Care of the Patient with Gastrointestinal Disorder

Question 1

What are gallstones composed of?

Answer 1

-cholesterol
-bile salts
-bilirubin
-calcium
-protein

Question 2

What can cause gallstones?

Answer 2

High concentrations of cholesterol

Question 3

What is responsible for intense spasmodic pain, known as biliary colic?

Answer 3

-If a stone cannot pass through, it causes an obstruction
-Ducts respond to obstruction with spasms in an effort to remove

Question 4

What happens if gallstones block the cystic duct?

Answer 4

Bile cannot leave the gallbladder and inflammation occurs

Question 5

Cholecystitis s/sx

Answer 5

-indigestion
-severe pain,fever,jaundice
-nausea,belching
-fever,chills
-right upper quadrant pain radiating to shoulder

Question 6

When do onset of symptoms occur for cholecystitis?

Answer 6

3 hours after a meal, especially after eating foods high in fat

Question 7

Physical characteristics of cholecystitis?

Answer 7

-dark-amber urine
-clay colored stool
-cannot absorb fat-soluble vitamins

Question 8

Nursing Interventions after T-tube surgery

Answer 8

-measure and record amount of drainage,notify if it exceeds 1000 ml in 24 hours
-patient in low fowlers, tube drained freely
-protect tube during movement
-if pain,fever,chills, unclamp
-aseptic technique

Question 9

If infection left untreated,gallbladder can rupture causing?

Answer 9

contents of gallbladder to leak into abdominal cavity causing peritonitis

Question 10

Critical rescue for Biliary Colic

Answer 10

-assess for shock
-stay with pt, keep head flat

Question 11

What is dumping syndrome?

Answer 11

rapid gastric emptying of undigested food from stomach to small intestine, causing distended duodenum/jejunum
Cause: surgical removal of most of stomach
Treatment: 6 small meals/day, high in protein/fat, low carb
-recline 1 hr after meals

Question 12

What causes pernicious anemia?

Answer 12

no stomach=deficient intrinsic factor, which usually aids absorption of B12