more GI and nut Flashcards
FML
Ulcerative colotis nutrition
-LOW RESIDUE foods
high calorie and high protein
-multivitamins containing ca2+
- oral hydration critical of greater than 10 liquid stools and causespt to be dehydrated so DRINK 2 LITERS
- avoid triggers (diary, nuts and legumes, cereal, etoh, fatty foods)
-JORNAL
ileostomy nutrition
LOW RESIDUDE DIET (LOW FIBER( to prevent obstruction
- introduce fibrous foods one at a time
- throughly chew foods
- white rice and refined grains and pasta are good choices
ileostomy foods to avoid
high fiber- popcorn, cocunut, brown rice
- stringy veg-aspargus, brocc, celery
- seeds and pits
- edible peels
losing weight drinks
water club soda (flavored and unflavored) unsweet tea or coffee fresh veg juice non fat/low fat milk
pt who had recent gi bleeding should avoid
anything red dyes so red popsucles and red gelatin and are not given even if it is part of clear liquids
barium enema is used to
visualize colon to detect polyps, ulcer, tumor, diverticula
barium enema contridincated in pt with
diverticula because it can cause peritontis
preprocedure for barium enma
take cathartic (go lyte or mg citrate) to empty stool
- follow clear liquid and avoid red and purple liquids
- do not eat or drink anything 8 hours before the test
- might exp urge to defecate and cramping but its normal
post procedure for barrium enema
chalk white stool until all of the barium has been expelled
- taake a laxative to expel barium because retained barium can lead to fecal impacition
- high fiber diet.bar
hepatic encephalopahy clinical manestifications
sleep disturbances to lethary and coma
-mental staatus altered
-asterixis (have them extend arms and foresiflex the wrists)
0 fetor hepaticus (musty, sweet ordor ) from digestive byproducts
-juandice is not related for HE
-amlyase and lipsae are elvated for hep but not HE
baraitric surgery
surgical modification of clients stomach or small intestines to restrict clients intake
what is conrindicated in bararic surgery
NG tube bc it can disrupt the surgical site—> hemm and anastomatic leak
what is contrindicated afer gastric surgery
NG
Bariatric surgery intervention
clear liquid for 48-72 hours after surgery
-low carb and sugar free drinks to decrease dumping syndrome
- low folwer is prefered
- morphine or pca for pain
dumping dyndrome signs
sweating dizz cramping diahrea hypotension tacycardia
guaiac fecal occult blood test
screening for colorectal cancer
guaiac fecal occult blood test collecting sample
assess for recent ingetion WITHIN LAST 3 DAYS of red meat or meds (vit c, aspirin, anticog, iron, ilbriphen, corticosteroid) because these can interfere with the test
2) get supples and wash hands and put nonsterile gloves
3) put stool sample on the slide
4) close the slide and allow it to sit and dry for 3-5 mins
5) open the slide and add 2 drops of solution
6) assess the color within 30-60 sec
positive guaiac fecal occult blood test
will turn paper blue
acute cholecystitic location
RUQ and pain to right shoulder and scapula
acute cholecystitis report
fatty food ingestion 1-3 hours before onset of pain
flank pain radiating to the groin
renal colic
signs of acute cholecystitis
fever
chills
NV
anorxia
TPN is adm through
central venous cathehrter
discontinuing TPN
lower the rate and replace with dextrose
findings of refeeding syndrome
PPM will be decreased fluid overload thamine def hyperglycemia sod retention
to prevent dumping syndrome
small meals
low carb diet
consume food and fluids 30 mins apart
RYGB complications
dumping dynsrome, iron def anemia, cobalamin def
highest priority of cholecystitis
sitrct NPO
laparoscopic cholecystectomy teaching
low fat diet
can revcover and resume normal act quicky than open surgical
-teach to remove surgical bandages the day after the surgery and can shower
- low fat diet
alt and ast are used to
gignose hepatic disorders, etoh and otc drugs but not to detect occult
thryamine foods
yogurt, cured meats agead cheese fermented foods beer choco avacaods red wine
food for depression
high in protein and cal
common liver failure includes
low albumin elevated INR elvated liver function low potassium increased ammonia
small bowel follow through (SBFT)
uses x ray to visualize the structure and function of small intestines
SBFT education
fast 8 hours prior
stools may be chaly for 72 hours bc of barium
-drink water to flush it out
-go lyte is not perscribed
-test takes 1-2 hours
- brown stool do not return after 72 hours or abdominal pain or feeling fullnnes- HCP
colostomy diet
fluid intake (3000 at least)
- elminate gasy and ordor food such as cauliflower, brocc, dried beans, brussels
- empty pouch when it is 1/3 dull to prevent leak due to increasing pouch weight
GERD FACTORS that preceptiate it
decreasing the tone (caff etoh)
- delaying gastric emptying (fatty foods)
- increases gastric pressure (large pressure)
preventing GERD
WEIGHT LOSS
SMALL freq meals
avoid gerd triggers
-chew gum to promote salivation and can help clear acid
-sleeping with head elveated
-dont eat at bedtime or lie down imm after eating
-dont need to minimize or eliminate diary foods
hypomag lvl
1.5-2.5
low mag two major issues
ventricular arrhymias (torsades de pointes) -- MOST SERIOUS and priority 2) neuuromuscular excitability (similar to calcium)- tremores, hyperactive reflex, troussea chvostek and seizures
clients who abuse etoh have
low mg levels
endoscopic retrograde (ERCP) complication
acute pancreatiis -life threatening
how long stool white after bariym
up to 3 days
small bowel obsutrciton normal color
bile colored (green brown) and it is expected
gastroduodenostomy (billroth 2) education
NPOOOO until bowel sounds retur
-small freq meal)
post op gastroduodenostomy (Billroth I)
high risk of dev venous thromboemolism and require prohalysis such as SCD and comrpession hose
- risk for hypoventilaiton and resp compromise so enoruage to run cough and deepbreathe and spint site
- APIRATION PRECAUTION
cloggged NG
report to HCP and attempting to manipulate and flush can cause hemm or gastric performation
Billroth II surgery (gastrojejunostomy) complication
dumping syndrome
Billroth II surgery (gastrojejunostomy) education
do eveyrthing to prevent dumping syndrome such as not drinnking fluids with meals and laying down after meals
healthy stoma characterisitc
vascular, moist, pink to brick red
minor oozing and bleeding can happen and mild to moderate swelling is normal 2-3 wk after surgery
when to report stoma
pale, dsuky and cyanotic because thse are signs of decreased blood supply
balloon tamponade tube (eg, Sengstaken-Blakemore, Minnesota)
used to temporarily control bleeding from esopgeal varcies
- compreses bleeding varcies
if balloon tamponade tube (eg, Sengstaken-Blakemore, Minnesota) gets disloged
airway obstruction so KEEP SCISSORS AT BEDSIDE
dont make pt do what if HE
DONT MAKE THEM WALKK
complications of severe pancreatitis
hypovolemia resp distress hypocalemia hyperglycemia ARDS
obesity behv modification
create reqrd system
dev health goals such as climmbing stairs without SOB
-adop anxiety reducing act (reading, medating) as coping mechanisms to reduce stress eating
-placing visual cues (motivational quotes) through env
-dont avoid social act with food and they can bring a seperate meal or plan ahead
