GI Module Flashcards
C-Diff
-long term antibiotic use destroys normal flora.
-Antibiotic resistant gram positive bacteria causes diarrhea.
NURSING CONSIDERATIONS
contact precautions
stool samples
skin integrity
treat with Flagyl
GI bleed
CAUSES -perforation of an ulcer SYMPTOMS decreased H/H tarry stools (melena) hematemesis board like stomach
General GI post-op care
(?)
NG-Tube nursing care
assess nares and provide nasal/oral care assess placement secure the tube assess suction strength reposition the tube
More on NG-tube care
Used most often for decompression
x-ray varification before use for feedings or administering medications.
Aspirate contents and check pH; should be less than 5.0
It is dangerous to check by instilling air into the tube and auscultating with stethoscope because the sound in the lungs may be the same.
Lubricate the nares and look for pressure ulcers in the nares
Tube patency should be checked q 4 hours and irrigate with 20 mL of NS.
Tube feeding nursing care
Check proper placement via x-ray
Patient in high fowlers position during feeding
high fowlers for 30 minutes after feeding
Clamp tube when applying syringe or bag so air doesn’t get into the patient’s stomach
bolus feedings slowly; gravity over 20-30 minutes.
Flush with water to prevent blockage; at least 30 mL water Q 4 hours
Administer medications one by one.
If there is diarrhea, slow the rate
administer free water via orders.
Ulcerative Colitis
Chronic inflammation of mucosa and submucosa in the colon and rectum.
Peak incidence is between 15 and 35 years of age with a second peak in people aged 50 to 70.
Characterized by periods of exacerbation and remission.
Ulcerative Colitis: Causes
The cause in unknown
May be related to anxiety or stress
genetics, infection, low fiber intake,
antibody formation
Inflammation develops into abscesses that penetrate the mucosa and spreads laterally
Begins in the rectum and can progress proximally, but is usually limited to the sigmoid colon and rectum.
Ulcerative Colitis: Manifestations
Diarrhea - 10 to 20 liquid stools a day often containing blood and mucus
Fatigue from blood loss/lack of sleep/fluid imbalance
Psychosocial - pt afraid to go out
Ulcerative Colitis: Complications
Hemorrhage Abscess formation Toxic megacolon Bowel obstruction Bowel perforation Risk of Colon cancer
Ulcerative Colitis: diagnostics
sigmoidoscopy which shows friable mucosa with a granular appearance.
CBC to look for anemia
Surgical treatment is curative.
Ulcerative Colitis: Nursing care
Take Medications as ordered Avoid food that exacerbate the symptoms (avoid dairy if lactose intolerant) Low residue diet Call doc if blood in the stool Avoid stess Exercise Rest to decrease intestinal activity Provide psychosocial support
Bowel Obstruction
Failure of bowel contents to move forward
complete or partial
Types of bowel obstructions
- Mechanical obstuction
resulting from forces outside of the intestine such as tumors, hernias, adhesions
blockage of the lumen itself - Non mechanical obstruction
impairment of muscle tone or nervous system innervation preventing peristalsis
(e.g., anesthesia, abd surgery, spinal cord injury, peritonitis, vascular insufficiency)
Bowel Obstruction facts
Most often occur in the ileum because this is where the diameter is the smallest.
Peristalsis increases in the intestine above the blockage leading to increased secretions, edema, and increased capillary permeability and resulting in fluid and electrolyte imbalances and hypovolemia.
