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NUR1400 GI

Gastrointestinal Disorders

Diet for GERD Diet: Reduction of acidic foods, no alcohol, cafeine, nicotine, avoidance of NSAIDS (Motrin). No eating before bedtime. Reduced fatty foods, avoid chocolate.
Fundoplication Surgery done to tighten the lower esophageal sphinchter. Fundus of stomach is wrapped around esophagus making a valve. Used in GERD.
Complications from Gastric Resections Dumping Syndrome
Effects of Aging on the Digestive Tract slower motility, intestinal wall weakens- diverticuli may form, decreased liver mass and bblood flow
Nursing Procedure for Minnesota or Sengstaken Blakemore tube (used in esophageal varices) Ballooon is periodically deflated, Iced isotonic saline lavages may be given through tube, During procedure: Pt. NPO, HOB up 30-45 degrees
Pharmological treatment of Esophageal Varices Octreotide (Sandostatin)given IV helps control bleeding to gut. Analgesics can be given: Avoid NSAIDS, aspirin, and anticoagulants.
Gastritis- inflammation of stomach mucosa when exposed to medications, smoke, food allergens or toxins Treatment: Antacids and H2 histamine receptor antagonists, proton pump inhibitors. If h pylori present, Bismuth preparations are used. Avoid NSAIDS.
Ulcers Stress ulcers form when gastritis starts bleeding; Gastric Ulcers caused by NSAIDS, smoking, alcohol, food allergens, toxins, h. pylori bacteria, and imparied mucosal defenses.
Diet for Ulcers Avoidance or consume in small amounts: milk, coffee, tea, cola, chocolate. No eating before bedtime- increases nocturnal acid secretion.
Crohn's disease (Definition) Lesions that affect the entire thickness of the bowel. Can occur anywhere in the small and large intestines (cobblestone appearance).
Ulcerative Colitis (Potential Complications) Increased risk of colon cancer
Ulcerative Colitis (Definition) An inflammatory disease of the clon and rectum; affects olny the mucosal lining of the bowel.
Ulcerative Colitis (Diagnostic Procedures) Abd xrays, stool for occult blood, mucous (C &S), colonoscopy, sigmoidoscopy, barium enema, endoscopy.
Intestinal Obstruction (Signs and Symptoms) Colicky abd pain, nausea, vomiting (could be fecal material), constipation, bloating.
Types of Obstructions Neurogenic- nerves blocked Vascular- Blood flow blocked Mechanical- tumors, fecal impact-twisted bowel (intussception) TREATMENT IS: NG tube for decompression; IV fluids, Bowel resection to remove bowel affected by obstruction.
Treatment of Hernias:TypesHiatal)portion of stomach goes above diaphragm into esophageal area.Umbilical(bowel through umbilicus,Femoral(can cause numbness tingling of feet,legs-absent pedal pulses when bowel pushes into leg area). Inguinal (groin area) May have surgeries. Diet for hiatal-avoid meals at bedtime; small frequent meals, avoid aggravating foods. If no surgery, a truss may be used to support
Medication: Zofran (Used for ?) Helps nausea and vomiting
Nursing Interventions needed after surgery for peritonitis Good pulmonary hygiene: Incentive spirometry, Cough and deep breathe, turing and respostioning, posteral drainage.
Peritonitis (defintion) Inflammation of the membrane covering the abdomen caused by fecal, gastric acid, bacteria, or blood. Common cause: ruptured appendix, ruptured tubal pregnancy, invasion of tumors.
Hepatitis A (transmission mode) Inflammation of the liver. Fecal oral route (can get from contaminated foods and water) Person to person.
Hepatitis B (transmission mode) Inflammation of the liver. Blood or body fluids from infected person
Hepatitis C (transmission mode) Inflammation of the liver Blood
Hepatitis D (transmission mode) Inflammation of the liver Only people with Hep B can get D; blood and blood products; needlesticks
Hepatitis E (transmission mode) Oral- fecal route. contaminated water; person to person is not common.
Stages of hepatitis: preicteric- flu like vomiting diarrhea Icteric- jaundice increased bilirubin Post icteric recovering increased energy, decrease pain, decrease jaundice, urine stool normal.
Pancreatitis- inflammation when enzymes digest the lining of pancreass- obstruction of pancreatic duct, tumors, or exposures to toxic chemicals or alchol. Diagnostic Procedures are: Endoscopic retrograde cholangiopancreatogram (ERC) will check pancrease, gall bladder, and ducts.
Labs drawn with pancreatitis Elevated serum amylase elevated bilirubin, Check H & H, Check electrolytes.
Cholecystitis (definition) inflammation of gallbladder
Diet for cholecystitis Low fat
Signs and symptoms of cholecystitis pain in upper quad which radiates to the right scapula, nausea, gassiness, flatulence, fever
Cholelithiasis (definition) presence of glasstones or calculi in gallbladder
Treatment of cholelithiasis Laproscopic cholecystecomy (surgery of choice)
Colorectal cancer (diagnostic procedure) fecal occult blood colonoscopy
Colorectal cancer (3rd most common cancer- diet high in fat and low fiber can contrinute to it) Risk if >50 and ulcerative colitis Treatment is: surgical removal of cancer either polps by polpectomy or resection of colon. Colostomy may be needed. Chemotherapy
Liver Cancer (signs and symptoms) abd discomfort, pain, anorexia, weight loss, jaundice, signs of cirrhosis.
Liver Cancer (Diet) Low sodium (if fluid in abd), low protein, may need fluid restriction.
Nursing interventions for (EGD-esophagostroduodenoscopy) Check the gag refex
Gastritis (Diet) Avoid milk, coffee, tea, colas, chocolate, no smoking, or alcohol.
Gastric Ulcers (signs and symptoms) Complain of epigastric pain 1 - 2 hours after eating, nausea, bloating.
Normal total bilirubin serum level - Adult 0.1 to 1.0 mg/dl
Normal serum albumin level- Adult 3.5 to 5.o g/dl
Treatment for peptic ulcers: Surgical and pharmacological. Vagotomy-vagus nerve is cut which supplies the innervation to the fundus of stomach. This eliminates HCL acid, and decreases gastrin hormone, slows motility of stomach. H2 blockers, proton pump inhibitors, prostoglandins, bismuth preparations.