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EMRG 1130 > Module 24- GI Assessment and Treatment > Flashcards

Module 24- GI Assessment and Treatment Flashcards

1
Q

Symptoms of GI Tract Diseases

A
  • Pain
  • Vomiting and/ or diarrhea
  • Bleeding
  • Alterations in bowel habits
  • Alterations of liver or pancreatic function
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2
Q

What patient history should you obtain when your pt obtains abdominal pain?

A
  • Nature
  • Time course
  • Location
  • Aggravating and relieving factors
  • Referred pain- due to autonomic nervous system pain nerves arising from a large area
  • Appendicitis
  • Peritonitis
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3
Q

Fluid losses- dehydration

A
  • Vomiting, diarrhea, poor oral intake, or malabsorption
  • Tachycardia
  • Hypotension heralds severe dehydration
  • Can be mild or life threatening
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4
Q

GI Bleeding

A
  • GI tract has generous blood supply to ensure nutrient absorption but make it vulnerable to severe hemorrhage
  • Hypovolemia
  • Since blood loss from GI tract can not be controlled by pressure dressing, GI bleeding can be fatal
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5
Q

Location can be determined by presentation

A
  • Vomiting of blood or a material that resembles coffee ground
  • Upper GI
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6
Q

Melena

A
  • Upper GI
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7
Q

Peptic ulcers, diverticular disease, cancer

A
  • Present with bleeding from the rectum
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8
Q

Crohn’s disease or ulcerative colitis

A
  • May develop bleeding ulcers of the intestines
  • Usually have additional systems
  • Pain, fever
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9
Q

Trauma

A
  • Not common mechanisms for GI bleeding
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10
Q

What are the alterations in bowel habits?

A
  • Contaminated food
  • Constipation
  • Bowel obstruction
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11
Q

Contaminated food

A
  • Food contains bacteria, viruses, and fungi
  • Most destroyed through cooking or pasteurization of food
  • Organisms that remain are usually killed by stomach acid and digestive juices
  • Bypass the immune system which can lead to gastrointestinal infection
  • One sixth of the Canadian population each year are infected
  • Deaths are rare
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12
Q

Constipation

A
  • Common complaint
  • Associated with severe pain and discomfort
  • Can occur from medications
  • Decreased activity
  • Acute or chronic
  • Able to still pass gas
  • No vomiting
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13
Q

Bowel Obstruction

A
  • Failure to peristalsis
  • Due to diseases, systemic illness, medications or blockage
  • Common reason is when intestines become twisted or entrapped
  • Twisting can occur in patients who have scar tissue from previous surgery or hernias
  • Can occur from structures that narrow the pathway
  • Present with crampy, poorly localized abdominal pain
  • Absence of stool and gas
  • Sometimes vomiting
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14
Q

Altered Organ Function

A
  • May be difficult to distinguish the organ without specific testing or imaging unless specific signs are present
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15
Q

Liver failure

A
  • Once at advanced stage pt’s develop yellow skin and sclerae from jaundice
  • Altered mental status from buildup of bilirubin, ammonia, and other toxins
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16
Q

Cirrhosis- chronic liver failure

A
  • Distended abdomen
  • Blood backs up in the GI organs and fluid accumulates in the abdomen
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17
Q

Esophageal Varices

A
  • Pressure increases within the blood vessels of the distal esophagus portal hypertension
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18
Q

What are causes of esophageal varices?

A
  • Liver damage
  • Cirrhosis
  • Alcohol (industrialized countries)
  • Viral hepatitis (developing countries)
  • Upper GI bleeding
  • Chronic alcohol consumption damages and scars the interior of liver leading to slower blood flow and higher venous pressure
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19
Q

Mallory-Weiss Syndrome

A
  • May lead to severe hemorrhage
  • Affect men and women equally
  • More prevalent in older adults and older children
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20
Q

What are causes of mallory-weiss syndrome?

A
  • Esophageal lining tears during severe vomiting
  • Boerhaave syndrome- rupture of esophagus
  • Pneumothorax- spillage of gastric contents
  • Sepsis
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21
Q

Hemorrhoids

A
  • Swelling and inflammation of blood vessels surrounding the rectum
  • Common problem
  • Increased pressure on the rectum
  • Irritation of the rectum
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22
Q

What are possible causes of hemorrhoids?

A
  • Pregnancy
  • Straining at stool
  • Chronic constipation
  • Anal intercourse
  • Diarrhea
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23
Q

Peptic Ulcer Disease

A
  • High levels of acidity
    • In the stomach and duodenum
    • Protective layer is eroded, allowing the acid to eat into the organ
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24
Q

What are some causes of peptic ulcer disease?

A

-In the past, thought to be the types of food that people were eating
- Variety of etiologies
- Majority are a result of infection of the stomach
- H-pylori bacteria
- Chronic use of NSAIDS- inhibits enzyme that protects the stomach lining and controls bleeding
- Alcohol and smoking can affect the severity

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25
Q

What is Cholecystitis caused by?

A
  • Obstruction of the cystic duct leading from the gallbladder to the duodenum, usually by gallstones
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26
Q

How are gallstones formed?

A

Gallstones are formed by either increased production of bile or decreased emptying of the gallbladder

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27
Q

Gallbladder

A
  • Stores bile
  • If blockage is present, the patient may experience severe pain
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28
Q

What is positive Murphy sign?

A
  • Have patient breather deeply while pressing deeply on the RUQ near costal margin
  • If the patient stops the inspiration suddenly due to pain-positive Murphy’s sign
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29
Q

What are the s/s of cholecystitis?

A
  • Fever
  • Jaundice
  • Tachycardia
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30
Q

Risk Factors of cholecystitis

A
  • females
  • older people
  • Caucasians
  • Overweight or recent extreme weight loss
  • Classic patient: fair, obese, female, and 50
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31
Q

Appendicitis

A
  • Accumulation of material
    • Usually feces
    • Organ is obstructed, pressure may build
    • Flow of blood and lymph fluid decreases
    • Hinders ability to fight infection
    • May eventually result in rupture, peritonitis, sepsis, and death
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32
Q

What are the risk factors of appendicitis?

A
  • Adolescents have the highest incidence of appendicitis
  • Number of cases drop as age increases
  • Elderly individuals have a higher mortality rate
  • Males are slightly more prone
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33
Q

Diverticular Disease

A

Fibre
- Western societies tended to eat less dietary fibre
- More solid tools
- Increased intraluminal pressures
- Bulges in the colon wall
- Diverticula- small outcropping turn into pouches
- Feces become trapped in these pouches
- Bacteria
- Scarring, adhesions, and fistulas occur due to infections

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34
Q

Pancreas

A
  • Produces several enzymes that help break down the food
  • If the duct carrying these enzymes become blocked, the enzymes are activated
  • Breaks down the protein and fat of the pancreas itself
  • Autodigestion of the pancreas begins
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35
Q

What are the risk factors of pancreatitis?

A
  • Increased alcohol consumption
  • Gallstones
  • Medication reactions
  • Trauma
  • Cancer
  • Very highly triglyceride levels
  • Can occur suddenly or may persist over months
  • Can have recurrent attacks
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36
Q

What is ulcerative colitis caused by?

A
  • Generalized inflammation of the colon
  • Unclear what cause the chronic inflammation
  • Genetics, stress and autoimmunity have be speculated to contribute
  • Causes thinning of the wall of the intestine
  • Weakened, dilated colon prone to infections by bacteria and bleeding
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37
Q

What are the risk factors of ulcerative colitis?

A
  • Disease of the young (between 15 and 30)
  • Equidal incidence among men and women
  • Strong hereditary component 20% of people have a family member with it
  • More prevalent in Caucasians and people of jewish decent
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38
Q

Crohn Disease

A
  • May affect the entire GI tract
  • Immune system attacks the GI tract
  • Most likely site of inflammation is the ileum
  • Scarred, narrow, stiff, and weakened portion of the small intestine
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39
Q

Risk factors of Crohn Disease

A
  • Most between the ages of 20 and 30
  • Men are diagnosed as often as women
  • People of Jewish descent have an increased incidence
  • May have a genetic component
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40
Q

Acute Gastroenteritis (Stomach Flu)

A
  • Present with diarrhea, nausea, and vomiting
  • Bacterial, viral, and parasitic organisms
  • Can run its course in 2 to 3 days or continue for several weeks
    • C-diffcile
    • Norwalk virus (most common cause in adults)
    • Rotavirus (most common cause in children)
    • Salmonella
    • E coli
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41
Q

Cholera

A
  • Type of acute gastroenetritis
  • Relatively unknown in Canada
  • Frequently encountered in the developing world
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42
Q

Acute Hepatitis

A
  • Caused by one of several viruses: A, B, C, D, and, E
  • In Canada: A, B, and C
  • Hepatitis is a general term referring to inflammation of the liver
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43
Q

What are other causes of Acute Hepatitis?

A
  • Epstein-Barr virus (from herpes family in adolescents causes mono)
  • Cytomegalovirus (herpes family)
  • Certain bacterial infections
  • Liver cancer
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44
Q

How is hepatitis A and E transmitted?

A
  • A and E move by the fecal-oral route
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45
Q

How is hepatitis B, C, and D transmitted?

A
  • B, C, and D are transmitted by person-to-person contact (sexual intercourse or blood to blood contact)
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46
Q

What are the symptoms of hepatitis infection?

A
  • Abdominal pain
  • Vomiting
  • Fever
  • Jaundice

*Time for initial infection to emergence of symptoms can range from 14-180 days

47
Q

What is included in you scene assessment for GI?

A
  • Scene safety
  • Mechanism of injury or nature of illness
  • Personal protective equipment and routine precautions
48
Q

Scene Safety

A
  • Paramount concern for all types of calls
  • No specific concerns related to patients with GI emergencies
  • Patient’s will often need some type of assistance with hygiene
  • Additional resources
49
Q

What additional resources should you include for GI emergencies calls?

A
  • Extra gloves, masks, gowns
  • Change of uniform
  • Suction equipment
  • Extra linens, blankets, wash rags, towels
  • Adult and child diapers
50
Q

Mechanism of injury or nature of illness

A
  • Contributes to initial impression
  • Most calls for GI problems will not involve multiple patients
  • If you are called for multiple patients in one building consider a biological or chemical agent
51
Q

Personal protective equipment (PPE) and routine precautions

A
  • Gloves
  • May need to manage vomit, diarrhea, and soiled patient clothing
  • Gowns are helpful
  • Masks can help with noxious odors
52
Q

What should be included in your initial assessment?

A
  • Forming a general impression
  • Odour
  • Airway patency
  • Breathing
  • Circulation
  • Pain or hemorrhage
  • Orthostatic vital signs
  • Gross bleeding
53
Q

Forming a general impression

A
  • Positioning of pt (fetal position can relive symptoms)
  • Location- where is the pt?
54
Q

Odour

A
  • Smell of the room
  • Noxious odor from stool
55
Q

Airway patency

A
  • More pertinent concern
  • Vomiting pt may aspirate
  • Open the airway
  • Remove or suction any obstructions
  • Bowel obstruction may cause breath to smell like feces
56
Q

Breathing

A
  • Rarely affected
  • Systemic complication
  • Suspect aspiration if breathing is affected
57
Q

Circulation

A
  • Skin color, temp, and condition
  • Heart rate
  • Peripheral pulses
58
Q

Pain or hemorrhage

A
  • Blood volume begins to drop
  • Epinephrine and norepinephrine are released to compensate for lower blood pressures
  • Vasoconstriction, increased HR
  • Pain stimulate similar responses
59
Q

Orthostatic Vital Signs

A
  • Help determine the extent of bleeding
  • Recline in a position of comfort
  • Accurate BP and HR
  • Have the patient sit or stand, wait a min or two, then repeat the BP and HR measurements
60
Q

Gross bleeding

A
  • Not usual to find large amounts of blood
  • Take note of the amount of blood lost
  • Volume estimation can be difficult, especially in the toliet
61
Q

Handling Smells

A
  • The sense of smell is the most acute for about a min
  • By then 50% of the intensity of an odour is lost
  • Due to the olfactory nerve becoming tired of sending the same signal
  • Try to stay in the environment for 2-5 mins
  • The smell may be less noticeable
62
Q

What focused history/ physical examination would you do on an unstable patient

A
  • Head-to-toe examination
  • DCAP-BTLS examination
  • Major effects from GI disease typically relate to the nervous, cardiovascular, and resp systems
63
Q

Examining the abdomen

A
  • Can be uncomfortable
  • Respect pt’s privacy; protect from onlookers
  • Maintaining straight legs and arms over the head can result in flexed abdominal muscles
  • Try to distract pt with conversation
64
Q

What should we look for on the skin?

A
  • Irregularities
  • Scars from trauma or previous surgery
  • Stretch marks
65
Q

Shape of the abdomen

A
  • Symmetry
  • Round
  • Protuberant (ascites and/or liver failure)
  • Scaphoid (concave) from malnutrition
66
Q

Listening to bowel sounds

A
  • Listening to bowel sound is not accurate (osculate)
  • One location is usually all that is needed, RLQ
  • Normal sounds- gurgles and glicks 5-30 times a min
  • Borborygmi- growling, indicates strong contractions of the intestines
  • Hyperperistalsis- enhanced bowel sounds. Can be heart in early stages of bowel obstruction as bowel tries to overcome obstruction
  • Decreased bowel sounds
  • Absence of bowel sounds
67
Q

Palpate the abdomen

A
  • Place your hand flat on the wall of the abdomen
  • Begin in the quadrant farthest from the complaint
  • With your hand sitting on the wall of the abdomen, raise your wrist so that you indent the abdominal wall with your fingers about 5 to 10 cm
  • Presence of rigidity, comfort, or masses
  • If pt flexes due to feeling ticklish may be difficult to assess, try to distract with conversation
68
Q

Assessing the Abdomen

A
  • Ask patient to breath with an open mouth
  • Much harder to hold the stomach contracted with mouth breathing
  • When pt exhales the abdomen typically relaxes
69
Q

Focused History and Physical Examination- Pain

A
  • Often a finding of importance with GI patients
  • Can indicate trauma, hemorrhage, infection, or obstruction
  • Determine the OPQRST of the complaint
  • Somatic patients
  • Visceral pain
  • Rebound tenderness
  • Examination goal is to have the peritoneum vibrate
70
Q

Somatic pain

A
  • found in skin and deep tissues, well localized
    ex. cut your skin you experience somatic pain, or stretch your muscles too far during exercise
71
Q

Visceral pain

A
  • comes from organs
72
Q

What are some questions to ask?

A
  • When does the patient have pain?
  • Does it increase with palpation?
  • Is there pain when not being touched?
73
Q

Rebound tenderness

A
  • suggestive of serious and potential life threatening pathology
  • Occurs when peritoneum is irritated due to either hemorrhage or infection
74
Q

How do we check for rebound tenderness?

A
  • We depress the skin about 5 to 10cm then quickly pull your fingers off the abdominal wall
  • Speed in essential
75
Q

Assessment of abdomen

A
  • Abdomen should be smooth when palpated
  • Any presence of bumps or masses may signal the presence of:
    • Engorged liver
    • Bowel distension
    • Aortic aneurysm
    • Tumors
76
Q

SAMPLE History

A
  • Elicit the relevant current and past medical history
77
Q

What should you monitor enroute?

A
  • Heart rate, ECG, BP, RR, and pulse oximetry
  • If GI bleeds, assess for signs of shock
  • Determine the effect of treatment
  • Monitor pain level
  • Repeat the assessments as if for a new patient where there is a dramatic change

Not necessary to diagnose the specific causes of a pt’s abdominal pain in order to appreciate that the pt is in a serious condition

78
Q

Gastrointestinal Bleeding Assessment

A

Presentation
- Variable
- Reflects the presence of a number of diseases

Medical history
- May provide important information
- Gathering information on how symptoms have
progressed is important
- Medications may irritate the GI tract
- NSAIDS are bad for the GI

How much bleeding has occurred
- Most important component of the physical
examination
- Focus assessment on evaluation for shock
- Need to determine if the patient is compensating
for the fluid loss
- Orthostatic vital signs are the key to gauging the
degree of fluid loss.

79
Q

Esophageal Varices Assessment

A
  • Initially patient may show subtle signs of liver disease
  • Once there is a variceal bleed, the presentation is quite dramatic
  • Throat discomfort, copious amounts of vomiting with bright red blood, hypotension, shock
  • If the bleeding is less severe, then hematemesis and melena predominate
80
Q

Mallory-Weiss Syndrome Assessment

A
  • Due to repeated vomiting
  • In women, may be associated with hyperemesis gravidarum (more dramatic morning sickness)
  • Extent of bleeding can range from very minor to severe
81
Q

Hemorrhoids Assessment

A
  • Bright red blood rectal bleeding
  • Hematochezia
  • Usually minimal and easily controlled
  • Patient may overreact as blood loss looks worse in toilet
  • May experience itching and a small mass on the rectum
82
Q

Peptic Ulcer Disease Assessment

A

Classic sequence:
- Burning or gnawing pain in the abdomen
- Subsides or diminishes after eating
- Reemerges 2 to 3 hours later
- Nausea, vomiting, belching, and heartburn are common
- Gastric bleeding can occur.

83
Q

Cholecystitis Assessment

A
  • Severe right upper quadrant pain after large or fatty meals.
  • Fever and tachycardia from inflammation of the gallbladder wall
84
Q

Appendicitis Assessment

A
  • Periumbilical (around umbilicus) visceral pain that migrates to the right lower quadrant
  • Rebound tenderness suggest possible perforation of the appendix with peritonitis
  • Additionally may develop:
    • Anorexia
    • Nausea
    • Fever
85
Q

Diverticular Disease Assessment

A
  • Abdominal pain
  • Tends to be localized to the left side of the lower abdomen
  • Classic signs of infection
    Fever, malaise (don’t want to do anything), body aches, chills, nausea, and vomiting
86
Q

Pancreatitis Assessment- pain

A
  • Tends to be localized to the epigastric area or right upper abdomen
  • Can be sharp and may be quite severe
  • May also experience nausea, vomiting, fever, tachycardia, hypotension, and muscle spasms in the extremities
87
Q

Pancreatitis Assessment- Greatest cause for alarm

A
  • Internal hemorrhage from erosion of nearby blood vessel
  • Advanced autodigestion
  • Hemodynamic instability may be present.
  • Grey Turner sign and Cullen sign represent retroperitoneal bleeding
88
Q

Ulcerative Colitis Assessment

A
  • Bloody diarrhea and abdominal pain
  • Other signs and symptoms include joint pain and skin lesions, from autoimmune response
  • May experience fever, fatigue, and loss of appetite
89
Q

Crohn Disease Assessment

A
  • Recurrent flares of abdominal pain
  • Rectal bleeding, weight loss, diarrhea, arthritis, skin problems, and fever may also be present
  • Bleeding tends to be small amounts over a long period of time
  • Chronic bleeding can cause anemia
  • May experience repeated episodes of mild to severe signs and symptoms
90
Q

Gastroenteritis Assessment

A
  • Vomiting and diarrhea
  • Inflammation of the intestines
  • Blood, mucous, or pus in the stool
  • Abdominal cramping
  • Fever, nausea, and anorexia
  • Dehydration and hemodynamic instability if diarrhea continues (asking if they can keep anything down)
91
Q

Acute Hepatitis Assessment

A

Different etiologies often associated with the same signs and symptoms

  • First phase
    • Joint aches
    • Weakness and fatigue
    • Fever
    • Nausea and vomiting
    • Abdominal pain
    • Anorexia
  • Second phase
    • Symptoms of liver failure
    • Acholic stools- absence of bile, pale or clay
      coloured)
    • Darkening of the urine
    • Jaundice
  • Abdominal pain in the right upper quadrant and an enlarged liver
  • Depending on the disease progression, total liver failure may be only days away
92
Q

Bowel Obstruction Assessment

A
  • Strictures- causes narrowing usually from scar tissue or tumor
  • Varies according to the underlying cause
  • Signs include abdominal pain and fullness
  • Diarrhea initially
  • Peristalsis increases as an attempt to overcome the obstruction
  • Constipation may eventually result
  • Nausea and vomiting are common in later stages
  • Emesis and the pt’s breath having a fecal odor
  • Eventually perforation of the bowel may occur (causing septic shock peritonitis)
93
Q

General Management Guidelines

A
  • Often little can be done
    • Prehospital care for the effects of the disease
    • Extreme amounts of pain, dehydration, hypotension, or extreme nausea
94
Q

What are the main goals of general management guidelines?

A
  • Maintain routine precautions and PPE
  • Manage the ABCs
  • Manage the patient’s pain and nausea.
95
Q

Routine Precautions and PPE

A
  • Essential due to the high likelihood of coming in contact with infectious agents
  • Be prepared to deal with large amounts of vomit, feces, and blood
  • Equipment
    • Gloves/gowns/eye protection/surgical mask
    • Towels and washcloths
    • Extra linen
    • Absorbent pads
    • Emesis basin
    • Disposable basin
    • Biohazard bags
    • Sterile water for irrigation
96
Q

Airway

A
  • Aspiration or obstruction of the airway due to vomit or blood
  • These complications are rare
  • Effective positioning
  • Portable suctioning
97
Q

Breathing

A
  • Often associated with decreased hemoglobin due to bleeding
  • Be liberal in delivering oxygen
  • Oxygen masks can cause some patients to experience a sense of confinement
  • Monitor patients to make sure they can get the mask off quickly if they start to vomit
98
Q

Administer fluids

A
  • One or two large bore intravenous cannulas
  • Degree of hemodynamic instability combined with evidence of pulmonary edema
  • If the patient is hypotensive, a rapid bolus of 10 to 20 ml/kg of an isotonic crystalloid
99
Q

Maintain peripheral perfusion

A
  • Check LOA- GCS of 15
  • Normal mentation
  • Skin condition
  • Presence of a radial pulse (if gone their BP is usually around 80)
  • Should all be adequate for to allow for perfusion of the brain, kidneys and other vital organs
100
Q

Pain Management

A
  • Controversial subject (NSAIDS causes bleeding in the stomach, masks the pain they are in)
  • System protocols should provide guidance.
  • Should be a priority
  • Hypotension is a contraindication
  • Medications for abdominal pain:
    • Morphine
    • Ketorolac
    • NSAID
    • Fentanyl
  • Medications for nausea
    • Dimenhydrinate
    • Hydroxyzine
    • Promethazine
101
Q

Gastrointestinal Bleeding Managment

A
  • Directed at maintaining perfusion of vital organs
  • Internal hemorrhage cannot be controlled in the prehospital setting
  • Volume replacement is critical
  • Hemodilution can be a side effect of aggressive volume replacement
102
Q

EsophageaL Varices Management

A
  • Follow general guidelines.
  • Accurate assessment of the extent of blood loss is critical.
  • Volume resuscitation and aggressive suctioning of the airway
103
Q

Mallory-Weiss Syndrome Management

A
  • Directed at determining the extent of blood loss
  • May be dehydrated from repeated vomiting
  • In hospital treatment includes possible repair of any damage
  • Most resolve spontaneously
104
Q

Hemorrhoid Management

A
  • Largely supportive
  • In isolation, more of an inconvenience than a life-threatening condition
  • Rarely, some patients suffer severe lower GI bleeds.
  • The majority resolve in 2 to 3 days.
  • Conservative management
  • Surgical removal (rarely)
105
Q

Peptic Ulcer Disease Management

A
  • Accurately assess the extent of blood loss
  • Prepare to manage any hypotension
  • Orthostatic vital signs are critical.
  • In hospital treatment includes acid neutralization and antibiotic therapy for H pylori can prevent new cases from occurring
106
Q

Cholecystitis Management

A
  • Directed at making the patient comfortable
  • Treating hypovolemia
  • Morphine and meperidine(narcotic)
  • IV fluids
  • Gravol
  • In hospital treatment may include antibiotics and surgical removal of gallbladder
107
Q

Appendicitis Management

A
  • Remain vigilant for signs of perforation or septic shock
  • Be prepared to use dopamine if crystalloids are not effective
  • In hospital treatment includes antibiotics and surgical removal of appendix
108
Q

Diverticular Disease Management

A
  • Directed at making the patient comfortable
  • Examine closely for severe infection.
  • May need large amounts of fluids and/or dopamine due to sepsis
  • In hospital treatment includes antibiotics, liquid diet and possible surgery
109
Q

Pancreatitis Management

A
  • Follow general guidelines.
  • Pay special attention to signs of severe hemorrhage.
  • Fluid resuscitation
  • In hospital treatment includes GI rest, analgesia
    Pancreas can not be removed
110
Q

Ulcerative Colitis Management

A
  • Determine the degree of hemodynamic instability
  • Look for signs of shock
  • Provide supportive prehospital care and follow general management guidelines
  • In hospital treatment includes anti-inflammatory medications, antibiotics,
  • Eventually removal of diseased sections of their colon
111
Q

Crohn Disease Management

A
  • Follow general management guidelines
  • Volume resuscitation may be necessary
  • Measures to control nausea and pain are commonly needed
  • In hospital treatment includes medications to stop inflammation and creating environment where GI tract can heal itself
  • If severe surgical resection of portions is needed
112
Q

Acute Gastroenteritis Management

A
  • Follow general management guidelines
  • Degree of fluid deficit
  • Patients often feel markedly better after rehydration.
  • Analgesic and antiemetic medications
  • In hospital treatment includes rehydration, and antibiotics if bacterial or parasitic
  • Best prevention is education on safe food and water use
113
Q

Acute Hepatitis Management

A
  • Supportive
  • Follow general management guidelines
  • Two important areas to focus on are:
    • Infection control and medication administration
    • Limit contact with bodily fluids
    • Hep B can stay in dried blood for a week
  • Liver detoxifies medication.
    • Drugs given may remain active within the body
      for longer than anticipated
    • Consider lower doses and at longer intervals

EMRG 1130 (13 decks)

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