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