Unit 2 GI, Ch 33 Nursing Care Of GI Disorders Flashcards
Measuring obesity
Weight 20% higher than ideal weight
Waist circumference for women >35
Waste circumference for men > 40
BMI
Overweight, 25 to 30
Obese, 30
Morbidly obese over 40
Caloric intake, exceeds energy expenditure
Obesity, comorbidities
Atherosclerosis
Gallbladder disease
Heart disease
Hypertension
Sleep apnea
Type two diabetes
Depression
What is atherosclerosis?
It’s from high cholesterol, and it is buildup of plaque
High fatty foods affect what organ most
Gallbladder
Therapeutic interventions, for obesity
Weight loss
Healthy, balance, diets
Calorie restriction
Exercise
Support group
Behavioral modifications
Surgical management bariatric surgery
What other professionals can assist with obesity
Dietitians
Nutritionist
Injection medication for obesity
Ozempic
Antidepressants that can help with the obesity
Wellbutrin
Types of bariatric surgeries
Restrictive
malabsorption
combination
Restrictive bariatric surgery
Limits how much stomach can hold
Malabsorption bariatric surgery
Decreases calorie and nutrient absorption
Combination bariatric surgery
Restrictive and malabsorption
Complications of gastric surgeries
Nausea and vomiting
Erosion of gastric tissue
Breakdown of staple line
Leaking of stomach secretions
Infection or death
Balloon leak or perforation
Protein, vitamin, and mineral deficiencies
Coughing and deep breathing
Postoperative care and education for bariatric patients
Diet is different from other postop pt
Clear, liquid diet in small amounts
Progresses to full liquids, puréed foods
Regular foods at six weeks
Abdominal distention
Movement is important after abdominal surgery
Sliding hiatal hernia
Lower esophagus/stomach slides up through hiatus of diaphragm into the thorax
Para esophageal hernia
Rolling hernia
Rare but serious
Part of the stomach squeezes through the hiatus, and is at risk for strangulation
Risk for tissue to become necrotic
Hiatal hernia are most common in?
Smokers
Those over 50
Obesity
Gerd is often secondary to the hernia
Therapeutic interventions for hiatal hernia
Antacids
Small meals
No reclining one hour after meals
Raise head of 6 to 12 inches
Avoid
Eating three hours before bedtime
Spicy foods
Alcohol, caffeine
Smoking
Tums, Maalox, Mylanta, famotidine Prozoles
Fundoplication
Surgical management of a hiatal hernia where they wrap a portion of the stomach around the hernia, so it can’t slide through the diaphragm
Nursing care for hiatal hernias
Teaching
Preoperative care
Postoperative
Monitor for dysphagia with eating
Report dysphagia
Repair may be too tight
What is GERD?
Gastro esophageal reflux disease
Stomach acids go up into the esophagus
Pathophysiology Gerd
Gastric secretions reflux into esophagus
Damages the esophagus
Lower esophageal Pinter does not close tightly
Gerd signs and symptoms
Heartburn
Regurgitation
Sour taste
Dysphagia
Erosion of teeth
Check gag reflex before offering foods or fluids
Gerd diagnosis
Barium, swallow
Esophagoscopy
PH monitoring
Complications of Gerd
Respiratory
Asthma
Aspiration pneumonia
Broncospasms
Larino spasms
Barrett’s esophagus
Pre-cancerous
What is Barrett’s esophagus?
Gerd can change epithelium of esophagus
Pre-cancerous
Esophageal cancer, risk factor
Treatment
Radio frequency, ablation removes Barrett’s tissue
Therapeutic interventions, for Gerd
Lifestyle changes
Medication’s
AntAcids
Histamine – 2 (H SUBSCRIPT 2) receptor antagonists
Proton pump, inhibitors, PPI
Therapeutic interventions for GERD
Transoral incisionless fundoplication TIF
Endoscopic procedure radio frequency waves
Fundoplication
Nursing care for GERD
Education
Lose weight
Eat a low-fat high protein diet
Avoid caffeine, milk, products, and spicy foods
Pediatric concerns of gastroenteritis
Inflammation of the stomach and intestinal track
Multiple causes
Abdominal pain, nausea, anorexia, diarrhea
Dehydration, primary concern, referred to fluid and balances in NT1
Nursing care for gastroenteritis
Stomach flu
Monitor weight
Vital signs
I&Os
ATB therapy
IV fluids for rehydration
Hiatal hernia signs and symptoms
Pain
None
Heartburn
Fullness
Reflux
Diagnosis for hiatal hernia
X-ray the x-ray watches movement
Fluoroscopy
Fluoroscopy
An x-ray that watches movement
What is fundus?
Top of the stomach
Dysphagia
Trouble swallowing
Check gag reflex
What is the best indicator of fluid balance?
Daily weights
BRAT diet
Bananas, rice, applesauce, toast
Fontanelle’s
Soft spot on babies you check this for dehydration, if the child is under one year old
