GI Flashcards
What is the function of the GI tract?
Large intestine – water absorption but primarily waste fxn
Change in motility, obstruction, accessory diseases, inflammation/infection, stress, NSAIDS, cigarettes, coffee can affect
digestion/absorption
Assessment includes:
Hx, meds, pain levels ,location (abdomen - acute or not), duration, diagnostic tests (endoscopy), fluid and electrolytes, CBC, PE – sores, dry mouth, tongue, teeth?, issues w/ swallowing, rectal exam, rectum (stool quality - soft, color?), food diary
Peristalsis and nutrition, immobility, medications, dehydration, anorexia, age, infections are all
risk factors
Upper GI issues will result in
bright red, tarry black stool, coffee grounds
Nausea is the feeling to vomit while vomiting is the
expulsion of gastric contents
Condition associated with N/V, amount, odor, content- undigested food, mucus, parasites, foreign bodies, color- green, red, coffee ground, black, brown
Assessment of vomit
Placement of a NG tube helps
Decrease nausea, keeps stomach empty, sumps gastric secretions
Antiemetic drugs include
Zofran and Reglan
Prevention of N/V include
Water, clear liquids, warm cola, increase in amount if no vomiting, dry toast, crackers, bland food, avoid foods that stimulate peristalsis (high fat foods, orange juice, caffeine, high fiber foods, extremely hot or cold foods)
Medical constipation is not noted until how many days without a BM?
3 days
How would treat/assess a pt with constipation?
Assist physician in treating the underlying cause of constipation, encourage to eat HIGH fiber diet to increase the bulk, increase fluid intake, administer prescribed laxatives, stool softeners, assist in relieving stress
Record the color, volume, frequency, and consistency of stools, identify factors that cause or contribute to diarrhea, eliminate gas-producing and spicy foods, Eliminate by trial foods containing lactose, eat a low-fiber, high-protein, high-calorie diet, use ant-idiarrheal medications, monitor skin, record weight regularly, rest the bowel are interventions for
Diarrhea
Diagnostic testing for the GI include:
Gastric analysis
Lab tests; serum, urine, X-rays Endoscopy, gastroscopy, EGD, ERCP, Colonoscopy, sigmoidoscopy( >55)
Gastric analysis includes
Aspiration of gastric juice to measure pH, appearance, volume and contents, Pre-test: NPO 8 hours, avoidance of stimulants, drugs and smoking, post-test: resume normal activities
Medications available for bowel prep include:
Polyethylene glycol (GOLYTELY - large sugar molecule to induce diarrhea), magnesium citrate, and senna
Enteral feedings are
intermittent, continuous in the small intestine, duodenum, and GI tract (kangaroo)
Parenteral feedings include
feedings inside the body for IV/medication administration
This is a long term feeding tube, however, it call roll up and move placement
Dophoff
What is a miller abbott feeding tube?
It is long and goes into the small intestine
What is a salem tube?
Short term
Name some nursing diagnoses for GI.
Altered elimination, N/V, FVD, pain, discomfort, Nutrition, Malabsorption, Metabolic, Self care deficit- feeding, elimination, Tissue integrity, Skin integrity, Risk of infection, Risk of injury
Nursing management of surgery includes:
Wound care, drains: JP, hemovac, penrose (latex tube that is pinned in), T tubes, Blood loss, Acute pain, Fluid loss, shifts (Third space phenomena), Complications – elimination, obstruction, bleed out
Nursing interventions for GI include:
Anticipation; pain, nausea
Monitor bowel sounds, elimination, I/O is a way to check fluid balance, nutritional (arrange for feeds
encourage supplements, dietary consults – no MD order required, Tube feedings)
For parenteral nutrition, what would you manage?
Site/line care, glucose levels
Disorders of the esophagus include
Hiatal hernia, Varices, Diverticulum, GERD, tumors, esophagitis, candida
dysphagia, odynophagia, regurgitation, vomiting, foul breath, chronic hiccups, pulmonary complications, chronic cough, and hoarseness are clinical manifestations of
esophageal tumors
Peptic Ulcers (Gastric), gastritis, cancer are disorders of
stomach
Peptic ulcers occur because of
Vascular occlusion causes localized necrosis and HCL backwash, histamine and inflammation, bacterial infection
Signs and symptoms of peptic ulcers include:
epigastric pain, nausea and vomiting, weight loss, pain-, food- relief pattern ( less than duodenal), heartburn, bleeding, perforation
elevates the level of the gastric contents
antacids
decreases acid production
histamine receptor antagonist
proton pump inhibitors (PPI) functions to
provide effective, long-acting inhibition of gastric acid secretion
Prokinetic drugs (Cisapride)
increase gastric emptying and improve lower esophageal sphincter pressure and esophageal peristalsis
treatment for GERD and peptic ulcers include
decrease risk factors, drug therapy, Histamine 2 blockers, pepcid, Antacids, Prostaglandins, Omperazole, surgery, vagotomy + pyloroplasty, Bilroth I Bilroth II- total gastric resection, manage complications: GI bleeding
post op care for GI surgery include
Monitor VS, monitor the nasogastric tube, NPO until peristalsis, monitor for postoperative complications: Dumping syndrome (constellation of vasomotor symptoms after eating) blood flow, changes, reflux gastropathy, bleeding
