GI Content
signs and symptoms of constipation
- absent or infrequent stool - hard or difficult to pass - dry, hard stools - abdominal distention - bloating - increased flatulence -increased rectal pressure
The nurse includes which of the following in the teaching plan for a patient with mild gastroesophageal reflux disease GERD? Select all that apply. Adapted from Lewis ch. 41 A. "Avoid peppermints to as they can cause symptoms." B. "Hot chocolate can help to soothe your stomach before bedtime." C. "Be sure to only have three meals per day." D. "You may try bubble gum to help ease your symptoms." E. "Try to limit the fat in your diet to help with symptoms."
Answer: A. "Avoid peppermints to as they can cause symptoms." D. "You may try bubble gum to help ease your symptoms." E. "Try to limit the fat in your diet to help with symptoms."
Chron's disease
chronic inflammation of the intestinal tract
nausea
is a feeling of discomfort in the epigastrium with a conscious desire to vomit
causes of acute abdominal pain
inflammation, infection, obstruction, peritonitis, internal injury
Geriatric considerations N/V
● Careful assessment and monitoring ● Life threatening fluid and electrolyte imbalances due to comorbidities, high risk for aspirations ○ Risk is higher for fluid imbalance ● Rehydration therapy: careful with heart failure patients/renal disease ○ Do not want to over hydrate ● Medication treatment: CNS side effects of antiemetic drugs (mentation, balance, coordination) ● Put them in semi-fowler's position High risk for falls, confusion
What causes hemorrhoids?
- Straining - Pregnancy (increased pressure with pushing) -Heavy lifting
A patient diagnosed with ulcerative colitis is admitted to the medical unit. When assessing the patient, which of these findings would be of the most concern? Khan Academy) A Borboygmi B Rebound tenderness C Bloody diarrhea D Oral temperature of 99.0 F
Answer: B Rebound tenderness
A patient fell from a ladder onto his back and is admitted for monitoring. A nurse notices new bruising around the patient's umbilicus. The nurse calls the physician, knowing that this can indicate which of the following? A. Lower GI obstruction B. Paralytic ileus C. Peritonitis D. Retroperitoneal bleeding
Answer: C. Peritonitis
The nurse cares for four patients. Each patient is displaying gastrointestinal symptoms. The nurse calls the physician immediately to report which of the following findings that are most concerning? A Burning in the upper abdomen and regurgitation B Frequent diarrhea after eating fast food C Bright red emesis and abdominal pain D Abdominal firmness and distention
Answer: D Abdominal firmness and distention
Management of Diverticular Disease
Diverticula/osis: high-fiber diet, decreased fat and red meat; weight reduction Diverticulitis ■ Can be more painful ■ Bowel rest: clear liquids or IV fluids and NPO ■ Antibiotics Watch for complications (perforation or abscess)
causes of constipation
- Fluid deficit - Diet: low fiber - Low physical activity - Disease conditions - Psychological: emotion, stress, ignoring urge -Medications: opioids
causes of diarrhea
- Infectious agents (big cause) - Certain foods or fluids -Symptom of another disorder
When preparing to assess a client with c. diff, which piece of protective equipment should be worn? a. head covering b. clear eye mask c. full plastic gown d. N95
c. full plastic gown
vomiting
the forceful ejection of partially digested food and secretions from the upper GI tract
obstructions
Intestinal content cannot pass through GI tract
A patient has acute episodes of diverticulitis. The patient is having Abdominal Pain,a temperature of 102.6 F, and elevated WBCs. The nurse does which of the following? (modified from Registered Nurse RN.com) A Monitor the patient for peritonitis B Encourage intake of high fiber foods C Apply a heating pad to the patient's abdomen for pain D Encourage intake of full liquids
Answer: A Monitor the patient for peritonitis
A patient has a new diagnosis of Crohn's disease. Which of the following reflects an understanding of this disorder? Select all that apply. A "If you ever have to have surgery, it will cure the disease." B "There is a small increase in risk of colorectal cancer with Crohn's disease." C "It is a good idea to keep track of foods that seem to make your symptoms worse, such as high-fiber foods." D "Complications like tunnelings between the GI tract and other areas are common with Crohn's disease."
Answer: C "It is a good idea to keep track of foods that seem to make your symptoms worse, such as high-fiber foods." D "Complications like tunnelings between the GI tract and other areas are common with Crohn's disease."
The health care provider is teaching a patient diagnosed with Crohn's disease who is recovering from a bowel resection. Which of the following statements made by the patient indicates the teaching has been effective? Khan Academy) A "Now that the bowel has been removed, the disease is cured." B "Now I can discontinue taking my multivitamin supplements." C "The disease might reappear in another part of the bowel." D "I might develop ulcerative colitis because some of my bowels are missing."
Answer: C "The disease might reappear in another part of the bowel."
A client with nausea and vomiting begins to improve after administration of an antiemetic. When resuming a diet, the nurse recommends which of the following foods because they are generally well-tolerated? Select all that apply. A Cereal B Coffee C Crackers D Dy baked potato E Pizza F Rice
Answer: C Crackers F Rice
A patient has a large bowel obstruction and begins to vomit. Which of the following findings is expected with regard to the characteristics of the emesis? A Green, thin, and projectile B Brown, coffee-ground C Bight red with clots D Fecal smelling
Answer: D. Fecal smelling
interventions for abdominal trauma
Diagnostic test: CT; abdominal ultrasound What would a CBC show?(Might show some blood loss) Why is a urinalysis important? (Watch for issues with blood) Type and crossmatch—for blood administration Potential surgery
diverticula- diverticulosis- diverticulitis
Diverticula (when you have one)- Diverticulosis (when you have more than one, teach patient and prevention)- diverticulitis
signs and symptoms of chronic abdominal pain
Dull, achy, diffuse
irritable bowel syndrome (IBS)
Idiopathic chronic, common functional disorder; intermittent bowel pain and diarrhea or constipation
non-mechanical obstructions
Neuromuscular or vascular disorder § Paralytic ileus- tends to happen after surgery § Pseudo-obstruction- can't figure out where it is something from §Vascular obstruction (emboli)
geriatric considerations constipation
Normal finding: • Peristalsis slows • Thirst is decreased & water intake is decreased • Medications: cause constipation • Decreased mobility/activity • Delayed gastric emptying
management of IBD
Ongoing: ■ Adequate nutrition: calories, protein, no ■ lactose ■ Avoid triggers: lactose? fat? cold? high fiber? ■ Medications: Table 42-17 Acute ■ Hemodynamics: watch BP and HR ■ Fluids and electrolytes ■ Bowel rest, NG tube possible and clear liquids ■ Pain control ■ Psychosocial: stress reduction Skin integrity, if they are stooling frequently
The nurse assesses a pt with the diagnosis of an intestinal obstruction in the descending colon. When auscultating the mid-abdomen, which type of sound would the nurse expect to hear? a. Tympany b. Borborygmi c. Abdominal bruit d. Plural fiction rub
a. Tympany (this is percussed and described as high pitched and musical due to the presence of gas) b. Borborygmi (rapid high-pitched sounding bowel songs that are indicative of the hyperperistalsis that occurs behind an intestinal obstruction)
The nurse is providing instructions for a client who has IBD of the ascending colon? what suggestion by the nurse is appropriate? a. consume scrambled eggs and applesauce b. consume barbecued chicken and fries c. consume fresh fruit salad with cheddar cheese d. consume chunky peanut butter on whole wheat bread
a. consume scrambled eggs and applesauce low-residue foods produce less decal water, decreasing bowel contents and irrational, protein promotes healing, calories provide energy
The nurse is caring for a client who is having diarrhea? Which client data would the nurse closely monitor to prevent adverse outcomes? a. skin condition b. fluid and electrolyte balance c. food intake d. fluid intake and output
b. fluid and electrolyte balance
An older clients colonoscopy reveals the presence of extensive diverticulosis. What type of diet would the nurse encourage the client to follow? a. low fat b. high-fiber c. high-protein d. low-carb
b. high fiber fiber promotes passage of residue through the intestine
A client is admitted to the hospital with a Diagnosis of chron's disease. Which is important for the nurse to include in the teaching plan for the client? a. controlling constipation b. meeting nutritional needs c. preventing increased weakness d. anticipating a sexual alteration
b. meeting nutritional needs to avoid pain and diarrhea these clients often refuse to eat and become malnourished
After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary health care provider. Which is most likely the significant factor that affected the clients decision? a. it is temporary until the colon heals b. surgical treat cures UC c. UC can progress to chrons disease d. without surgery eating table food is contradicted
b. surgical treat cures UC
A client develops an intestinal obstruction. An NG tube is inserted and connected to low, continuous suction. The nurse monitors the client for fluid volume deficit. Which clinical finding would the nurse expect if the client becomes dehydrated? a. restlessness b. constipation c. inelastic skin turgor d. increased blood pressure
c. inelastic skin turgor
ulcerative colitis
chronic inflammation of the colon with presence of ulcers
diverticular disease
condition in which bulging pouches (diverticula) in the gastrointestinal (GI) tract push the mucosal lining through the surrounding muscle
A client was admitted to the hospital with blunt trauma to the abdomen. The client was treated for lacerated liver and abdominal hemorrhage. During the recovery period the nurse would monitor for what indications for peritonitis? select all that apply a. jaundice d. board-like abdomen c. abdominal tenderness d. decreased bowel sounds e. rapid decrease in coagulation ability
d. board-like abdomen c. abdominal tenderness d. decreased bowel sounds
The nurse is assessing two clients. One client has ulcerative colitis and the other client has Chron disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with chrons? a. inclusion of transferal involvement with the small bowel wall b. higher occurrence of fistulas and abscesses from changes in the bowel wall c. pathology beginning proximally with intermittent plaques found along the colon d. involvement staring distally with rectal bleeding that spreads continually up the colon
d. involvement staring distally with rectal bleeding that spreads continually up the colon
An older adult client who is accustomed to taking enema periodically to avoid constipation is admitted to a long-term facility and is bed bound. Which during action would be included in the initial plane of care to prevent the client from developing constipation? a. arrange to have enemas prescribed for the client b. obtain a prescription for a daily laxative for the client c. place a commode by the bedside to facilitate defecation d. offer a large glass of prune juice with warm water each morning
d. offer a large glass of prune juice with warm water each morning
treatment of GI obstruction
· NPO · NG tube to suction · IV therapy, Potassium PRN · Pain control ·Surgery if needed
characteristics of feces
• Amount: about 150 grams per day • 3 times a day- every 3 days • Color: brown, redness, black, tar like • Consistency: hard, loose, or liquid • Constituents: undigested food, bacteria • Odor: it smells, but there are unique smells • Shape
geriatric considerations diarrhea
• Careful assessment and monitoring • Life threatening fluid and electrolyte imbalances due to comorbidities and thirst is decreased • Rehydration therapy: careful with heart failure patients/renal disease •Medications used to tx GERD: decreases stomach acid increases the instance that pathogens will survive
signs and symptoms of abdominal trauma
• Positioning: guarding and splinting (peritonitis) • Hard, distended abdomen (bleeding) • Decreased/absent bowel sounds • Pain • Blood in emesis (hematemesis) • Blood in urine (hematuria) • Bruising (ecchymosis): • Cullen's sign- right around the belly button •Grey Turner's sign- turn patient over, on the side
Should you remove an impaled object?
• We do not remove these objects • We would stabilize these objects
Treatment of fecal incontinence
● Kegel exercises ● Assess, treat impaired skin integrity* ● Fiber and fluids ● Avoiding diarrhea-causing foods- coffee, dried fruits, spicy foods, green veggies ● Skin: fecal management system ● Disimpact if needed ● Regular bowel training program ● Increase fiber ● Increase fluids ● Surgical repair if damaged anal sphincters
goals with abdominal pain
- Prevent and treat hypovolemia, electrolyte imbalances, and infection - Treat cause, surgery as needed -Pain relief
Management of IBS
- Slow fiber introduction; avoiding trigger foods - Medications based on symptoms -Stress reduction (stress, anxiety, PTSD can cause symptoms)
Fecal incontincence
Loss of voluntary ability to control fecal and gaseous discharges
constipation
Absent or infrequent stools and hard, dry stools that are difficult to defecate
diagnosis of GERD
Diagnosis: usually symptoms; may use endoscopy (goes down mouth into esophagus to visualize the upper GI tract)
Causes of diverticular disease
Diet low in fiber High in refined sugars Red meats Obesity
signs and symptoms of peritonitis
abdominal pain, abdominal tenderness abdominal distention Fever Tachycardia Tachypnea N/V
vital signs to watch for with abdominal trauma?
Watch for increase in HR and decrease in BP Watch for increase in temperature
signs of fecal impaction
- Frequent, nonproductive - Fecal seepage - Rectal pain -Anorexia
Signs and Symptoms of GERD
- Heartburn: pyrosis (tight, burning feeling near sternum) - Dyspepsia (discomfort in the mid abdomen) - Regurgitation (feel hot, bitter, or sour) -Chest pain; respiratory symptoms
Treatment of constipation
- Increase Fluids - Increase Fiber - Physical activities - Medications
Prioritization with abdominal pain
- Airway—probably not related? - Breathing—probably not related? - Circulation: including vital signs, I&O • Tract vital signs, is there a trend • Are they getting rid of fluids? - Assessment of cause, pain - Assessment of symptoms (pain, neuro, infection) and output (dehydration, blood loss) - NG tube - Lab values - NPO for surgery?
signs and symptoms of hemorrhoids
- Bleeding - Anal pruritus (itching in that area) -Pain
diagnostic tests for abdominal pain
- CT scan - MRI - Laparotomy (opening them up) - Barium studies -CBC- complete blood count to see if there are changes
signs and symptoms of IBS
- Constipation or diarrhea - Flatulence -Abdominal discomfort
Treatment of fecal impaction
- Enemas- fluid to remove it - Disimpaction: e.g., manual with gloved, lubricated finger but avoid bleeding -Fiber and fluids—fiber (20-30 g) increased slowly, and it is accompanied by fluids
Complications of GERD
- Esophagitis, ulcerations - Barrett's esophagus: precancerous changes
signs and symptoms of diarrhea
- Fatigue - Increased bowel sounds - Irritation of anal area - Malaise - Spasmodic cramps - Weakness - Abd pain -Anal redness, breakdown
Causes of fecal incontinence
- Fecal impaction - Impairment of anal sphincter or nerve supply - Neuromuscular diseases - Spinal trauma -Tumor
treatment of hemorrhoids
- Fiber - Fluid - Ointments, pads - Laser treatment - Pain treatment - Hemorrhoidectomy - Sitz baths
diarrhea
3+ loose/liquid stools per day - Acute ~ ≥ 3 loose stools in one day - Chronic ~ last for > 4 weeks
A patient with vomiting begins to tolerate clear liquids. Which additional menu choice would be most appropriate? A Rice B Bland chips and salsa C Decaf coffee D Coca-cola
Answer: A. Rice
GERD=
Gastroesophageal Reflux Disease Reflux, inflammation; incompetent lower esophageal sphincter Not really a disease but more so a syndrome
A patient's son calls the clinic about his mother. She has been nauseated all day and has vomited twice. The nurse tells the patient's son which of the following? Adapted from Lewis ch. 41 A. Administer antiemetic drugs and assess skin turgor B. Provide sips of water and elevate head of bed C. Offer a high-protein supplement to drink D. Offer large quantities of Gatorade
Answer: B. Provide sips of water and elevate head of bed
complications with IBD
F&E Concerns for older adults as they lose fluid they are more risk for dehydration
Mechanical obstructions
Able to find occlusion; may be after surgery § Adhesions § Hernia § Strictures- narrowing in an area § Intussusception- something goes into itself § Cancer § Diverticular disease § Volvulus- twisting
signs and symptoms of N/V
Anorexia (feeling of not wanting to eat) Dehydration Electrolyte imbalances (loss of K+, Na+, Chloride) Metabolic alkalosis Aspiration (vomit goes into lungs)
Bob Reynolds is a 50year-old African American professional cross-country truck diver. In this role, he finds it difficult to eat healthy foods. As a result, he eats fast food most meals of the week. During his routine colonoscopy, the physician finds that he has several diverticula and diagnoses him with diverticulosis. Mr. Reynolds is surprised by his diagnosis, saying, "I've never even had any symptoms." Which response by the nurse is most appropriate? A "Diverticulosis may be present without any symptoms." B "Nausea and vomiting are common symptoms of diverticulosis." C "Often the only signs are an increased white blood cell count." D "It is common to have a mass in the right lower quadrant."
Answer: A "Diverticulosis may be present without any symptoms."
Which of the following are indicative of an abdominal perforation? Select all that apply. A Abdominal pain B Coffee ground emesis C Elevated white blood cell count D Regurgitation of undigested food
Answer: A Abdominal pain C Elevated white blood cell count
treatment of GERD
Avoid triggers: smoking, fatty foods, chocolate, acidic drinks, peppermint, coffee, tea Avoid late eating and milk at bedtime; HOB elevated after eating Medications: ○ Proton Pump Inhibitors (PPIs) ("-prazole") ○ H2-receptor Blockers ("-tidine") ○ Antacids, can be used to help with discomfort Surgery to strengthen LES (lower esophageal sphincter strength) Chewing gum can help Weight loss Eat small frequent meals
causes of peritonitis
Blood-borne after perforation or rupture
Types of abdominal trauma
Blunt- Does not break the skins surface, so not sure what has been affected on the inside Penetrating- Impaled object, stab wound Organ damage: hypovolemic shock- Liver and spleen are very vascular organs, bleeding internally- Bladder or GI tract: bacteria leak out, spread infection, can develop peritonitis
complications of diarrhea
C. diff: -Handwashing, not hand sanitizer, friction of washing - Bleach to clean - Best treated with: Vancomycin, metronidazole -Contact isolation (enhanced)
inflammatory bowel disease (IBD)
Chronic inflammation of GI tract; includes Crohn's Disease and Ulcerative Colitis
Diagnostic Tests
Colonoscopy- Goes into colon Sigmoidoscopy- Lower point Endoscopy Blood tests: H&H: to see if someone is bleeding WBCs: elevation in WBC if there is an infection BUN and Cr. (creatinine): elevated lack to perfusion to the kidneys, renal failure CRP: inflammation Electrolyte imbalances CT scan- Can see different organs X-rays- Used to detect abnormalities in certain areas
treatment of diarrhea
Consider changes to fluids and electrolytes—prevent and treat - Treat cause - Prevent transmission Medications—but often want to allow passage of infectious organism so won't use antidiarrheals • Antidiarrheals (sometimes, if it is an infectious agent we want to get rid of it ) • Antibiotics
ulcerative colitis vs chron's disease
Crohn's Disease Location- Skip lesions, likely terminal ileum (Anywhere from the esophagus all the way down lower) Depth- Entire thickness, COBBLESTONE appearance Symptoms- Diarrhea, pain, fever, weight loss, nutritional deficiencies Complications: Fistulas- tunneling, Strictures- area becomes narrowed, Abscesses, Perforation, Slight INCREASE sm/lg intestine cancer Surgery- Reoccurrence possible, does not mean it is gone, NO CURE Ulcerative Colitis Location- Continuous from the rectum up (In the colon area) Depth- Portion Symptoms- Diarrhea, pain, fever, rectal bleeding Complications- Toxic megacolon (really distended, lots of stool there can pop open), Perforation, Colon cancer increased after 10 YEARS Surgery- CURE, can remove the part of the colon
obstruction diagnosis
H&P (history and physical) CT Abdominal X-ray Visualization Labs
complications with constipation
Hemorrhoids Valsalva: breathing deeply; bearing down; reducing venous return to heart (caused by increased intrathoracic and intra abdominal pressure); HR decreases; BP decreases and then increase (p. 930) Impaction
geriatric considerations GERD
Hiatal hernia and GERD increase with age: weakening diaphragm, obesity, kyphosis Medications decrease LES pressure (nitrates, CCB, antidepressants) Severe cases can cause- aspiration pneumonia or esophageal bleeding
causes of chronic abdominal pain
IBS, Peptic Ulcers, Pancreatitis, Hepatitis, Pelvic Inflammatory Disease, Vascular Insufficiency
fecal impaction
Mass or collection of hardened feces in folds of rectum
treatment of N/V
Medications (Table 41.1 on page 891) promethazine (Phenergan)- can cause sedative effects, given IV or PO ondansetron (Zofran)- Block the action of serotonin metoclopramine (Reglan)- prokinetic- increases gastric motility and emptying Placement of nasogastric (NG) tube: possible to remove stomach contents, mostly with bowel obstructions (discussed later) NPO: nothing to eat or drink but give IV fluids for hydration as needed IV fluids: electrolytes, glucose Position to prevent aspiration: semi-Fowler's or side-lying Clear liquids, glands foods BRAT diet High carbs, low fat Avoid spicy, acidic, strong odors Avoid things with too much sodium
signs and symptoms of acute abdominal pain
N/V, diarrhea, constipation, flatulence, fatigue, fever, bloating May have changes indicative of hypovolemic shock (when that person loses too much fluid) -- ↑HR, ↓BP, caused by fluid not in the vascular space
causes of N/V
Pregnancy, infection, CNS problems, CV disease, metabolic disorders, psychological, irritations, dietary
nursing assessment of N/V
Regurgitation Projectile vomiting, pretty forceful Emesis: color, odor, consistency -bleeding: Mallory-Weiss tear (tear in esophagus) or lower GI) -Bright red- upper GI bleeding or issues -Looks like coffee grounds, it is partially digested then maybe lower GI bleeding -Note any of these findings
hemorrhoids
swollen, twisted, varicose veins in the rectal region
Cause of GERD
There is not one single cause GERD results when the reflux of acidic gastric contents into the esophagus overwhelm the esophageal defenses Risk factors: obesity, smoking, hiatal hernia
The nurse is assessing a client with the diagnosis of hemorrhoids. Which facts in the client's history most likely played a role in the development of hemorrhoids? select all that apple a. constipation b. hypertension c. eating spicy foods d. bowel incontinences e. numerous pregnancies
a. constipation e. numerous pregnancies
A client develops peritonitis and sepsis after the surgical repave of a ruptured diverticulum. Which signs would the nurse expect when assessing the client? Select all that apply a. fever b. tachypnea c. hypertension d. abdominal rigidity e. increased bowel sounds
a. fever b. tachypnea d. abdominal rigidity
Peritonitis develops in a client who had surgery for a ruptured appendix. Which clinical finding related to peritonitis should the nurse expect the client to exhibit? select all that apply a. fever b. hyperactivity c. extreme hunger d. urinary retention e. abdominal muscle rigidity
a. fever e. abdominal muscle rigidity
The nurse teaches a client about foods that may help prevent constipation. Which Of The following has the most fiber? A Turkey sandwich, an apple, and a handful of sweet potato chips B 1 cup of bran cereal, 1 cup of raspberries, and a pear C Beef taco on a con totilla, 1⁄4 cup refied beans, tomato salsa, and totilla chips D 1 cup of shredded wheat, 1 banana, and orange juice
answer: B 1 cup of bran cereal, 1 cup of raspberries, and a pear
Treatment of peritonitis
antibiotics, NG suction, analgesics, IV fluids; surgery *We will want to treat this quickly*
The nurse provides education to a client on how to precent constipation. The nurse concludes that the teaching is understood when the client makes what statements? Select all that apply. A. "I can eat potatoes at dinner daily" b. " I should drink at least six glasses of water everyday" c. "I should eat eggs for breakfast three times a week" d. "I can include bran muffins in my breakfast daily" e. "I will walk everyday as a part of my exercise regimen"
b. " I should drink at least six glasses of water everyday" d. "I can include bran muffins in my breakfast daily" e. "I will walk everyday as a part of my exercise regimen"
Which prescribed medications would the nurse anticipate initiating for a client with C.diff-associated disease (CDAD)? SELECT ALL THAT APPLY a. Penicillin b. Fidaxomicin c. Ciprofloxacin d. Metronidazole e. Vancomycin
b. Fidaxomicin d. Metronidazole e. Vancomycin
which of the prescribed medicines would the nurse anticipate intuition for a client with c. diff? Select all that apply. a. penicillin b. Fidaxomicin c. ciprofloxacin d. metronidazole e. vancomycin
b. Fidaxomicin d. metronidazole e. vancomycin metronidazole and vancomycin have been the medications of choice to treat c. diff
Which should the nurse include when teaching a pt with C.diff about decreasing the risk of transmission to family members? a. Increase fluid intake b. A high-fiber diet c. Soap and water for hand washing d. Wash hands with an alcohol-based hand sanitizer
c. Soap and water for hand washing
Which category of isolation would the nurse implement for a client who is positive for c. diff? a. airborne precautions b. droplet precautions c. contant precautions d. protective equipment
c. contant precautions
signs and symptoms of diverticular disease
may not have many symptoms or be aware of Diverticula/osis
The nurse is teaching a client about GERD. Which statement made by the client indicated current understanding of GERD management? a. "Three meals per day is the best regimen for GERD symptoms" b. "I can reduce my GERD symptoms though a high carb, low fat diet" c. "A snack at bedtime will help reduce the acidity of my stomach during the night" d. "I will place a six inch block under the head of bed to help with digestion"
d. "I will place a six inch block under the head of bed to help with digestion"
A nurse is eliciting a health history from a client with ulcerative colitis. What factor does the nurse consider to be most likely associated with the client's colitis? a. food allergy b. infectious agent c. dietary components d. genetic predisposition
d. genetic predisposition
peritonitis
inflammation of the peritoneum
what factors influence fecal elimination?
· Activity level · Different medications · Surgery · Know the patient's normal daily patterns · Fear of pain · Use of pain medications · Age · Influenced by the things you eat, food sensitivities · How much fluid you are drinking? · Diet: fiber · Diagnostic procedures
symptoms of lower GI obstruction
· Gradual abdominal pain · N/V: foul, it can take a long time to come up, could be fecal · Distention · High-pitched bowel sounds above obstruction · Constipation, no flatus
complications of GI obstruction
· Ischemic bowel · Hypotension and shock · F&E, acid-base imbalance · Perforation