Challenge Your Exam Readiness With Our Free AOCNP Practice Questions

In malignant bowel obstruction where surgery is not feasible, symptom control focuses on reducing gastrointestinal secretions and edema and relieving nausea/vomiting. Octreotide (or lanreotide) decreases splanchnic secretions and NG output; dexamethasone reduces inflammatory edema and may transiently improve patency; antiemetics (haloperidol, olanzapine, serotonin antagonists) relieve nausea. NG decompression is useful acutely; a venting gastrostomy provides longer-term relief and discharge feasibility. Prokinetics like metoclopramide (Option A) can worsen colicky pain and are avoided in complete obstruction. TPN alone (Option C) does not palliate symptoms and is reserved for selected patients with potential for benefit. Declining to treat symptoms (Option D) is inconsistent with palliative goals; hospice can be combined with active symptom management. APRNs align plans with patient goals, address mouth care and fluid balance, manage opioids/anticholinergics for colic, assess for delirium due to dehydration/opioids, and coordinate home supports, ensuring frequent reassessment as disease evolves.