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May 2010, Volume 40 Number 5 , p 72 - 72


  • Ellen Pfadt MSN, RN
  • Dorothy S. Carlson DEd, RN


YOU'RE CARING FOR Tom Williamson, 65, in the postoperative vascular surgical unit. Mr. Williamson says he has crampy left lower abdominal pain and feels an urgent need to move his bowels. You assist him to the bathroom where he passes a moderate amount of bright red bloody diarrhea. After you assist him back to bed, he states he feels nauseated and still has abdominal pain. He has two more bloody diarrhea stools within the next 45 minutes.Two days ago, Mr. Williamson had an aortoiliac aneurysm repair via an open surgical approach. He's receiving subcutaneous enoxaparin for prevention of deep vein thrombosis. He has a 40 pack-year smoking history, as well as a history of coronary artery disease, hypertension, hypercholesterolemia, and hypertriglyceridemia. His temperature is 99.8° F (37.7° C); apical pulse, 92; respirations, 22; BP, 140/88; and SpO2, 93% on room air. When you assess his abdomen, you note distension and hypoactive bowel sounds.Based on your assessment

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