Week 5 Elimination, infection, inflammation lecture

Question 1

What three aspects of the body does a disorder of the GI tract affect?

Answer 1

1. Fluid and electrolyte imbalance
2. Tissue integrity (d/t excess stools)
3. altered nutrition (poor absorption)

Question 2

What are the 4 goals when someone has a GI tract disorder?

Answer 2

1. correct underlying problem/improve symptoms
2. maintain good fluid and electrolyte balance
3. prevent skin breakdown
4. maintain adequate nutrition

Question 3

How do people with GI disorders control chronic inflammation?

Answer 3

medications

Question 4

What causes abscesses in the mucosal lining of the GI tract and what does that lead to?

Answer 4

Inflammation flare ups can cause abscesses and lead to infection

Question 5

What Pt history questions should we ask someone with GI issues?

Answer 5

nutritional status
weight loss
triggers such as smoking or alcohol
pain level
better/worse
psychological coping?
Sleep
Stressors - worse under stress?

Question 6

What/how do we assess someone with GI issues and what is the rationale for each?

Answer 6

1. bowel sounds- tells us where the issue is
2. stool frequency, amount, consistency, characteristics - (look for blood, baseline, colour tells us a lot)
3. *Skin integrity - perineal area (loose stools = tissue issues)
4. skin turgor/mucous membranes - tells us hydration status
5. Hemodynamic status - watch for over hydration from IV (hypervolemia)
6. Assess blood work - *lytes imbalances, Hct/HBG, dehydration
7. Assess coping skills/emotiona status - tells us about stress/sleep/contributing factors

Question 7

What can we do and teach patients with GI issues about nutrition ?

Answer 7

1. appropriate diet for condition
2. Avoid triggers - food/stress/smoking/alcohol
3. Food diary
4. assess for weight loss

Question 8

What can we teach patients with GI issues about fluid and electrolyte balance?

Answer 8

1. encourage fluid intake
2. sometimes IV is needed to hydrate and/or replace electrolytes
3. Potassium can be lost in diarrhea so monitor for heart palps and muscle pain/fatigue
4. calcium can be lost so monitor for tetany (muscle cramps & hand/feet tingling)

Question 9

what can we do and teach patients to prevent tissue breakdown in the perineal area?

Answer 9

1. keep dry and clean
2. topical barrier when needed
3. monitor for infection (fissure) - antibiotics if needed

Question 10

What can we do and teach patients to help control pain with GI issues?

Answer 10

1. analgesics as needed
2. Emotional support
3. promote sleep - get good sleep