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Gastric Tubes,GI diagnostic Tests, CH 21 Diets

MYELOGRAPHY type of radiographic examination that uses a contrast medium to detect pathology of the spinal cord, including the location of a spinal cord.A myelogram may help to find the cause of pain not found by an MRI or CT.
HEMACULT Detects occult blood in feces
LIVER BIOPSY procedure whereby small pieces of liver tissue are removed in order to be sent to a laboratory for examination.rarely internal bleeding occur,bile from the liver or gallbladder.blood count,platelet count,& measurement of blood's ability to clot IS TESTED
PARACENTESIS procedure to remove fluid that has accumulated in the abdominal cavity (peritoneal fluid), a condition called ascites
BARIUM test that may be used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, bloodstained vomit..shows up on x-ray and is used to help see abnormalities in the esophagus and stomach.
GASTROSCOPY Examination of the gullet, stomach & duodenum.;Performed by using a thin, flexible fibre-optic.passed through the mouth and allows to see any damage to the lining of the oesophagus (gullet) or stomach, and any ulcers in the stomach or duodenum.
BRONCHOSCOPY Technique of visualizing the inside of the airways for diagnostic and therapeutic purposes.including the voice box and vocal cord to examine inside your airway for any abnormality such as foreign bodies, bleeding, a tumor, or inflammation.
ELECTROLYTES any substance containing free ions that make the substance electrically conductive
REFLUX dyspepsia, dry cough, chronic sore throat, dysphagia, and chest pain. condition in which the stomach contents (food or liquid) leak backwards from the stomach into esophagus
DEFECATE final act of digestion by which organisms eliminate solid, semisolid or liquid waste material (feces) from the digestive tract via the anus.
ENEMA procedure of introducing liquids into the rectum and colon via the anus. This causes rapid expansion of the lower intestinal tract, resulting in powerful peristalsis, a feeling of extreme urgency and complete evacuation of the lower intestinal tract.
HEMATEST Benzidine-based tests to find blood in feces
LIVER BIOPSY procedure using a needle whereby small pieces of liver tissue are removed in order to be sent to a laboratory for examination. NPO, afterward check VS for shock & pneumothorax
LARGE INTESTINE 1. Absorbs water & electrolytes. 2. Synthesis vitamin K & B. (bacteria) 3. Eliminates waste. 4. Storing site of waste: FECES.
CHARACTERISTICS OF STOOL Normal:formed, solid tubular in shape Color= brown Abnormal: • MELANE- Dark brown or black- GI Bleed (Upper GI, mixed with digestive juices) • HEMATOCHEZIA- Red color, below the GI tract • Clay color • DIARRHEA • STEATORRHEA= Fatty stool-
BOWEL ELIMINATION It depends on balanced diet (green vegetables, high fiber foods), daily fluid intake of 2000 to 3000 mL and exercise Normal stool is expelled every 1-3 days
HYPOACTIVE BOWEL Slow peristalsis- Irritable Bowel Syndrome/ Hypothyroid An absence or reduction of peristaltic movement of the bowels
CONSTIPATION Decreased frequency of bowel movement or passage of hard dry feces • Muscle tone is lacking • Irregularity of BM • Electrolyte balance will be off
FECAL IMPACTION Rectum and sigmoid colon: hardened feces SEEPAGE OF SMALL UNIT LIQUID OR SEMI SOFT STOOL IS A FREQUENT SIGN OF IMPACTION • Bacterial action on the hardened surface of the fecal matter causes Liquefication
RETENTION ENEMA constipated Pts • Oil is introduced into the rectum and sigmoid colon, retained 20 mins • It softens the feces and lubricates the rectum and anal canal
CLEANSING ENEMA complete evacuation of feces from the colon stimulating peristalsis through the infusion of a large volume of solution • 1000 mL is the normal level ADULTS INFANT: 150-250 ADOLESCENCE: 500-700 (Temp 95-105 F)
CARMINATIVE ENEMA • Provide relief of gaseous distention & ability to pass flatus MGW sol
MEDICATED ENEMA drugs that will promote defecation KAYEXALATE
PREPACKAGED ENEMAS lubricated tip into the rectum towards the UMBILICUS o 3-4 inches for the adult o 2-3 inches for the child o 1-1.5 inch for infants • insert slowly to prevent sphincter spasms
GUIDELINES FOR ENEMAS position: LEFT SIDE LYING (SIM’s Position) knees slightly flexed-curve of sigmoid colon and rectum • Encourage taking deep breaths while inserting:helps to reduce pressure on colon & cramping no more than 3 enemas-deplete fluid and electrolytes
STOP ENEMA COMPLETELY If… • Pallor Bleeding • Diaphoresis:person sweats excessively and unpredictably • Severe cramping • Fainting Abd pain • Nausea
SENSITIVITY Lab method of determining the effectiveness of antibiotics, usually performed in conjunction w/ culture
ASPIRATION means to draw in or out using a sucking motion.release of a strong burst of air after some obstruents. inhalation of either oropharyngeal or gastric contents into the lower airways.
DECOMPRESSION condition arising from the precipitation of dissolved gases into bubbles inside the body on depressurization
DISTENTION he state of being distended, enlarged, swollen from internal pressure
EMESIS Vomiting/forceful expulsion of the contents of one's stomach
ENTERAL the intestines or other portions of the digestive tract-system methods of introducing drugs or substances into the body A method of nutritive delivery where fluid is given directly into the gastrointestinal tract.
FLATUS Gas generated in or expelled from the digestive tract, especially the stomach or intestines
GASTRIC Having to do with the stomach
GASTROSTOMY surgical opening into the stomach. Creation of an artificial external opening into the stomach for nutritional support-Feeding tube called a gastrostomy tube
GAVAGE Introduction of nutritive material into the stomach by means of a tube.forced feeding, especially through a tube passed into the stomach. 2. superalimentation
LAVAGE stomach pumping or Gastric irrigation, is the process of cleaning out the contents of the stomach
LUMEN (NG TUBES) the cavity or channel within a tubular structure, EX interior of the gastrointestinal tract
PERISTALSIS contraction of muscles which propagates in a wave down the muscular tube,That occur throughout the digestive tract TO MOVE FOOD.mixes food with gastric juices, turning it into a thin liquid
RESIDUAL Something left behind. With residual disease, the disease has not been eradicated.
ENDOSCOPY examining the inside of the body using a lighted, flexible instrument called an endoscope.Evaluate the esophagus (swallowing tube), stomach, and portions of the intestine.
PARALYTIC ILEUS Intestinal obstruction is a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
GUIAC Method for detecting the presence of fecal occult blood.Most common form of fecal occult blood test
ASCITES excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity)
OSTOMY surgically created opening in the body for the discharge of body wastes
STOMA the actual end of the ureter or small or large bowel that can be seen protruding through the abdominal wall.
COLOSTOMY surgically created opening of the colon (large intestine) which results in a stoma. A colostomy is created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall
EFFLUENT outflowing of water or gas from a human-made structure
Kock Pouch variation of the ileostomy, reservoir pouch created inside the abdomen w/ portion of ileum. Valve constructed in pouch & stoma is brought through the abdominal wall. Catheter inserted into pouch to drain feces.no need for appliances or bags
NG TUBE PURPOSES Gastric Decompression(removal) of flatus and fluids from stomach Helps prevent Vomiting & distention caused by reduced peristalsisfrom postsurgery
LEVIN TUBE Large single Lumen and several opening near the tip
SALEM TUBE-Sump Tube Large Double-Lumen: One provides AIR & the other REMOVAL of gastric contents,Has blue pigtail for equalizing stomach pressure
NURSING DIAGNOSES WITH INTUBATION Imbalanced Nutrition Impaired Swallowing Risk for aspiration Diarrhea Constipation
MILLER-Abbott Tube- (LONG) Lg bore NG tube, Double w/ 1 tube for Passageway for drainage & 1 connected to balloon for addition or removal (mercury)
PEG TUBE- PERCUTANEOUS ENDOSCOPIC GASTROSTOMY Indicated when the nasal route is contraindicated/ Long term enteral feeding Allows more freedom of ambulating & SELF administration Sometimes require replacing tube bc of gastric juices deterioration Surgical opening used to create STOMA: abdominal wa
Types of Enteral Tubes: -Nasogastric tubes – a tube placed through the nose into the stomach -Gastrostomy tube or PEG (Percataneous endoscopic gastrostomy tube) – tube placed directly into the stomach -Jejunostomy & Dudenal tube – placed into the intestines
Cantor tube (Harris) TUBE (Long) Used primarily for treating a bowel obstruction,
Tomey syringe – used to insert air into NGT to help measure the accuracy
Care of Tube Site (NGT and PEG) clean and dry soap and water usually after 1 week.½ peroxide and saline solution to remove encrustation signs of infection Accidentally removed:Call the Doctor & make arrangement to replace within 2 hours!!!! Oral hygiene with tube sites are a must
GASTRIC GAVAGE *Bolus (100-240) q4-8hrs – able to feed themselves *Continuously – 24hr –pt. Cannot tolerate large amt. At risk for aspiration. *Cyclically – daytime/nighttime, 8-18 hrs
COMPLICATIONS OF TUBE FEEDING DIARRHEA- most common/too concentrated ASPIRATION-most DANGEROUS VOMITING CRAMPING & REFLUX-too HOT/COLD CLOGGED TUBE-Avoid using bulk forming med/food BACTERIA-change tubing q 24hrs.No more than 250cc of formula
CATHARTICS Solutions that promote Bowel movement
NURSING DIAGNOSES Constipation Acute Pain Deficient Knowledge Disturbed body image Anxiety Ineffective Coping Imbalanced Nutrition Impaired swallowing Diarrhea Risk for Aspiration
OLDER ADULTS CONSIDERATIONS-BOWEL ELIMINATION Prone to Arrhythmia & problems w/ VAGAL Stimulation Fiber: 6-10 g/day) Avoid hot water to peristomal area Week's diary of meals & fluids intake Evaluate & teach Ostomy care
LARGE INTESTINE ***FUNCTIONS: 1. Absorbs water & electrolytes. 2. Synthesis vitamin K & B. (bacteria) 3. Eliminates waste. 4. Storing site of waste: FECES.
o URETEROSTOMY- Ilea conduct or Bricker’s loop. OsTOmy in the ureter. Opening into Ureters • Disease: cancer. Obstructive Uropathy • Congenital: Spina Bifida, Meningomyelocele,bladder extrophy • Trauma: Spinal injury (neurogenic bladder) • Or
ILOCONDOID- Bladder is removed, then the ureter is connected to Intestine
STOMA CARE Pouches changed 3-7 days to prevent skin imp. Supine position Cleanse skin w/ warm water Gauze for Ileostomy-Over Stoma Cut center of water 1/16 inch larger than stoma Protective barrier 1/16 inch-1/8 from Stoma
ILEOSTOMY Produces LIQUID FECAL-EFFLUENT Constant fewr bacteria,but contains enzymes & bile-Damaging to skin
ASCENDING COLOSTOMY From Ascending colon Liquid drainage w/ odor Digestive enzymes
TRANSVERSAL COLOSTOMY From Transverse Colon Malodorus MOUSHY-bc some water absorption
SIGMOID COLOSTOMY NORMAL stool, odor can be controlled May not have to wear APPLIANCE @ all times
LOOP COLOSTOMY two limbs.both the upstream (proximal) and downstream (distal) openings of the bowel are brought out through the same place in the abdominal wall one stoma is usually called the proximal stoma, while the other is called the distal stoma.
double- barrel COLOSTOMY where two distinct stomas are made and brought through the abdominal wall. The stomas may or may not be separated by an expanse of skin.defunctioning colostomy as it prevents the spill of faeces from the proximal to the distal loop.
END COLOSTOMY Stoma is created from one end of the bowel. The other portion of the bowel is either removed or sewn shut
CLEAR LIQUID DIET fruit drinks,grape juice,gelatin,tea-coffee,supp formulas Nonirritating diet consisting of liquids easily digested w/ little residue in GI Tract. Postoperative,usually for V/D Low in calories,protein & most nutrients
FULL LIQUIDS All clear liquids Ice cream,Custard,Puddings Transition diet after clear liquid diet Liquid nutritional supplements-Lactose free & source of K,P & Nutients
SOFT DIET Progressing from Liquid to reg diet Indigestion,Diarrhea,GI tract conditions Low fiber: Meat,fish,poultry,eggs,milk,grains,fruits & vegetables
LOW RESIDUE DIET Includes restrictions on milk & milk products
HIGH FIBER Treatment of Constipation Fresh cooked food or raw vegetables Adequate fluid intake is essential
MEAL FREQUENCY 6-8 Small meals
HIGH KILOCALORIE & HIGH-PROTEIN Powder mil,Peanut butter,extra cheese,meat,add nuts,snakcs @ all times
LOW KILOCALORIE Emphasis on whole grains and cereals,fruits & vegetables Reduced fat & increased fiber in diet
• MELANE- Dark brown or black- UPPER GI bleeding, mixed with digestive juices)
STEATORRHEA Fatty stool- floaters (because is lighter)
Abnormal Stool Diarrhea, melane,hematochezia,Steatorrhea, Any mucous or parasites, clay color
Guidelines for Diagnostic Examination • VS • Pt’S Level of education • Pt’s awareness of medical diagnosis • Nursing assessment • Know Normal value of tests • Risk of DYSRHYTHMIA-coffee, tea, tobacco, electrl. Imbalances.. pt are @ risk for cardiac arrest IODINE DYE ALLERGIES ANAPHYLA
ANAPHYLAXIS Exaggerated hypersensitivity reaction to a previous antigen-respiratory distress, low BP or shock-Benadryl,steroids &epinephrine
UPPER GI SERIES Esophagus,stomach,duodenum after swallowing CONTRAST MEDIUM-Barium. NPO, fluids,cathartics & enemas as ordered. Stool will be LIGHT after p.
LOWER GI SERIES Large Intestine exam with BARIUM via an enema. NPO, Importance of PASSING BARIUM,fluid intake, stool color for consistency-light, Constipation, laxatives & enemas as ordered
ERCP- ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY 492- XRAY & Endoscope to visualize Ducts & related to liver & pancreas
LIVER SCAN 495- Imaging of BLOOD FLOW IN LIVER after IV.
GASTRIC ANALYSIS Looking for Ulcers, Pernicious Anemi
ABDOMINAL PARECENTHESIS 498- ABdominal cabity punctured to drain off ASCITES, when bleeding is suspected. Fluid is obtained from LOWER PORTION OF ABDOMEN Monitor VS, amt,color of specimen, bleeding, an signs of SHOCK
Created by: 510756990