so the proper diagnosis and treatment can take place. A situation such as bowel obstruction can be life-threatening. 
  • Wash or sanitize your hands and document your findings on the clients record. 
    • Documentation provides communication about the client intestinal motility and enhances continuity of care.

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