When signs of bowel obstruction with risk of peritonitis are present, which action should the nurse take first?

• A. Administer the dose as scheduled concurrently with the IV fluids
• B. Notify the health care provider and insert a nasogastric tube and a urinary catheter
• C. Stop the IV fluids until the dose of antibiotics is administered
• D. Hold the dose until the health care provider arrives to evaluate Jessica

Answer: (B)

When there is a suspected bowel obstruction with risk of peritonitis, the priority is to involve the health care provider quickly and begin measures to decompress the GI tract and monitor the patient’s status. Notifying the physician is essential to get urgent orders for further management, including possible imaging, antibiotics, or surgery. In the meantime, inserting an nasogastric tube to decompress the stomach helps relieve distension, reduce vomiting and the risk of aspiration, and provide a route for drainage. A urinary catheter allows accurate monitoring of urine output, which is a key indicator of perfusion and fluid status in a patient who may be dehydrated or progressing toward sepsis. Together, these steps address immediate threats and keep the patient stable while awaiting definitive orders.

Other options don’t address the obstruction and potential peritonitis promptly. Administering a scheduled dose without addressing decompression doesn’t relieve the blockage or the risk of complications. Stopping IV fluids or delaying antibiotics until the provider arrives could worsen dehydration or delay critical treatment.