LOW RESIDUDE DIET (LOW FIBER( to prevent obstruction - introduce fibrous foods one at a time - throughly chew foods - white rice and refined grains and pasta are good choices

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Ulcerative colotis nutrition

-LOW RESIDUE foods
high calorie and high protein
-multivitamins containing ca2+
- oral hydration critical of greater than 10 liquid stools and causespt to be dehydrated so DRINK 2 LITERS
- avoid triggers (diary, nuts and legumes, cereal, etoh, fatty foods)
-JORNAL

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ileostomy nutrition

LOW RESIDUDE DIET (LOW FIBER( to prevent obstruction

introduce fibrous foods one at a time
throughly chew foods
white rice and refined grains and pasta are good choices

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ileostomy foods to avoid

high fiber- popcorn, cocunut, brown rice

stringy veg-aspargus, brocc, celery
seeds and pits
edible peels

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losing weight drinks

water
club soda (flavored and unflavored)
unsweet tea or coffee
fresh veg juice
non fat/low fat milk

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pt who had recent gi bleeding should avoid

anything red dyes so red popsucles and red gelatin and are not given even if it is part of clear liquids

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barium enema is used to

visualize colon to detect polyps, ulcer, tumor, diverticula

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barium enema contridincated in pt with

diverticula because it can cause peritontis

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preprocedure for barium enma

take cathartic (go lyte or mg citrate) to empty stool

follow clear liquid and avoid red and purple liquids
do not eat or drink anything 8 hours before the test
might exp urge to defecate and cramping but its normal

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post procedure for barrium enema

chalk white stool until all of the barium has been expelled

taake a laxative to expel barium because retained barium can lead to fecal impacition
high fiber diet.bar

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hepatic encephalopahy clinical manestifications

sleep disturbances to lethary and coma
-mental staatus altered
-asterixis (have them extend arms and foresiflex the wrists)
0 fetor hepaticus (musty, sweet ordor ) from digestive byproducts
-juandice is not related for HE
-amlyase and lipsae are elvated for hep but not HE

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baraitric surgery

surgical modification of clients stomach or small intestines to restrict clients intake

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what is conrindicated in bararic surgery

NG tube bc it can disrupt the surgical site—> hemm and anastomatic leak

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what is contrindicated afer gastric surgery

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Bariatric surgery intervention

clear liquid for 48-72 hours after surgery
-low carb and sugar free drinks to decrease dumping syndrome

low folwer is prefered
morphine or pca for pain

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dumping dyndrome signs

sweating
dizz
cramping
diahrea
hypotension
tacycardia

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guaiac fecal occult blood test

screening for colorectal cancer

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guaiac fecal occult blood test collecting sample

assess for recent ingetion WITHIN LAST 3 DAYS of red meat or meds (vit c, aspirin, anticog, iron, ilbriphen, corticosteroid) because these can interfere with the test

2) get supples and wash hands and put nonsterile gloves
3) put stool sample on the slide
4) close the slide and allow it to sit and dry for 3-5 mins
5) open the slide and add 2 drops of solution
6) assess the color within 30-60 sec

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positive guaiac fecal occult blood test

will turn paper blue

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acute cholecystitic location

RUQ and pain to right shoulder and scapula

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acute cholecystitis report

fatty food ingestion 1-3 hours before onset of pain

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flank pain radiating to the groin

renal colic

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signs of acute cholecystitis

fever
chills
NV
anorxia

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TPN is adm through

central venous cathehrter

discontinuing TPN

lower the rate and replace with dextrose

findings of refeeding syndrome

``` PPM will be decreased fluid overload thamine def hyperglycemia sod retention ```

to prevent dumping syndrome

small meals low carb diet consume food and fluids 30 mins apart

RYGB complications

dumping dynsrome, iron def anemia, cobalamin def

highest priority of cholecystitis

sitrct NPO

laparoscopic cholecystectomy teaching

low fat diet can revcover and resume normal act quicky than open surgical -teach to remove surgical bandages the day after the surgery and can shower - low fat diet

alt and ast are used to

gignose hepatic disorders, etoh and otc drugs but not to detect occult

thryamine foods

``` yogurt, cured meats agead cheese fermented foods beer choco avacaods red wine ```

food for depression

high in protein and cal

common liver failure includes

``` low albumin elevated INR elvated liver function low potassium increased ammonia ```

small bowel follow through (SBFT)

uses x ray to visualize the structure and function of small intestines

SBFT education

fast 8 hours prior stools may be chaly for 72 hours bc of barium -drink water to flush it out -go lyte is not perscribed -test takes 1-2 hours - brown stool do not return after 72 hours or abdominal pain or feeling fullnnes- HCP

colostomy diet

fluid intake (3000 at least) - elminate gasy and ordor food such as cauliflower, brocc, dried beans, brussels - empty pouch when it is 1/3 dull to prevent leak due to increasing pouch weight

GERD FACTORS that preceptiate it

decreasing the tone (caff etoh) - delaying gastric emptying (fatty foods) - increases gastric pressure (large pressure)

preventing GERD

WEIGHT LOSS SMALL freq meals avoid gerd triggers -chew gum to promote salivation and can help clear acid -sleeping with head elveated -dont eat at bedtime or lie down imm after eating -dont need to minimize or eliminate diary foods

hypomag lvl

1.5-2.5

low mag two major issues

``` ventricular arrhymias (torsades de pointes) -- MOST SERIOUS and priority 2) neuuromuscular excitability (similar to calcium)- tremores, hyperactive reflex, troussea chvostek and seizures ```

clients who abuse etoh have

low mg levels

endoscopic retrograde (ERCP) complication

acute pancreatiis -life threatening

how long stool white after bariym

up to 3 days

small bowel obsutrciton normal color

bile colored (green brown) and it is expected

gastroduodenostomy (billroth 2) education

NPOOOO until bowel sounds retur | -small freq meal)

post op gastroduodenostomy (Billroth I)

high risk of dev venous thromboemolism and require prohalysis such as SCD and comrpession hose - risk for hypoventilaiton and resp compromise so enoruage to run cough and deepbreathe and spint site - APIRATION PRECAUTION

cloggged NG

report to HCP and attempting to manipulate and flush can cause hemm or gastric performation

Billroth II surgery (gastrojejunostomy) complication

dumping syndrome

Billroth II surgery (gastrojejunostomy) education

do eveyrthing to prevent dumping syndrome such as not drinnking fluids with meals and laying down after meals

healthy stoma characterisitc

vascular, moist, pink to brick red | minor oozing and bleeding can happen and mild to moderate swelling is normal 2-3 wk after surgery

when to report stoma

pale, dsuky and cyanotic because thse are signs of decreased blood supply

balloon tamponade tube (eg, Sengstaken-Blakemore, Minnesota)

used to temporarily control bleeding from esopgeal varcies | - compreses bleeding varcies

if balloon tamponade tube (eg, Sengstaken-Blakemore, Minnesota) gets disloged

airway obstruction so KEEP SCISSORS AT BEDSIDE

dont make pt do what if HE

DONT MAKE THEM WALKK

complications of severe pancreatitis

``` hypovolemia resp distress hypocalemia hyperglycemia ARDS ```

obesity behv modification

create reqrd system dev health goals such as climmbing stairs without SOB -adop anxiety reducing act (reading, medating) as coping mechanisms to reduce stress eating -placing visual cues (motivational quotes) through env -dont avoid social act with food and they can bring a seperate meal or plan ahead

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