Upgrade to remove ads
CH: 22 Gastrointestinal Problem
Terms in this set (47)
Function of GI system?
- Taking in and breaking down food for energy
- Absorbing useful nutrients and eliminating waste
Mass movements is also known as
What is the consistency of the content when entering the colon?
GI system (Mouth - Anus)
Esophagus, stomach, pyloric sphincter, small intestine, ileocecal valve, large intestine, sigmoid colon, rectum.
Nausea vs Vomiting
- Nausea is the unpleasant sensation of the need to vomit.
- Vomiting is the forcing of stomach contents up through the esophagus and out through the mouth.
The process of vomiting consists of three phases
nausea, retching, and vomiting
Where is our vomiting center?
Brain (Medulla) and receptors within the GI tract.
What are the complications of nausea and vomiting?
Nausea and vomiting are not only stressful to a person having these experiences; they can also create complications such as bleeding, aspiration pneumonia, dehydration, and reopening of surgical wounds, which can lead to longer hospital stays.
severe nausea and vomiting in pregnancy that can cause severe dehydration in the mother and fetus
Antiemetic Drugs (Intended Response)
- Treat nausea and vomiting often occur together, and the same drugs are used for both problems.
- Patient is sedated, nausea is relieved, vomiting prevented
- Phenothiazines: promethazine (Phenergan)
- Anticholinergics: scopolamine (Anticolonergic)
- Antihistamines: meclizine (Dramamine, Antivert)
- 5HT3-receptor antagonists: ondansetron (Zofran)
- Dopamine receptor agonists
5HT3-receptor antagonists work against nausea and vomiting caused by?
antihistamines work against nausea and vomiting caused by
Opiate drugs or motion
The 5HT3-receptor antagonists bind to and block
serotonin receptors in the intestinal tract and the chemotrigger zone of the brain.
Dopamine antagonists directly block dopamine from binding to receptors in the
chemotrigger zone and the intestinal tract
Things to look at when assessing stool
Scant (Very small amount), Consistency, frequency, size, smell
Antiemetic (Side Effects)
- Vary with drug type
- Double vision
- ECG changes
Antiemetic (Adverse Effects)
- Vary with drug type
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Respiratory depression
Neuroleptic malignant syndrome
Rare but life threatening
- Fever/Respiratory distress/ Tachycardia/ Seizures/Diaphoresis/ BP change/ Palor/ Fatigue/Severe muscle stiffness
Antiemetics (Check Before)
- Baseline vital signs, LOC, weight, electrolyte levels
- Bowel sounds; assess for abdominal distention
- Obtain a complete list of drugs the patient is currently taking
Antiemetics (Check After)
- Episodes of nausea and vomiting
- Vital signs, daily weights, status of abdomen
- Immediately report any signs of respiratory depression
- Watch for signs of side effects or adverse effects
Antiemetics (Patient Teaching)
- Caution patients about driving or operating heavy equipment
- Instruct patients to use sunscreen, wear protective clothing, and avoid tanning beds
- Teach patients about the signs and symptoms of malignant neuroleptic syndrome and tardive dyskinesia
- Tell patients about eating foods with increased bulk and about the importance of drinking enough fluids to prevent constipation
If Antiemetics are given IV, be sure to do what?
dilute it first to decrease the risk of tissue necrosis.
Children may have muscle spasms of the jaw, neck, and back, along with jerky movements of the head and face, balance disturbance
Antiemetics (Older Adults)
More likely to experience side effects like confusion and dizziness, shaking hands, balance disturbance
- Under three bowel movements per week
- Stools are hard, dry, difficult to eliminate
- Bowel movements can be painful
Constipation (Common Causes)
- Age related (Slower peristalsis)
- Low-fiber diet
- Lack of physical activity
- Not taking in enough fluid
- Delaying going to the bathroom
- Misuse of laxatives
- Drugs affect nerve activity of the colon and fluids
Drug that affect constipation
Types of Drugs to treat constipation (Classes)
- Bulk-forming laxatives (psyllium)
- Stool softeners (Colace and docusate sodium)
- Lubricants (mineral oil)
- Saline laxatives (magnesium hydroxide, polyethylene glycol) - MOM Milk of Magnesia
- Stimulant laxatives (biscodyl) - Dulcolax
Intended response for constipation Drug
Soften, pass stool
Relieve, prevent constipation
- GI motility and diarrhea are decreased
Fluid from bowel is reabsorbed and secretion of fluids decreased, activity of bacteria is decreased
Side Effect for Constipation Drug
Vary with drug type
Diarrhea, skin rash, stomach cramps, abdominal distention, nausea, gas, headache, reflux
Adverse Effect for Constipation Drug
Severe, life-threatening effects are rare
Psyllium and docusate may cause allergic reactions
Constipation (Check Before)
- Check Bowel sides
- Have 6 oz of fluid to give with oral drugs
- Intake of Antacid?
- Symptoms vs disease
- Prehydration rapidly in infants/children
- Acute to Life threatening do to electrolyte imbalanced
- Most risk: Infant/Elderly
4 types of Diarrhea
- Motility Disorder
Caused by medication
IBS - Irritable bowel syndrome
Diarrhea Drug types?
Antidiarrheal Drugs (Side Effects)
- Uncommon in healthy adults, vary by drug
Antidiarrheal Drugs (Adverse Effects)
Calcium polycarbophil may cause intestinal obstruction
Toxic megacolon (potentially life-threatening)
Fever, abdominal pain, rapid heart rate, dehydration
Antidiarrheal Drug (Check Before)
- Complete list of drugs patient is taking
- Baseline weight and vital signs
- Abdomen, skin turgor for dehydration
- Sedation (No alcohol)
Antidiarrheal Drug (Check After)
- Reassess abdomen for bowel sounds and distention
- Watch for signs of toxic megacolon
- Monitor vital signs, diarrhea stools, skin turgor
Antidiarrheal Drug (Patient Teaching)
- Take drug exactly as prescribed
- Do not double-dose; may cause constipation
- Avoid driving, activities that require alertness
- If no relief in 2 days; fever develops, abdominal pain or distention occurs; blood or mucous appears in stool, notify prescriber
- Avoid alcohol, other CNS depressants
When a patient is dehydrated how do we check?
Gently pinching and lifting the skin over the sternum, back of the hand, or arm will form a "tent."
YOU MIGHT ALSO LIKE...
Drug therapy for gastrointestinal problems CH22
pharm Drug therapy for gastrointestinal problems C…
PHARM CH 22 (1)
Ch. 15 Drugs for Seizures
OTHER SETS BY THIS CREATOR
CH 28: Insomnia
CH 27: Psychiatric Problems
CH 26: Drugs for Alzheimer's and Parkinson's Disea…
CH: 25 Seizures