Interventions Gastrointestinal Assessment and Problems Flashcards
Barrett’s epithelium
More resistant to acid and therefore supports esophageal healing.
Considered premalignant
Can produce esophageal stricture
Clinical manifestations of GERD
Dyspepsia (heartburn)
Regurgitation (backward flow of the throat)
Belching and Flatulence after eating
Assessment of GERD
Auscultate lungs for crackles (aspiration)
Ask about coughing, hoarseness, or wheezing at night.
Bronchitis may occur in those who have long-term regurgitation.
Water brash
Dysphagia (difficulty swallowing)
Odynophagia (painful swallowing)
Chronic cough (mostly at night)
Older Adults and GERED
Incidence of heartburn decreases.
More serious complications are increased.
Atypical cheast pain
Ear, nose and throat infections
Pulmonary problems (aspiration pneumonia)
Sleep apnea
Asthma
Barrett’s esophagus and esophageal erosions more common
Endoscopic Therapies for GERD
Stretta procedure- Uses radiofrequency energy that reduces vagus nerve activity.
gastroplication procedure- the physician tightens the lower esophageal sphincter through the endoscope using sutures near the sphincter.
Interventions for hernia
Health teaching Avoid eating late in the evening Avoid foods associated with reflux Reduce body weight if indicated Sleep with HOB elevated Remain upright several hours after eating Avoid straining Avoid excessive vigorous exercise Avoid clothing that is restrictive clothing around the waist
Advantages of MIE
Less blood loss during surgery; fewer blood transfusions
Decreased healing and recovery time
Decreased trauma to the body
No large incisions
Less postoperative pain
Shorter hospital stay (5 to 7 days rather than 7 to 10 days)
type of ulcers
Gastric ulcers
Duodenal ulcers
Stress ulcers
Zollinger-Ellison Syndrome
a rare disease that is manifested by upper GI tract ulceration, increased gastric acid secretion, and one or more duodenal or pancreatic tumors.
Zollinger-Ellison Syndrome treatment
Proton pump inhibitors
H2-receptor antagonists
Surgical resection of tumor
Gastric Cancer risks
H. pylori Pernicious anemia Gastric polyps Chronic atrophic gastritis Achlorhydria (absence of secretion of hydrochloric acid) Eating pickled foods Nitrates from processed foods Salt added to food Diet low in fruits and vegetables
Surgery for Gastric Cancer
post op
Prevent atelectasis, paralytic ileus, wound infection
Monitor for return of bowel sounds.
Monitor VS for signs of bleeding or infection
Monitor wound
Keep HOB elevated to prevent aspiration
