A patient with suspected small bowel obstruction presents with vomiting, abdominal distension, and absent bowel sounds. What is the initial nursing action?

• A. Administer laxatives
• B. Start IV fluids and prepare for surgery
• C. Keep NPO, place patient on bed rest, and prepare for NG tube; monitor
• D. Administer antiemetics

Answer: (C)

The situation calls for protecting the patient from aspiration and beginning bowel decompression. In suspected small bowel obstruction, vomiting and abdominal distension with absent bowel sounds point to a blockage in the intestine, so the most immediate priority is to keep the patient NPO to prevent any oral contents from being aspirated if vomiting recurs. Placing the patient on bed rest helps minimize movement and discomfort and keeps monitoring straightforward, while preparing for an nasogastric tube to suction allows immediate decompression of the stomach and proximal bowel. This reduces vomiting, lowers distension, and decreases the risk of aspiration, all of which are crucial in the initial management. Ongoing monitoring of vital signs, fluid status, and abdominal findings guides timely escalation if the obstruction worsens or complications develop. While starting IV fluids is important to treat dehydration and electrolyte losses, the described initial action focuses on preventing complications and decompressing the obstruction rather than medications or laxatives, which can worsen the condition.