Chapter 13 -Gastrointestinal Disorders

Question 1

GI parameters

Answer 1

• wt + wt changes
• lab values
• eliminatn patterns
• I+O

Question 2

low fiber diet

Answer 2

avoids foods that are high in residue content

• reduce frequency + volume of fecal output
• slow transit time

Question 3

foods w high residue concent

Answer 3

• whole grain breads + cereals

- raw fruits + vegetables

Question 4

low fiber diet is useful in…

Answer 4

• clients w diarrhea + malabsorption of syndrome

- short term

Question 5

high fiber diet

Answer 5

focus on foods containing more than 5g of fiber per serving

Question 6

high fiber diets are useful in…

Answer 6

• increase stool bulk
• stimulate peristalsis
• prevent constipation
• protect against colon cancer

Question 7

N/V possible causes

Answer 7

• gastric acid secretion
• decr GI motility
• allergy
• bacterial/viral
• incr ICP
• liver, pancrtc, gall bladder disorder
• a/e of med

Question 8

pale green vomit indicates…

Answer 8

bile

Question 9

once manifestation of NV subsides..

Answer 9

begin w clear liquids> full liquids> continue advancing

Question 10

well-tolerated meals w N/V

Answer 10

low-fat carb foods

• crackers
• toast
• oatmeal
• pretzel
• plain bread
• bland fruit

Question 11

N/V nursing actions

Answer 11

• good oral hygiene: mouth swab, brush, wash, ice chips
• elevate head
• food at room temp or chilled

Question 12

N/V client education

Answer 12

• avoid hot + spice
• avoid liquids w meals (promotes feeling of fullness)
• avoid high fat (contributes to nausea bc hard to digest)

Question 13

anorexia nursing actions

Answer 13

• decr stress at meal times
• modify unpleasant odors
• manage anxiety/depress
• small frequent meals
• avoid high fat
• bevg should be 30 min before or after to prevent feeling full
• supplements to incr cal + protein
• lrger meals are earlier in day
• mouth care before + after

Question 14

constipation can be caused by…

Answer 14

• irreg bowel
• psychogenic
• inactivity
• chronic laxative
• obstruction
• GI disorders
• pregnancy
• inadequate fiber + fluid

Question 15

constipation client education

Answer 15

• fluid: 64oz
• fiber: 25g(F)/38g(M)
• exercise
• 2 serv of fruit, 3 serv of vege

Question 16

diarrhea requires a ___ diet

Answer 16

low fiber

Question 17

clients w dysphagia may be referred to…

Answer 17

a speech therapist

Question 18

dysphagia client education

Answer 18

• small bites
• adequate chewing
• upright/high fowler
• take pills w 8 oz of fluid (can be thickened)
• avoid THIN liquids + sticky food**

Question 19

dumping syndrome

Answer 19

normally stomach controls the rate of nturients entering the sml intsntn
-when portion of stomach is surgically removed, the contents are rapidly emptied into sml intestine

Question 20

early manifestations of dumping syndrome typically occurs __ after eating. later manifestations occur ___ after eating.

Answer 20

10-20 minutes; 1-3 hours

Question 21

early manifestations of dumping syndrome

Answer 21

• sensation of fullness
• ab cramping
• nausea
• diarrhea
• vasomotor manifestations (faintness, syncope, diaphoresis, tachycardia, hypotension, flushing)

Question 22

late manifestations of dumping syndrome

Answer 22

• diaphoresis
• weakness
• tremors
• anxiety
• nausea
• hunger

Question 23

in dumping syndrome, manifestations resolve after…

Answer 23

intestine is emptied

Question 24

dumping syndrome leads to a risk for…

Answer 24

• hypoglycemia

- iron + B12 deficiency

Question 25

dumping syndrome client education

Answer 25

- small frequent meals - consume protein + fat w each meal - avoid concentrated sugars + lactose - liquids 1 hr AFTER meals or 30 min before - lie down after meals to delay gastric emptying

Question 26

possible trigger foods for GERD

Answer 26

- citrus fruits + juice - spicy - carbonated - foods that reduce the lower esophageal sphincter

Question 27

foods that lower the LES

Answer 27

- fatty - caffeine - chocolate - alcohol - cigarette smoke - nicotine - peppermint or spearmint

Question 28

main concerns w ileostomy + colostomy

Answer 28

fluid + electrolyte imbalance | -colon absorbs liquids, Na, + K

Question 29

ileostomy + colostomy | client education

Answer 29

- fluids (1.9-2.4L) - soluble fiber - avoid food that cause gas (beans, eggs, carbonation) - avoid stomal blockage (popcorn, nuts, raw carrots) - odorous foods (eggs, fish, garlic) - incr intake of cal _ protein to promote healing

Question 30

diverticulitis

Answer 30

inflammation that occurs when fecal matter becomes trapped in diverticula (pouch protruding thru muscle)

Question 31

diverticulitis client education

Answer 31

- high fiber low fat diet | - during acute phase, clear liquid diet is prescribed until inflammation is decreased. then high fiber, low fat

Question 32

IBD diet

Answer 32

low residue, high protein, high calorie w vitamin + mineral supplements

Question 33

IBD client teaching

Answer 33

- yoga, hypnosis, breathing exercise - avoid substances that cause diarrhea - avoid nicotine

Question 34

pancretitis diet

Answer 34

npo - tpn - ng tube for suctioning

Question 35

liver disease diet

Answer 35

- high protein to incr nitrogen - multivitamins (BCK) - no etoh, nicotine, caffeine

Question 36

gluten is found in...

Answer 36

wheat, rye, and barley

Question 37

celiac disease nursing consideration

Answer 37

- monitor for bleeding (vit K deficiency) - signs of osteoporosis - iron, folate, vit B deficiency

Question 38

bariatric surgery diet

Answer 38

- 60 g protein - gradually increase from liquid to soft/pureed foods - chew foods thoroughly + slowly in small amounts

Question 39

adjustable gastric bandinf

Answer 39

restricts stomach capacity to 15-30 mL w inflatable band

Question 40

roux-en-Y gastric bypass

Answer 40

ingested food bypasses 95% of stomach, duodenum, + jejunum | -wt loss achieved thru malabsorption + dumping syndrome

Question 41

upper GI absorbs

Answer 41

iron, calcium, B12

Question 42

duodenum

Answer 42

helps w iron, calcium, B12

Question 43

meds for PUD can cause

Answer 43

deficiency in iron, calcium, B12

Question 44

calcium rich food for lactose intolerant

Answer 44

``` low lactose (ages cheese, cream cheese, yogurt) -broccoli, almonds, edamame ```