Git Disorders 1 Flashcards
Gastri-oesophageal reflux disease
Chronic symptom of mucosal damage in the stomach acid into the lower oesophagus
Causes of gord
Incompetent lower oesophageal sphincter( decreases presseure) Decreased oesophageal clearance Decreased gastric emptying Reflux of gastric contents Obesity Smoking Pregnancy
Gord symptoms
Heartburn Dyspepsia Respiratory symptoms Lump in throat Atypical chest pain
Gastric symptoms (delay gastric emptying )
Post meal bloating
N&v
Gord multidisciplinary care
Life style modifications Nutritional therapy ( avoid food that can decrease low oesophagus sphincter pressure) Drug therapy Surgical therapy Endoscopic therapy
Gord nursing management
Patient education \:avoid smoking ( prevrnt reflux) food that cause lower oesophagus sphincter pressre to decrease, meds) Do not lie down 2-3 hours after eating Weight reduction Elevate head of bed 30% ( with pillow)
Peptic ulcer disease
Ulceration in the gi mucosa
Peptic ulcer disease aetiology
Develop in acid environment
Caused by digestive action in hydrochloric acid and pepsin
Where git is in contact with gastric secretions (stomach and duodenum)
Helicobacter pylori - 70-95%
Types of peptic ulcer
Acute/chronic
Gastric/duodenum
Gastric ulcer
Less common
Factors:
Helicobacter pylori medications, smoking
Chronic alcohol abuse, chronic gastritis, bile reflux gastritis
Increase nsaid and aspirin use
Symptoms:
N&v
Pain - burning, gaseous pressure in high left epigastrium, back and lower abdomen
Onset 1-2 hrs
Duidenal ulcer
80% of all peptic ulcers Factors Increase hydrochloride acid secretions Helicobacter pylori (90-95%) Associate with physiological stress High risk of development of certain disease Signs Pain- burning cramping , pain in upper abdomen Onset 2-4 hrs afer meal Pain releved by antacid and food v&n
Peptic ulcer collaborative therapy
Conservativ etherapy
Conservative therapy Stress reduction Rest Dietary modifications Cessation of smoking Reduce alcohol intake Pharmacological therapy Surgical therapy
All considered complications
Haemorrhage
Perforation
Gastric outlet obstruction
For acute exacerbation without complications
Nbm Ng sunction Rest Cessation of smoking Iv fluids Drug therapy
With complications
Include blood transfusions
Possible stomach lavage
Peptic upcer pharmacological
Antacid Histamine receptor antagonists Antibiotic therapy Antidepressants Anticholinergics Anti secretory and cytoprotective drugs
Some common git procedures
Oesophagectomy - oesophageal cancer
Laparoscopic fundoplication - hiatus hernia
Gastrectomy - gastric cancer
Appendicectomy - appendicitis
Gut surgeries and nursing BBG management
Assessment Nursing diagnosis Acute pain Anxiety Risk of ineffective airway clearance
Planning
Interventions
Evaluation
Inflammatory disorders of git
Oesophagitis Gastritis Appendicitis Peritonitis Gastroenteritis
Inflammatory bowel disease
Types
Chronic disorders
Crohn’s disease
Ulcerative colitis
Inflammatory bowel disease
Immunological related disorders
Characterised by chronic inflammation of the intestine with periods of remission interspersed with periods of exacerbation
Inflammatory bowel disease
Crohn’s disease
Crohn’s occurrence
Can affect any part of digestive tract
Inflammation in ALL layers of bowel wall
Symptoms Bloody diarrhoea Abdominal cramping pain Systematic symptoms such as fever Weight loss
Ulcerative colitis
Occurence
Affects colon
Recurrence ulcerative and inflammatory disease of the mucosal and submucosal layers
Symptoms
Diarrhoea, frequent emptying of the colon
Abdominal cramping pain
Management of chronic ibd
Medical treatment:
Aims- reduce inflammation suppress inappropriate immune response, rest bowel/promote healing, prevent / minimise complications, improve quality of life
Nutritional therapy
Pharmacological therapy of ibd
Aminosalicytes Antimicrobials Corticosteroids Immunosuppressant Biological and targeted therapy
Nursing care of ibd
Includes management of diarrhoea, associated abdominal pain and cramping, risk of fluid volume deficit and impaired skin integrity.
Nursing interventions of ibd
Stool chart Vital signs Weight monitoring Assessing fluid intake Skin care
