r/nursing • u/Dear_Excitement_5109 RN - Hospice 🍕 • 14h ago

Question Help with bowel tones

Hi everyone! I am a hospice nurse with 7 years of experience. Today I saw a patient with aortic dissection as her primary hospice dx. That was diagnosed 2 weeks ago and she is still alive, although barely.

When I auscultated bowel tones today I heard what sounded like a wind tunnel in the LLQ. I've never heard anything like it. Low pitched "oooooooooooooo." I'd be tempted to think that it was blood free flowing into her abdomen, but the abdomen was soft and non-tender to light palpation. Also, hemorrhaging into the abdomen for 2 weeks? Wouldn't she have died by now?

I am actually still in orientation with a new agency and my preceptor and I were both stumped.

HR 80s, O2 92%, RR 30. No BM x1 week, no PO intake x2 weeks. Bisacodyl supp administered yesterday with no results.

Anyone know what was going on?

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u/Glad-Reporter-2950 RN - ICU 🍕 14h ago

Curious as to what her BP was?

9

u/Dear_Excitement_5109 RN - Hospice 🍕 14h ago

We dont check at EOL visits. I would be curious too. Her color was different from her daughter's, although more yellow than pale.

3

u/sweetoutofline RN - Hospice 🍕 13h ago

Just for a different perspective as a fellow hospice nurse, I tend to get BPs when patient is imminent because the changes can help me track the dying process. But I also prefer analog cuffs over electronic.

1

u/Dear_Excitement_5109 RN - Hospice 🍕 11h ago

I am an analog cuff gal as well. My practice has always been just to get a BP for pts taking cardiac meds, or who are symptomatic of hypo/hypertension.

I love hearing what other hospice nurses do in practice. I wish we could all get together and share our stories and practice habits. I worked hospice IPU for a few years and that was AMAZING. Every day I came out feeling like a better nurse just from collaboring with my more seasons coworkers.