Test 9 GI disorders- DONE Flashcards
- Antacids K,H,K(med surge ATI pg.284)
Neutralize acid in the gut, provides relief but doesn’t accelerate healing
-Can be given 7x per day, 1-2hr after meals & at bedtime.
-Give 1-2 hr apart from other medications
-Monitor kidney function of clients prescribed aluminum hydroxide & magnesium hydroxide.
-Aluminum causes constipation
-Magnesium causes diarrhea
-avoid in pts w/heart problems
-can cause electrolyte imbalances
- Gastrectomy nursing considerations/client Education (pg.594, ch.45 pp slide 13)
-Can lead to B12 deficiency = B12 shots for life
-dumping syndrome: rapid emptying of large amounts of chyme (partly digested food) sweating, palpitating, abdominal cramps, diarrhea.
- Barium swallow nursing considerations and client education (Ch.44 PP slide 3, pg.571)
-Monitor for passage & color of stool
-low residue diet 2-3 days before the procedure
-NPO for 8-12hrs before the test.
-barium is very constipating, drink fluids to dilute the barium & promote its elimination from the GI tract.
-Teach client stools will appear white, streaky or clay colored from the barium.
-Nurse must wait to collect stool specimens until the client has fully excreted the barium.
- G-tube/NG tube nursing considerations (ch.45 pp slide 18, ATI pg.270)
-Provide good mouth care to counter tastes/odors (frequent mouth/nares care)
-frequent assessment of bowel sounds
-Flush tube every 4hr
-Elevate HOB to 45 degrees/semi fowlers
-change bag & tubing daily
-Include drainage in I&O’s
-Check labs (electrolytes, hematocrit)
- EGD nursing considerations (ATI pg.259)
-position client left side lying w/head of bed elevated
-NPO 8hrs
-Remove dentures prior to procedure
-Monitor VS & respiratory status, maintain an open airway until client is awake
-Notify provider of bleeding, abdominal or chest pain or any evidence of infection
-Withhold fluids until return of gag reflex
-Discontinue IV fluid therapy when client tolerates oral fluids w/out nausea & vomiting.
-Teach client not to drive or use equipment 12-18hrs after the procedure
-Teach client to use throat lozenges if a sore throat or horse voice persists following the procedure.
- Dysphagia nursing considerations (ATI pg.53)
-Check gag reflex
-have suction equipment nearby
-tuck chin down into chest to reduce risk of choking
-keep client NPO until evaluate by the SLP
-provide eating environment w/out distractions
- Esomeprazole and omeprazole K,H,K (Ch.45 pp slide 13, pharm ATI pg.202, med surge ATI.276 &290)
-Can be given prophylactically
-limit NSAID use on PPIS
-can cause bone fractures & C-DIFF
-increases digoxin levels (risk for toxicity)
-monitor electrolyte imbalances (hypomagnesemia, hypocalcemia)
-monitor for hypoglycemia in diabetic clients
-Pneumonia w/long term treatment (assess the lungs)
-take 60 mins before eating
- Peptic Ulcer Disease manifestations (ch.45 pp slide12 & ATI pg.283)
-severe pain (upper abdomen & back) could mean perforation
-bleeding: hematemesis (vomiting blood), melena (dark sticky feces w/partly digested blood)
-relief after eating
-weight loss
- Peptic Ulcer Disease Complications (ATI pg.285)
-perforation/hemorrhage: (emergency)
*Severe epigastric pain across the abdomen, can radiate into the shoulders especially right shoulder due to irritations of the phrenic nerve. Abdomen will become tender & rigid (board like)
- Hemorrhoids manifestations (ch.46 pp slide 19)
External hemorrhoids
-soreness
-lumps
-itching
Internal hemorrhoids
-bleeding
-anemic
-protrusion
- Colonoscopy recommended screenings/criteria (ch.44 pp slide6, ATI pg.528)
-begin screenings at age 50
-average risk adults get colonoscopy every 10 years
-Pt’s w/history of constipation or diarrhea, persistent rectal bleeding
-Lower abdominal pain when results of proctosigmoidoscopy & barium enema test are negative or inconclusive
- Anorexia nervosa manifestations (ch.45 pp slide 2)
-Place client on EKG to monitor
-Absence of hunger
-Amenorrhea
-Nausea
-Constipation
-Risk for hypokalemia electrolyte imbalance: muscle weakness & fatigue, EKG changes
- Sulfasalazine K,H,K (ATI pg.303)
Ulcerative colitis & Crohn’s Disease
-Take w/full glass of water after meals
-Increase fluids intake to 2L/day
-Avoid exposure to sunlight/ultraviolet lights
-Urine, skin can have a yellow orange color, contact lenses (can tint)
-watch for sulfa or salicylate allergy
-monitor CBC, kidney & hepatic function
-monitor for agranulocytosis, heolytic anemia &. macroctic anemia.
-AE: N/V, fever, rash.
- Colon cancer manifestations (ch.45 pp slide 18)
#1 thing to look for is change in bowel habits and bleeding
-distended abdomen
- Ulcerative colitis manifestations (ch.45 pp slide 9)
-Weight loss
-Anorexia
-Pain
-Blood
-Diarrhea
-Dehydration
- Endoscopy nursing considerations (ATI pg.258)
-Notify physician if dietary restrictions weren’t followed
-Ensure client is NPO prior to procedure
-Ensure client followe proper bowel preparation
-Report unexpected findings of laboratory tests, chest x-ray, ECG, and ABG’s
-Verify consent form has been signed
-Obtain vitals & verify client’s allergies
-Review client’s medical history for increased risk of complications.
- Adalimumab K,H,K (med. Surge ATI pg.304, pp slide 8)
-Monitor liver enzymes, coagulation studies & CBC
-Monitor for bleeding, bruising or infection, & transfusion or allergic reaction
-Avoid crowds & other exposures to infectious diseases (risk of TB development or reactivation)
-AE: chills, fever, hypo/hypertension, dysrhythmias &blood dyscrasias
-Can cause immunosuppression
-Crohn’s Disease<— For
- FOBT client education (ch.44 pp slide 11, ATI pg.258)
-no aspirin
-raw fruits & veggies, red meats, poultry, fish, vitamin c rich foods 3 days prior to test.
-adhere to proper collection technique, need for refrigeration
- Ulcerative colitis and Crohn’s disease nursing considerations (ch.45 pp slide10)
-Monitor & schedule colonoscopies
-Monitor for mega colon(from inactivity, risk for perforation)
-Monitor for anemia
-Monitor for electrolyte imbalance
-Avoid high fiber intake
-Assess for dehydration w/good I&O’s
-Find triggering foods
-Educate client may have exacerbations & remissions
- Peritonitis manifestations (Ch.46 pp slide 13)
-rapid respiration
-rigid abdomen
-tachycardia
-lack of bowel motility
- Nursing interventions for hiatal hernia (ch.45 pp slide8 , ATI pg.278)
Before surgery: sit upright for 2hrs
-raise HOB
-avoid Valsalva
-avoid spicy foods
-avoid alcohol/smoking
- Sucralfate K,H,K(pg.594, pharm flashcard)
-Coats the stomach
-Administer 2hrs after (h2 receptor antagonist) famotidine, cimetidine. Given for 4-6 weeks.
-Take 1hr before meals for maximum effectiveness w/full glass of water
-not a PRN med, stick to a scheduled dosage
-take 30 mins before antacid (antacids can interfere w/effects)
-can cause constipation
-caution in pts w/chronic kidney disease, diabetes
- Appendectomy nursing considerations (ch.46 pp slide 12)
-prep for surgery NPO status
-administer IV fluids
-obtain surgical consent
-Asess pain level: If pain suddenly subsides, that’s a warning sign that appendicitis will rupture > call provider
- Gastric bypass nursing considerations (ch.45 pp slide 16)
-gradually progress to 5-6 small meals a day less than one cup
-chew food slowly (take an hr to eat)
-withhold fluids 15 minutes before & during meals
-less than 2g fiber per serving
-stop eating when full
- Diverticulitis client education (ch.46 pp slide16)
-high fiber
-avoid foods w/small seeds
- Diarrhea complications (ch.46 pp slide 4)
-increase foods that are high in potassium
-dehydration
-electrolyte imbalance (hypokalemia)
- Corticosteroids (ATI pg.303)
Crohn’s Disease
(-one & budesonide)
-causes immunosupression
-Monitor BP
-Reduce systemic dose slowly (avoid discontinuing suddenly)
-Monitor electrolytes (potassium) & glucose
-take oral dose w/food
-report unexpected increase in weight or other indications of fluid retention
-Avoid crowds & other exposures to infectious diseases
-report evidence of infection (Crohn’s disease can mask infection)
- Risks for colon cancer (ch.45 pp slide 9)
-Polyps
-Age (uncommon under 40)
-Lifestyle
-Environment
-Genetics
- Nursing consideration during/after Upper GI series? (ch.44 pp slide 4)
-During: asses for pain/discomfort
-After: assess for gag reflex
- Nursing management of GERD (ch.45 pp slide 4)
-Radiating pain to neck, jaw, back
-burning in esophagus
-pain worsens w/positions
-throat irritation
-relieved by sitting upright after eating for at least 2hrs
-avoid large meals, carbonated beverages
- Esophageal cancer implementation (ch.45 pp slide 10)
-soft or semi-liquid foods w/protein
-avoid straws
-small frequent meals
-avoid gassy foods
-improve nutrition & weight loss
- IBS education & implementation (ch.46 pp slide6)
-monitor daily weights
-monitor I&O’s
-increased risk of colon cancer
-monitor bowel sounds
-avoid high fiber quickly
-exacerbation & remission is common
- Crohn’s Disease manifestations (ch.46 pp slide 7)
-RLQ distention (near ileum) & pain
-chronic diarrhea
-fever
-weight loss
-moulnourishment
-growth failure
