GASTROINTESTINAL II Flashcards
Lower GI and issues
Bulimia nervosa nursing care
- therpeutic intervention
- V.S.
- daily wt
- I/O monitoring
- electrolyte balance
- dysrhythmias
Bulimia nervosa may cause:
1. teeth erosion and Calcium deficiency
2. Osteoporosis and brain cancer
3. Rectal discomfort and dry skin
1.
SELECT ALL THAT APPLY
Stomatitis treatment includes which of the following? Select all that apply:
1. Treat with acycolvir
2. avoid brushing with toothpaste
3. avoid oral care altogether
4. avoid stressful situations if possible
1.,4.
aphthous stomatitis cause ____ in the mouth but HSV-1 stomatitis causes ____ on the facial surface.
small, painful ulcers; sores/blisters on the face
apthous stomatits–treated with topical anesthetic, HSV-1–Treat with acyclovir
Fundoplication
- surgery that prevents sliding
- used for Hiatal hernia/GERD PTs
- risk r/t aspiration if sutures are too tight
*
Mallory-Weiss tear
- longitudinal mucous membrane tear of espohagus at stomach junction
- causes bright bloody emesis, black/tarry stools
- EGD and H&H used to diagnose
- self-healing, antiemetics/PPI meds, and alcohol avoidance used for intervention
Hiatal hernias are present in most PTs with
- Mallory Weiss Tear
- A DVT
- Bulimia nervosa PTs
1
Peptic Ulcer Disease
- GI lining erodes from H. pylori infection
- ulcers found in GI spots exposed to peptic acid/hydrochloric acid
- transmitted from oral-oral/oral-fecal
- gastric– abd. burning, gnawing pain getting worse 1-2 hrs after eating, risk for gastric cancer, malnurition, hematemesis … duodenal–abd. burning, pain 2-4 hrs after eating or at night, anorexia, n/v, bleeding
Peptic Ulcer diagnostics and Therapy
- tests: urea breath test, immunoglobulin G antibody, biopsy, culture…monitor H&H
- triple H therapy,.2 antibiotics and a PPI/H2 antagonist, 14 day tx, bland diet
- perforated ulcer is a medical emergency
Gastric Bariatric Surgery and S/S With Therapy Interventions
- for PTs when wt loss isn’t sufficient
- surgery goal is to restrict intake by limiting stomach’s capacity
- vomiting, mineral/protein deficiency, stomach secretions leak, incision site breakdown, gastric tissue erosion
- post-OP PT may have NG, clear liquid/full liquid diet, regular food can resume after 6 weeks
- monitor for distention… suture can pop
Gastric bleeding
- from ulcer perforation, tumors, gastric surgery
- mild bleed can cause some weakness/sweating
-
serious bleed can cause hypovolemic shock-hypotension, weak/thready pulse, chills, palpitations, sweating, LOC change, fatigue
*
Gastric Bleeding diagnostics and therapy
- test: endoscopy, low H&H
- therapy: treat shock: NPO, IV fluids, O2 therapy, NG tube, lígate bleeding vessels, meds to limit gastric acids
Nursing care after gastric surgery
- monitor vitals and respiratory status
- monitor PTs with large incisions for pain
- control pain & monitor I/O
- NG tube care
- early ambulation
- abdominal status
- education
Gastric surgery complications
- hemorrhage—restlessness, cool skin, increased pulse/respiration, decreased temp/BP, LOC change
- acute gas distensión— enlarged abdomen, epigastric pain, tachy, hypotension, hiccup/gas .. Report to DR
- dumping— dizziness, tachy, fainting, sweating, nausea, abdominal fullness .. monitor for hypoglycemia 2 hrs after eating
- nutritional problems—B12, folic acid deficiency, reduced calcium and vitamin d absorption, food coming in too fast=inadequate absorption
- pernicious anemia—vitamin B12 deficiency from intrinsic factor secretion reduction, lifelong supplements, monitor for anemia, weakness, sore tongue, GI upset, numbness/tingling
- steatorrhea— fat in stools, reduce fat intake
Appendicitis
- appendix inflammation
- symptoms include fever, elevated WBC, general upper abdominal pain…pain localizes down to McBurney’s point within hrs
- CBC and US used to diagnose
- keep PT NPO, surgery ASAP unless there’s no perforation/peritonitis
- if there’s infection, surgery’s delayed until it’s cleared up via IV fluids & antibiotics
