Differences between PUD and GERD?
-PUD is not precipitated by any kind of food or beverage, GERD is precipitated by caffeine, spicy, strawberries, chocolate)
-PUD is caused by H.PYLORI, GERD is caused by loosening of esophageal funciton
-PUD actually has ulcer that goes through GI linning
Nursing interventions for PUD
-assess stool, urine, occult blood
-no bedtime snacks
-small frequent meals
-Following postoperatively gastric resection or vagotomy
-Lye down after meals to help
Diverticulosis vs Diverticulitis
Losis: Presence of pouches in the intestine wall
Itis: Actual inflammation of pouches in the wall, may cause bowel perforation!!!!
Dehydration and diarrhea more common in?
Large intestine is involved in water and electrolyte absorption
Blood, pus, and liquid stools are common
Signs of intestinal obstruction?
Diarrhea alternating with constipation
What should you keep the patient with diverticulitis?
NPO, risk for perforation or obstruction of bowel
Interventions for diverticulitis?
Recovery: NO fiber
Long-term: High-fiber diet and bulk forming laxatives to prevent pooling of foods in the pouches where the ycan become inflamed
-Metamucil (bulk-forming lax)
-Increase Fluid intake to 3 L/day
Maalox, Aluminum hydroxide, magnesium hydroxide
-Buffer the PH in the esophagus (keep at 3.5)
-take 1 hour after meals
-contraindicated in renal disease
Works on secreting and protecting the mucous lining
-Take 1 hour before meals
-Antacids interfere with absorption
"PRAZOLE" (Lansoprazole, Prilosec, nexium)
-Many side effects includding tinnitis, chest pain, dyspnea, diarrhea, constipation, heartburn, vertigo, confusion
When will ABG's show alkalosis vs acidosis in an obstruction?
-Alkalosis will be if the obstruction is high up in the small intestine because gastric acid is secreted there, leaving an alkalotic environment
-Acidosis if it is lower in the bowel because base is secreted there so the acid will be left over
Interventions for obstruction?
-Iv fluids, electrolyte therapy
-NG tub intubation *suction 80mmhg
-reposition client ever 2 hours to assist with placement of tube
Assessment findings in Colorectal cancer
-Change in bowel pattern, consistancy, color
-Abdominal distention or Ascites
-Pain, Nausea, vomitting
-History of Polyps
-family history of cancer
Surgical procedure for colocrectal cancer
-Laxatives or gut lavage
-High-calorie and high-protein diet
-Prevent constipation with high-fiber diet
-Screen with hemooccult Guaaric test
-Anorexia, weight loss
-Increased abdominal girth (measure it)
-Fector hepaticus (fruity breath)
-Dark colored urine (amber) (Presence of billibrubin)
-Clay colored or chalky stools (absence of bilirubin)
-Asterixis (hand flapping)
Labs and clotting defects with cirrhosis?
-Elevated BUN, Creatine, bilirubin, AST, ALT, alkaline phospatase, PT, and ammonia
-They can not break down ammonia because the liver is damaged so they will have increased ammonia
-Drug metabolism is longer because the liver can not break it down
Interventions for cirrhosis
-Restrict sodium/fluids (<1,500/day)
-High-carbohydrate diet (energy)
-Observe for change in mental status frequently
-Observe for signs of bleeding and be cautious of causing a bleed (small bore for needles)
-Pressure on puncture sites for 5+ minutes
-Measure abdominal girth
-weigh daily (signs of edema)
Cirrhosis patients are prone to what? Therefor you need to take precautions....
Bleeding (pressure on site, toothbrush, razor, small needles)
Cirrhosis and elimination
-They need to not strain when they are pooping
-Use stool softners
-High-fiber diet if they do not have
Nursing diagnosis/interventions for Hepatitis
Activity intolerance R/T fatigue, discrimination, joint pain, myalgia
-Plan periods of rest between activity
-High calorie and high-carb diet
-Do not share personal items in case of spreading
Hep A, B, C
A: Food contaminal (oral, fecal route), abrupt onset
B: Blood products (needles, sex, mother to child)
C: Blood, Dialysis (Sex, parenternal) Insididuous onset, no vaccine!!!!
Patients with Hepatitis should avoid what kind of substances because of damage to what organ?
-Hepatoxic substances (aspirin, acetaminophen, sedatives, alcohol)
Pancreatitis may cause what electrolyte imblance?
-change in deep tendon reflexes