NURSING DIAGNOSIS: Altered comfort: abdominal distention and gas pain

related to accumulation of gas and fluid in the gastrointestinal tract associated with:
  1. decreased peristalsis resulting from manipulation of the bowel during abdominal surgery and depressant effect of anesthesia and some medications (e.g. narcotic [opioid] analgesics);
  2. decreased activity.
Desired Outcome
The client will experience diminished abdominal distention and gas pain as evidenced by:
  1. verbalization of decreased abdominal fullness and pain
  2. relaxed facial expression and body positioning
  3. decrease in abdominal girth.
Nursing Actions and Selected Purposes/Rationales
  1. Assess for signs and symptoms of abdominal distention or gas pain (e.g. verbal reports of abdominal fullness or gas pain, clutching or guarding of abdomen, restlessness, reluctance to move, grimacing, increasing abdominal girth).
  2. Implement measures to reduce the accumulation of gas and fluid in the gastrointestinal tract:
    1. encourage and assist client with frequent position changes and ambulation as soon as allowed and tolerated (activity stimulates peristalsis and expulsion of flatus)
    2. instruct the client to avoid activities such as chewing gum, drinking through a straw, and smoking in order to reduce air swallowing
    3. maintain patency of nasogastric, gastric, or intestinal tube if present
    4. maintain food and oral fluid restrictions as ordered
    5. when oral intake is allowed, instruct client to avoid intake of carbonated beverages and gas-producing foods (e.g. cabbage, onions, beans)
    6. encourage client to expel flatus whenever the urge is felt
    7. consult physician regarding insertion of a rectal tube or administration of a return flow enema if indicated
    8. encourage use of nonnarcotic analgesics once the period of severe pain has subsided (narcotic [opioid] analgesics depress gastrointestinal activity)
    9. administer gastrointestinal stimulants (e.g. metoclopramide, bisacodyl) if ordered to increase gastrointestinal motility.
  3. Consult physician if signs and symptoms of abdominal distention and gas pain persist or worsen.