- Include all information related to GI function
- Abdominal pain, indigestion, gas, nausea and vomiting, constipation, diarrhea, fecal continence, change in bowel patterns, characteristics of stool, jaundice, history of GI surgery or problems, appetite and eating patterns, teeth, and nutritional assessment including weight patterns
Psychosocial, spiritual, and cultural factors (determines diet)
- Assess knowledge; need for patient education - Gastroscopy: endoscope goes down esophagus, NPO, moderate sedation, assess gag reflex post. Using a slightly different type of imaging scope this technique allows us to look into the upper gastrointestinal tract to assess for problems afflicting the esophagus, stomach, and the first parts of the small intestines. Common problems diagnosed or treated with this procedure include swallowing problems, heartburn, abdominal pain, bloating, ulcers, infections, and autoimmune/allergic disorders.
- ERCP: endoscopic retrograde, down esophagus to visualize the biliary tract for gull stones and pancreas. disorders of the bile and pancreatic ducts. Gallstones which travel into and obstruct the bile ducts are the most common reasons for this intervention. Other reasons for this procedure include evaluating and treating benign and malignant blockages, infections, and other abnormalities of the bile ducts
- Colonoscopy - lg intstine Definition: RAPID onset of symptoms lasts a few days, usually caused by dietary indiscretion. Other causes include meds, alcohol, radiation therapy.
S/Sx: abdominal discomfort, headache, lassitude (lack of energy), N/V, hiccuping
Management: Refrain from alcohol and food until s/sx subside, avoid emetics and lavage due to danger of perforation and damage to esophagus, supportive therapy (NG intubation, IV fluids, antacids, analgesics) Definition: Prolonged inflammation lasting weeks to months often caused by H Pylori, due to benign or malignant ulcers of the stomach. May also be associated with autoimmune, dietary, meds, alcohol, smoking, chronic reflux of pan creative secretions/bile
S/Sx: epigastric discomfort, anorexia, heartburn after eating, belching, sour taste, N/V, intolerance to foods. May have vitamin deficiency due to malabsorption of B12.
Management: Modify diet, promote rest, reduce stress, avoid alcohol and NSAIDs (inhibits HCl, can trigger s/sx more) - health history to identify onset, duration, characteristics of pain, diarrhea, urgency, nausea, anorexia, weight loss, bleeding
- dietary patterns
- bowel elimination patterns and stool
- abdominal assessment
- electrolytes, CBC, cardiac dysthrhythmias and tachycardia
- COLONOSCOPY TO DIAGNOSE
- I&Os, daily weight, s/sx of dehydration/fluid loss, encourage oral intake, measures to decrease diarrhea - most common, rapid onset
- intestinal contents, fluid and gas accumulate above the intestinal obstruction
- s/sx: cramping, abdominal pain, distention, absence of stool and flatus, vomiting, dehydration
- Diagnose: X ray/CT shows gas/fluid
- Treat: NG tube decompression to low wall suction, measure output, NPO, fluid and electrolyte imbalances, assess for improvement (no distention, no vomiting, moving bowel and bowel sounds)
- May require surgical procedure if NG tube doesn't help
- Hypoactive bowel sounds with this obstruction**** - not as common, more gradual, s/sx present gradually and are vague
- accumulation of intestinal contents, fluid and gas proximal to the obstruction
- s/sx: constipation, abdominal distention, blood in stool, cramps lower abdominal pain, fecal vomiting
- Diagnose: x ray / CT to show a distended colon
- Rectal tube may be inserted to decompress an area that is lower in the bowel
- Other interventions: NPO, IV fluids, electrolytes, I&Os - Detailed description of the pain including severity, duration, characteristics, radiation, associated symptoms such as leg weakness (if sciatic nerve is involved, trouble walking), description of how the pain occurred, and how the pain has been managed by the patient, does it interfere with every day life, can lead to depression (can't get out of bed, isolated)
- Work and recreational activities
- Effect of pain and/or movement limitation on lifestyle and ADLs
- Assess posture, position changes, and gait
- Physical exam: spinal curvature, back and limb symmetry, movement ability, DTRs, sensation, and muscle strength
- If obese, complete a nutritional assessment - weight loss can help -Bursitis (inflammation of bursa (bursa help prevent friction of joints), and tendonitis (inflammation of tendon)
- Inflammatory disorders commonly in the shoulder
Rest, heat & ice, NSAIDs
-Impingement syndrome - r/t over use of the arm, Limited shoulder motion, bicep tendon can become edematous
Rest, NSAIDs, PT, joint injections
-Carpal tunnel syndrome - compression of nerves in wrist
- Entrapment neuropathy
- Pain, numbness, paresthesia Bloodborne infection
- Systemic symptoms may initially overshadow local symptoms
- Systemic (fever, chills, tachycardia, general malaise) (osteomyelitis is often overlooked at this stage)
- Local (painful, swollen, erythema, tender area)
Soft tissue infection or direct bone contamination
- Swollen, warm, painful, erythema and tender
- May have systemic symptoms , usually do not
- Focus on actual area of osteomyelitis Contusion: soft tissue injury produced by blunt force
Pain, swelling, and discoloration: ecchymosis
Strain: Pulled muscle-injury caused by overuse, overstretching or excessive stress
Pain, edema, muscle spasm, ecchymosis, and loss of function
Sprain: injury to ligaments and supporting muscle fiber around a joint
- Joint is tender and movement is painful, edema, disability and pain increases during the first 2-3 hours, more painful than strain
Dislocation: bones are out of the joint
- A traumatic dislocation is an emergency with pain, change in contour and length of the limb and loss of mobility, acute pain - Common injuries include strains, sprains, contusions, fractures, back injuries, tendonitis, and amputations.
- Prevention measures may include personnel training, proper use of equipment, availability of safety and other types of equipment (patient lifting equipment, back belts), correct use of body mechanics, and institutional policies. 7th Edition•ISBN: 9780323527361Julie S Snyder, Mariann M Harding2,512 solutions
8th Edition•ISBN: 9780803669222Barbara A. Gylys1,379 solutions
9th Edition•ISBN: 9780323399098Jennifer Yeager, Kathleen DiMaggio, Linda McCuistion, Mary Winton359 solutions
4th Edition•ISBN: 9781260920345David M Allan, Rachel Basco2,732 solutions
