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Chapter 50

Unit 7: Nursing care of clients with gastrointestinal disorders

Acute and Chronic gastritis (Pg. 559) Inflammation of the lining of the stomach acute: sudden onset, short duration, bleeding if severe chronic; slow onset, may result in pernicious anemia *ulcers can be formed
Risks; infection, meds, drinks, reflux, age H.pylori, etc. fam hx, NSAIDs/corticosteroids excessive alcohol use, smoking, caffeine, stress bile reflux disease autoimmune disorders older age radiation
S/S of gastritis: dys__, pain, appetite/wt, abdominal, vomit like? dyspepsia, general abdominal discomfort/indigestion -upper abdominal pain, increase/decrease w/ eating -nausea, low appetite, bloating (wt loss) -hematemesis
S/S of erosive gastritis: Black, tarry stools; coffee-ground emesis -acute abdominal pain
Labs; CBC serum & stool antigen C 13 urea breath test CBC- anemia? bleeding? -->others testing for H.pylori
What is anemia in women and in men? Women; hgb <12, rbc <4.2 Men; hgb<14, rbc <4.7
How do you dx gastritis? Upper endoscopy (through mouth into esophagus, stomach, duodenum)
Upper endoscopy: NPO? Anesthetic? perforation? NPO 6-8 hrs before -local anesthetic sprayed into back of throat -perforation is a risk
Medications you can give? H2 antagonists(dine's), antacids (hydroxides), PPI's (zoles) -prostaglandins, anti-ulcer/mucosal barriers, antibiotics
Surgery? Prescribed when ulcerations or significant bleeding -
Surgery: Vagotomy nerve fibers only responsible for gastric production -laproscopically common
surgery: Pyloroplasty usually done at the same time as the vagotomy
Surgery: Partial gastrectomy Removal of the involved portion of the stomach
Methods for stopping gastric bleeding: Insert a NG tube for gastric lavage (irrigate w/ NS or water to stop active gastric bleeding)
Complications to gastritis; gastric bleeding, outlet obstruction, dehydration, pernicious anemia, dumping syndrome --> why pernicious anemia? Chronic gastritis may damage the parietal cells. leads to a reduced production of intrinsic factor= (necessary to absorption of vitamin b12) -insufficient vit b12 can lead to pernicious anemia
Pernicious anemia you need monthly ___? Injections of vit b12
Created by: mary.scott260!