Psychological Aspects GI Disease Flashcards
with regards to a psychological assessment what would you pay attention to?
timeline
nutritional assessment
mental state assessment
age
psychological problems CAUSED by GI disease
conditioning
nausea and vommiting
loss of appetite
weight loss
diarrhoea
sexual problems
stress
psychological problems PRESENTING as GI disease (the psychological component not the effect)
stress
anxiety
depression
somatisation
eating disorders
mental state examination
drugs that can have a psychological impact on GI
opiates
amphetamines
cocaine
anticholinergics
antidepressants
investigations to rule out a physical cause of the symptoms rather than it being psychological
FBC
biochemical profile
pregnancy test
urinalysis / culture
h. pylori
erect chest x-ray
abdominal film
ultrasound
endoscopy
simple treatment measurement for someone admitted with suspected malnutrition
IV fluids
pabrinex (multivitamin complex)
dietetic review in the morning
NG tube?
refeeding syndrome
metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved, severely malnourished or metabolically stressed due to severe illness
adapted starvation cause
reduced intake of carbohydrates
what effect does adapted starvation have on the body
reduced secretion of insulin
what happens upon refeeding that causes the possibly dangerous effects associated with refeeding syndrome
rapid rise in insulin
rapid generation of ATP
phosphate moves into cells
hypophosphataemia rapidly develops
weight loss disorders that don’t involve eating
self-starvation
self-induced vomitting
compulsive activity and exercise
laxatives
diet pills
herbal medicines
deliberate exposure to the cold
team approach for eating disorder patient in hospital
whole team
avoid arguments at bedside
decide on management as a team
may need NG feeding - watch line
refeeding syndrome observation
management principles of an eating disorder
listen to patient carefully
treat symptoms seriously
reach a firm diagnosis
explain it is a ‘functional disease’ - emphasise that it is a real diagnosis
manage the underlying disease
