Term
| Upper gi bleed nursing considerations |
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Definition
Avoid:
nsaids
coumadin
corticosteroids
aspirin (use enteric coated)
alcohol
smoking
chocolate/caffeine |
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Term
| Upper gi bleed assessments |
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Definition
Assess vomit and stool
Start with clear liquid and advance as tolerated - WATCH FOR REBLEED |
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Term
| Esophogeal varicies nursing considerations |
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Definition
Prompt treatment of upper respiratory infection
Avoid irritating spicy foods |
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Term
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Definition
heartburn; can mimic cardiac pain
At risk: hiatal hernia, ascites, pregnancy, smoking
Complications: esophagitis, Barrett's esophagus-distal end, precancerous
DX: endoscopy, barium study (obstruction) |
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Term
| GERD Nursing considerations |
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Definition
Lifestyle & nutritional mods: no chocolate/peppermint; avoid spicy foods, tea, coffee, milk, tomato; weight reduction; fluids should be taken between meals not with meals
Drugs: Pepcid, Protonix, Nexium, Carafate
Surgical: tighten sphincter and pull up stomach |
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Term
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Definition
"outpouching" that slides above diaphragm; cause unknown but increase in abdominal pressure
TX: Initially, dietary restriction; meds; surgery (unbearable nocturnal heartburn) |
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Term
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Definition
Risk: Barrett's esophagus, alcohol abuse, smoking
Rarely diagnosed early; 5 yr survival less than 20%
DX: encoscopy, biopsy
s/s: progressive dysphasia; can't eat coarse food; abdominal pain (late sign)
TX: photodynamic therapy (internal radiation)= avoid sunlight up to 4 weeks; BIG surgery-esophogectomy (take portion of esophagus out and then stretch stomach up)
Post op: DO NOT TOUCH NG TUBE Will have NG tube and red foley out of nose-balloon expanding esophagus |
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Term
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Definition
inflammatin of gastric mucosa
Risk: alcohol, NSAIDS, steroids, h. pylori (bacteria in bowel), autoimmune (RA, chronics)
s/s: could be asymptomatic, anorexia, nausea, vomiting, epigastric pain
DX: Endoscopy, biopsy
TX:rest stomach, no irritating foods, H2 blockers, PPI |
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Term
| Peptic ulcer disease types |
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Definition
Gastric (more common in women and older adults over 50, smoking)
Duodenal |
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Term
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Definition
S/S:
Gastric: pain 1-2 hours after meals, burning sensation, food worsens pain, rarely occurs at night
Duodenal: Pain occurs later after eating, back pain, episodic-goes away and comes back every couple weeks, happens at night
Complications: G-more common to perforate; obstruction; h. pylori
DX: endoscopy, test for h. pylori, check H&H for bleeding
TX: carafate, PPI, H2 blockers, flagyl for h.pylori; bland diet, 6 small meals/day, no alcohol, spicy foods, carbonated beverages |
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Term
| Treatment of complications of PUD |
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Definition
Perforation:
s/s hard rigid distended abdomen, severe pain, increased resp, hypoactive to absent bowel sounds, nausea, vomiting
Acute exacerbation (bleeding):
TX: rest bowel for 2-3 days, NG tube to suction, NPO
Gastric outlet obstruction-due to swelling and edema
TX: NG tube, rest bowel for 2-3 days, if NG tube is putting out less than 200cc/12 hours, start clear liquids |
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Term
| Nursing care for complications |
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Definition
| Strict I/Os, daily weights, oral care every 4 hours, watch for complications (what's NOT expected) |
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Term
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Definition
for perforation or uncontrolled bleeding
Billroth (partial gastrectomy) |
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Term
| PUD Post op complications |
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Definition
Dumping syndrome-
s/s: 30-60 mins after eating, massive diarrhea, sweating, restless, flushing, diaphoretic
TX:no fluids during meals, smaller meals, low carbs
Post prandial hypoglycemia-
s/s: sudden rise in blood sugar-insulin goes up-body produces too much insulin=hypoglycemia (2 hours after eating, sweating, tachy, weakness)
TX: no fluids with meals, smaller meals, low carb
Bile reflux gastritis-
amylase and lipase go up instead of down
TX: Questran (binds to bile salts), aluminum based antacids |
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Term
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Definition
| At risk for pernicious anemia (parietal cells in stomach excrete intrinsic factor),NG tube to suction, pain meds, coughing, deep breathing, clear fluids 2-3 days post op |
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Term
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Definition
loose, liquid stool
Reason: decreased fluid absorption, problem with lining of colon; motility disturbances
Origin: viruses, e coli, c diff, antibiotics (amoxicillin, clindamyacin, ampicillin)
DX: stool culture, ova & parasites
TX: Pepto, Immodium, Sandostatin, rest the bowel, maybe NPO, bland food diet |
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Term
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Definition
| TX: flagyl, vancomycin PO, restore normal flora (lactus bacillus, stool enema) |
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Term
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Definition
disruption in "normal" number or frequency
s/s: abdominal pain, bloating, nauseous, decreased appetite
DX: KUB (kidney ureter bladder x-ray-flat plate), Abdominal series (include signs-see fluid levels), Barium-must have bowel sounds
TX:stool softener (3 days); dulcolax (15-60 mins); ambulation; fluids; fiber; prunes |
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Term
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Definition
s/s: intermittent abdominal pain, stool irregularities, emotional component
TX:symptom management,Zellnorm (not common), Immodium, Bentyl
DX: ruled out everything else |
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Term
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Definition
Blunt-seatbelt, steering wheel
Penetrating - gunshot wound, stabbing |
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Term
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Definition
s/s: pain, rigid abdomen, guarding, splinting, low/absent bowel sounds, referred pain-liver/spleen into shoulder/back, Cullen sign (bruising around umbilicus)
DX: CT scan without contrast; ultrasound = look for free fluid or air |
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Term
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Definition
bicyclists
graded 1-2=little blood=observe
graded 3-5=surgery |
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Term
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Definition
| NPO, keep airway open, EKG, Type & cross, consent |
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Term
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Definition
| WBC-spleen removed-compromised immune system; vaccinations; tetanus (penetrating) |
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Term
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Definition
inflammation of appendix due to fecalith obstruction and becomes inflamed
s/s: pain generalized and then localized to RLQ; fever; vomiting; relief with knees bent; rebound tenderness (hurts on letting go); McBurne's Point (halfway between umbillicus and right illiac crest)
DX: CBC (high WBC); CT scan
Surgical: non-ruptured - go home 24 hrs
ruptured - inflamed, sepsis, pain gets better after rupturing |
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Term
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Definition
| NPO, labs, don't stimulate bowel (no Golytely) |
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Term
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Definition
local or generalized inflammation Reasons: gunshot, ruptured appendix, peritoneal dialysis, ruptured bowel
s/s: distended & painful, then rigid, rebound tenderness, fever, low BP, raised HR & RR, shallow breathing
DX: CBC (high WBC), ultrasound, CT scan |
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Term
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Definition
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Term
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Definition
| NG tube = no coffee ground emesis; IV fluids; antibiotics; ICU (worried about sepsis) |
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Term
| Inflammatory Bowel disease types |
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Definition
Crohn's Disease (cobblestone)
Ulcerative Colitis |
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Term
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Definition
chronic and common inflammation of intestines; periods of exacerbation and remission; unknown cause and no cure; autoimmune; overactive sustained inflammatory response that attacks the lining of the bowels; heriditary
DX:late teens-early 20's or 60's |
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Term
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Definition
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Term
| IBD S/S, DX, Complications |
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Definition
s/s: diarrhea (U=bloody, no weight loss; C=non bloody, weight loss)
DX: colonoscopy, biopsy
Complications: fistulas (hole between 2 layers); abcesses (pocket of puss); perforation |
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Term
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Definition
Prednisone-only for exacerbations
Imuran-use pre-surgery for 3-6 months
Remicade: 0,2,8 weeks |
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Term
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Definition
| NPO; Prednisone; antibiotics; alleviate stress; symptom relief; maintain overall quality of life |
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Term
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Definition
| Total colectomy w/ileoanal reservoir-take out all of colon; still have BMs but always diarrhea |
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Term
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Definition
| Risk for dehydration (maintain fluid status); teach bag care pre-op; bowel sounds within 3-5 days; JP drain-amount of drainage and color (red-pink-cirrous); body image; 1-2 L stool/day; assess stoma (output-first mucous) |
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Term
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Definition
Prevent exacerbation
Prevent malnutrition
Prevent weight loss
Replace fluids/electrolytes
Avoid milk and fatty foods
Take multivitamin and iron supplements due to altered absorption
Meticulous peri care (due to diarrhea)
Colostomy/ileostomy-foods that decrease gas |
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Term
| Intestinal obstruction types |
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Definition
| small bowel (nausea, vomiting stool) vs. large bowel (distension, diarrhea); partial (ribbon of stool) vs. complete; mechanical (no peristalsis, paralytic ileus) vs. non-mechanical (actual hinderance=adhesions, cancer, hernia) |
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Term
| Intestinal obstruction DX & care |
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Definition
DX: CT scan (to see obstruction), dilated loops of bowel=obstruction
Care: rest bowel to see if resolves on own, then surgery |
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Term
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Definition
Men more than women; midlife; family history (yearly colonoscopy=polyps)
s/s: no symptoms early on; bloody stool, bloating, ribbon stools later
DX: colonoscopy, CT scan, CEA=tumor marker
Surgical: polyp removal, Colon resection,metastisis-liver, breast, bone
Depending on stage: chemo, radiation |
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Term
| Colorectal cancer pre and post-op |
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Definition
| Colostomy care teaching; avoid foods that cause gas; ileostomy(whole colon removal)-risk for dehydration |
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Term
| foods that cause gas, folate, iron |
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Definition
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Term
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Definition
| outpouching within large intestine |
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Term
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Definition
inflammation of outpouching
s/s: lower quadrant pain-usually left
DX:osis-colonoscopy; itis-CT scan (risk for rupture)
TX:antibiotics (decrease inflammation), rest bowel-liquids, see if resolves on own; no resolve or perf=colon resection |
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Term
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Definition
umbilical
inguinal (common in men) |
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Term
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Definition
s/s: outpouching, bulge
Complication: strangulation (twists on itself) and/or necrotic
TX: reduce (push back in); surgical (put mesh over hole)
Post-op:splint when coughing, no bending, no lifting over gal milk |
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Term
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Definition
gluten sensitivity (wheat, rye, barley), genetic, immune response to gluten
s/s: chronic inflammation, malnutrition, poor calcium and vitamin D absorption, diarrhea, bloating
Long term-lower bone density (osteoperosis), iron deficiencies (anemia)
DX: biopsies, IGA antibody, try diet
TX: Avoid flour, baked goods,pasta; corticosteroids |
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Term
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Definition
internal or external enlarged engorged vein, change in bowel habits (constipation=increased pressure)
s/s: internal=blood in stool; external=itching, inflamed=painful
TX: Increase fiber and fluids, OTC treatments, surgical removal (rubber band) |
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