GI System Diet And Problems Flashcards
What are some swallowing aids for pts experiencing dysphagia?
- encourage pt to think and talk about food before meals :can help stimulate flow of saliva, helps in formation of boils and help chewing and swallowing process
- eat tart or sour foods will stimulate salive
- have pt lick jelly from lips, pucker, hum or whistle: helps strengthen mouth muscles and may help pt learn to close lips around fork
What are some warning signs of dysphasia?
- reluctant to eat
- reluctant to eat certain food consistencies
- very slow chewing or eating
- fatigue from eating
- frequent throat clearing or food sticking in throat
- holding pockets of foods in cheeks
- painful swallowing
- regurgitation, coughing, choking
What will be the diet for pts with dysphasia?
- diet individualized based on swallowing abilities and food preference
- assess ability to swallow liquids and solid foods
- may modify texture, cohesiveness, density, viscosity, temperature and taste of folds
- always eating upright to avoid aspiration and choking
What is the role of the small intestine?
Complete absorption, absorbs nutrients and water
What is the role of the large intestine?
Forming and storing stool, extract essential vitamins
What is the role of the rectum?
Stores and expels feces
What are the types of inflammatory diseases for the GI system?
- celiac’s disease
- Crohn’s disease
- diverticulosis
- ulcerative colitis
What is the name of the gas and mucous producing syndrome of the GI system?
Irritable bowel syndrome
What are the possible non- pharmacological management for GI conditions?
- diet changes
- resting the bowel
- replace the guy flora
What are some curative med classes used in the pharmacological management of GI conditions?
- antibiotics
- anti-diarrheals
- anti- inflammatories
- laxatives
- monoclonal antibodies
What are possible conditions behind a chronic diarrhea?
- tumors
- AIDS
- diabetes
- Crohn’s disease
- ulcerative colitis
- hyperthyroidism
- irritable bowel disease
What are possible causes of constipation?
- diet
- fluid intake
- environmental constraints
- avoiding need to defecate
- abuse of laxatives
What are the risks with chronic constipation?
- will cause malabsorption (micronutrients, vitamins, electrolytes)
- malnutrition
- decreased appetite - weight loss
- bowel obstruction- can lead to bowel perforation- peritonitis- sepsis- death
What are some lifestyle interventions with constipation?
- increase dietary fiber and fluids (20-30g/day)
- insoluble or soluble fibres
- walking 3x per week
- recording bowel pattern
- avoid overuse of laxatives
After the nurse has completed teaching a pt with newly diagnosed celiac disease, which of the following breakfast choices by the pt indicates good understanding of the information?
A) corn tortilla with eggs
B) bagel with cream cheese
C) oatmeal with non fat milk
D) whole wheat toast with butter
A
True or false, a pt with ulcerative colitis should be on an elemental diet to help with absorption of nutrients?
True
True or false, a low fibre diet is encouraged in the treatment of diverticulosis?
False
What is lactose intolerance? And what is it’s usual symptoms?
- cannot digest dairy protein (lactose), undigested lactose goes to the colon and mixes with bacteria and ferments
S&S:
- gas
- bloating
- diarrhea
What is cow milk protein intolerance CMPI)? And how does it usually present?
- abnormal response by the body’s immune system to a protein in the cows milk, which causes injury to the stomach and intestines
Usually appears around 3 months and goes away after 12
S&s:
- skin: rash or eczema
- GI: vomiting & diarrhea, abdominal pain and bloating, bloody and mucousy stool
What is celiacs disease? How does it usually present? And what are the usual treatments ?
Celiac’s disease (autoimmune)
- chronic inflammation from ingestion of gluten (immune system attacks lining of intestines causing inflammation post consumption of gluten)
S&S:
- bloating/gas (pain)
- constipation or diarrhea
- abdominal pain
- N&V
- malabsorption/malnutrition
- fatigue/weight loss
Usual treatments:
- gluten free diet
- NSAIDs +/- corticosteroids: PO prednisone, IV: methylprednisone (Solu-Medrol)
What is crohn’s disease? How does it usually present? And what is it’s usual treatment?
Crohn’s disease - autoimmune:
- abnormal inflammation of GI tract from mouth to anus, resulting in thickening and narrowing of the lumen
- impaired absorption, especially fat soluble vitamins (A,D,E,K), malnutrition
- high fat poorly tolerated
S&S:
- abdominal/GI pain
- anemia
- dehydration
- diarrhea
- electrolyte imbalances
- fatigue
- malabsorption/malnutrition
- weight loss
Treatments:
- elemental diet
- high calorie, reduced fat, low residue, no lactose
- liquid replacement parental feeding produce wound healing, reduce complication and help recovery
- blood transfusions
- NSAIDs +/- corticosteroids IV methyl prednisone
What is diverticulitis? How does it present? What is it’s usually treatments?
Diverticulitis:
- trapped feces and bacteria in the diverticula, causes inflammation and infection
S&S:
- abdominal mass
- abdominal pain (severe)
- anorexia
- chills, fever, increased WBCs
- mucousy, green stool
can sometimes cause bowel obstruction, perforation and peritonitis which leads to sepsis
Treatments:
- rest the bowel (NPO)
- antibiotics : cipro, Flagyl (metronidazole)
- corticosteroids: IV methylprednisolone (soul-medrol)
- bulk laxatives
- surgery: bowel resection/ ostomis
What is ulcerative colitis? How does it usually present? And what are its treatment ?
Ulcerative colitis- autoimmune/chronic IBD:
- inflammation and ulceration beginning in the rectum spreading to the colon,
Causes development of abscess that lead to ulcers
Which causes bleeding and diarrhea
Can cause decreased absorption of fluid and electrolytes, takes place mainly in large intestines
Increases risk of colorectal cancer
S&S:
- abdominal pain
- bloody diarrhea
- loss of fluid and electrolytes
- fever, weight loss, anemia, dehydration
Treatments:
- rest the bowel (NPO)
- manage fluid and nutritional needs
- decrease GI inflammation
- moderate: medication
- severe: surgical interventions (ostomies)
- nutrition management
- stress management
- IV methylprednisolone (solu- medrol)
What does an elemental diet consist of?
- nutrition is delivered via liquid formulas by feeding tube or IV
- high calorie, high nutrient, low residue
- fortified with vitamins, minerals and electrolytes
- Every nutrient is broken down already so the GI system doesn’t have to do the work
What is an elemental diet used for usually?
Crohn’s disease, IBD, IBS
What is TPN? What is it’s goal?
Total parenteral nutrition
Used for pt who are unable to tolerate oral intake
To allow the bowel to rest
What is the difference between PPN (peripheral parenteral nutrition) and TPN (total parenteral nutrition)?
PPN:
- for shorter periods of time
- in small peripheral veins
- uses less concentrated solutions through small peripheral veins
TPN:
- also called CPN
- can be used for longer periods
- used for large energy and nutrient requirement
- given through large veins
- often given through PICC (peripherally inserted central catheter)
Can TPN be stopped abruptly?
No, should always be tapered down
Discontinue slowly
What are the priorities with TPN and steroids?
- monitor and manage blood glucose
- prevent infections
What should be monitored and assessed when on TPN?
- monitor blood glucose q6hrs (can cause hyperglycaemia)
- assess tolerance (if want to increase increase slowly)
- monitor for signs of infections
- monitor for signs of intolerance
- monitor for signs of hyperglycaemia
- monitor for signs of fluid excess
What are some important interventions when a pt is on TPN?
- start slowly
- schedule carefully
- monitor closely for intolerance
- monitor BG q6hrs
- increase volume gradually
- makes changes cautiously
- maintain a constant rate, always with a pump
- never stop abruptly (discontinue slowly)
- monitor for infections
What is irritable bowel syndrome? How does it usually present? What are the possible treatments?
Irritable bowel syndrome (IBS) :
- abnormal muscle contractions and/or GI secretions associated with changes in stool frequency and appearance
S&S:
- abdominal distension, gas, bloating
- diarrhea or constipation
- urge to defecate but unable to appropriately evacuate the bowel
Triggers: stress, inflammation, GI irritation, allergies, antibiotic and alcohol use
Treatment:
- high fiber diet (20g/day)
- low FODMAP diet
- elimination of gas causing foods (carbonated beverages, beans)
- decrease stress
- must be relieved with defecation
What are some foods included in the low FODMAP diet:
- Vegetables: lettuce, carrot, cucumber
- Fruits: strawberry, pineapple, grape,
- Proteins: chicken, eggs, tofu,
- Fats: oils, butter, peanut,
- Starches and cereals: potatoes, tortilla chips, popcorn
What are some foods to AVOID when on a FODMAP diet?
-Vegetables: garlic, beans, onion
- Fruits: blackberries , watermelon, peaches
- Proteins: sausages, battered fish, breaded meats
- Fats: almonds, avocado, pistachios
- Starches and cereals: beans, gluten-based bread, muffins
What is a FODMAP usually used for? With which condition?
IBS
