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Chapter 46

Unit 7: Nursing care of clients with gastrointestinal disorders

GI dx procedures (Common w scopes & x-rays) 1. LFT's, other blood tests & indications Liver function tests; AST, ALT, ALP, bilirubin and albumin -also blood tests for amylase, lipase, alpha-fetoprotein & ammonia -indications: suspected liver, pancreatic or biliary tract disorder
Urine bilirubin (Pg. 512) also known as ____ indications; interpretations urobilinogen; urine test; dipstick or 24-hr urine collection indications: suspected liver or biliary tract disorder Interpretations: positive/^ = possible liver disorder or biliary obstruction
Fecal Occult Blood test & stool samples -indications indications- GI bleeding or unexplained diarrhea Interpretation- Gi bleeding (ulcer, colitis, cancer) *infections and genes can be found too (pg.512)
Fecal occult blood test & stool samples -preprocedure -foods/meds to avoid before -cards impregnanted w guaiac that can be mailed to provider w. specimen cup. 3 samples required w/ cards usually. -avoid red meats & anticoagulants before
Endoscopy: what do you use Ex's Direct visualize; flexible, lighted tube (endoscope) -colonoscopy, EGD (esophagogastroduodenoscopy), ERCP (endoscopic retrograde cholangiopancreatography), sigmoidoscopy
Endoscopy procedure PRE insructions/nursing: verify informed consent, VS allergies, labs, diet instructions before hand (NPO usually certain amount of time), bowel preps, avoided meds (NSAIDs, warfarin, etc.)
1. Colonoscopy: (Pg. 515) what do you use, where do you enter what do you see -anesthesia? Flexible fiber-optic scope, entering through the anus -rectum, colon (all parts) --> Moderate sedation- midazolam (Versed); opiate analgesic
Positioning for a colonoscopy? Preparation (bowel prep) left side w/ knees to chest -laxatives (bisacodyl (dulcolax) and polyethylene glycol (golytely) -Clear liquid diet (avoid colored fluids), NPO after midnight
Colonoscopy post procedure -notify provider if severe __ -___ bleeding -Resume ___ diet -fluids -may be increased __ d/t air installation pain; perforation or hemmorrhage -rectal bleeding, normal diet, increase fluid intake, flatulence increased
2. EGD -through what? into what? -anesthetic? -position? -Preparation? Through mouth into esophagus, stomach & duodenum -moderate sedation; topical anesthetic -left side-lying -NPO 6-8 hrs; remove dentures
Post op EGD; -Withhold fluids until what? Return of gag reflex
3. ERCP -through what? -anesthesia? -Position through mouth into biliary tree via the duodenum, -allows seeing biliary ducts, gall bladder, liver & pancreas -Conscious sedation-topical anesthetic -Semi-prone w/ repositioning throughout procedure
ERCP prep & post op -NPO how long? -withhold fluids until 6 tp 8 hrs & remove dentures -return of gag reflex
4. Sigmoidoscopy -scope -anesthesia -position -prep (bowel, diet) -post -shorter scope than colonoscopy(anus, rectum, sigmoid colon visualization) -no anesthesia required -left side -Laxatives -clear liquid diet, NPO after midnight -post same as colonoscopy
GI series (Pg. 517) -if upper GI imaging.. client drinks ___ & stools will be ___ for 24 to 72hrs barium (radiopaque liquid) -white
Created by: mary.scott260!