git disturbances
TRANSCRIPT
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GASTROINTESTINAL SYSTEM
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Gastrointestinal
AssessmentLaboratory Procedures
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COMMON LABORATORY PROCEDURES
FECALYSIS
Examination of stool consistency,
color and the presence of occultblood.
Special tests for fat, nitrogen,
parasites, ova, pathogens andothers
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COMMON LABORATORY PROCEDURES
FECALYSIS: Occult Blood Testing
Instruct the patient to adhere to a
3-day meatless diet
No intake of NSAIDS, aspirin and
anti-coagulantScreening test for colonic cancer
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COMMON LABORATORY PROCEDURES
Upper GIT study: barium swallow
Examines the upper GI tract
Barium sulfate is usually used
as contrast
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COMMON LABORATORY PROCEDURES
Upper GIT study: barium swallow
Pre-test: NPO post-midnight
Post-test: Laxative is ordered, increasept fluid intake, instruct that stools will
turn white, monitor for obstruction
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COMMON LABORATORY PROCEDURES
Lower GIT study: barium enema
Examines the lower GI tract
Pre-test: Clear liquid diet and
laxatives, NPO post-midnight,
cleansing enema prior to the test
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COMMON LABORATORY PROCEDURES
Lower GIT study: barium enema
Post-test: Laxative is ordered,
increase patient fluid intake,
instruct that stools will turn
white, monitor for obstruction
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COMMON LABORATORY PROCEDURES
Gastric analysis
Aspiration of gastric juice to measure
pH, appearance, volume and contentsPre-test: NPO 8 hours, avoidance of
stimulants, drugs and smoking
Post-test: resume normal activities
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COMMON LABORATORY PROCEDURES
EGD
(esophagogastroduodenoscopy)
Visualization of the upper GIT byendoscope
Pre-test: ensure consent, NPO 8hours, pre-medications likeatropine and anxiolytics
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COMMON LABORATORY PROCEDURES
EGD
esophagogastroduodenoscopy
Intra-test: position : LEFTlateral tofacilitate salivary drainage and
easy access
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COMMON LABORATORY PROCEDURES
EGD (esophagogastroduodenoscopy)
Post-test: NPO until gag reflex returns,
place patient in SIMS position until heawakens, monitor for complications,saline gargles for mild oral discomfort
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COMMON LABORATORY PROCEDURES
Lower GI- scopy
Use of endoscope to visualize the
anus, rectum, sigmoid and colonPre-test: consent, NPO 8 hours,
cleansing enema until return is clear
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COMMON LABORATORY PROCEDURES
Lower GI- scopy
Intra-test: position is LEFT
lateral, right leg is bent andplaced anteriorly
Post-test: bed rest, monitor forcomplications like bleeding andperforation
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COMMON LABORATORY PROCEDURES
Cholecystography
Examination of the gallbladder todetect stones, its ability to
concentrate, store and release the bilePre-test: ensure consent, ask allergies
to iodine, seafood and dyes; contrast
medium is administered the nightprior, NPO after contrastadministration
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COMMON LABORATORY PROCEDURES
Cholecystography
Post-test: Advise that
dysuria is common as thedye is excreted in the urine,resume normal activities
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COMMON LABORATORY PROCEDURES
Paracentesis
Removal of peritonealfluid for analysis
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COMMON LABORATORY PROCEDURES
Paracentesis
Pre-test: ensure consent,instruct to VOID and empty
bladder, measure abdominalgirth
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COMMON LABORATORY PROCEDURES
Paracentesis
Intra-test: Upright on theedge of the bed, back
supported and feet restingon a foot stool
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COMMON LABORATORY PROCEDURES
Liver biopsy
Pretest
Consent
NPO
Check for the bleeding
parameters
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COMMON LABORATORY PROCEDURES
Liver biopsy
Intratest
Position: Semi fowlers LEFT lateral
to expose right side of abdomen
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COMMON LABORATORY PROCEDURES
Liver biopsy
Post-test: position on RIGHT
lateral with pillow underneath,monitor VS and complications like
bleeding, perforation. Instruct toavoid lifting objects for 1 week
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The NURSING PROCESS in GIT
Disorders
Assessment
Health history Nursing History
PE
Laboratory procedures
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The ABDOMINAL examination
The sequence to follow is:
Inspection
Auscultation
Percussion
Palpation
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The GIT System: Anatomy and
Physiology
The GIT is composed of two general parts
The main GIT starts from the
mouth Esophagus Stomach SI LI
The accessory organs are the
Salivary glands
Liver
Gallbladder
Pancreas
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The GIT ANATOMY
The Mouth
Contains the lips, cheeks, palate, tongue,
teeth, salivary glands, masticatory/facial
muscles and bones
Anteriorly bounded by the lips
Posteriorly bounded by the oropharynx
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The GIT Physiology
The Mouth
Important for the mechanical digestion of
food
The saliva contains SALIVARY AMYLASE or
PTYALIN that starts the INITIAL digestion of
carbohydrates
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The GIT ANATOMY
The Esophagus
A hollow collapsible tube
Length- 10 inchesMade up of stratified squamos
epithelium
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The GIT ANATOMY
The Esophagus
The upper third contains skeletal
muscles The middle third contains mixed
skeletal and smooth muscles
The lower third contains smoothmuscles and the esophago-gastric/cardiac sphincter is found here
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The GIT PHYSIOLOGY
The Esophagus
Functions to carry or propel foods from the
oropharynx to the stomach
Swallowing or deglutition is composed of
three phases:
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The GIT ANATOMY
The stomach
J-shaped organ in the epigastrium
Contains four parts- the fundus, the cardia,
the body and the pylorusThe cardiac sphincter prevents the reflux of
the contents into the esophagus
The pyloric sphincter regulates the rate ofgastric emptying into the duodenum
Capacity is 1,500 ml!
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The GIT PHYSIOLOGY
The functions of the stomach aregenerally to digest the food (proteins)and to propel the digested materials into
the SI for final digestionThe Glands and cells in the stomach
secrete digestive enzymes:
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The GIT PHYSIOLOGY
Stomach:
1. Parietal cells- HCl acid and Intrinsicfactor
2. Chief cells- pepsin digestion ofPROTEINS to POLYPEPTIDES
3. Antral G-cells- gastrinINC HCL acidproduction
4. Mucus neck cells- mucus
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The GIT ANATOMY
The Small intestine
Grossly divided into the Duodenum, Jejunum
and Ileum
The duodenum contains the two openings for
the bile and pancreatic ducts
The ileum is the longest part (about 12 feet)
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The GIT physiology
The intestinal glands secrete digestive
enzymes that finalize the digestion of all
foodstuff
Enzymes for carbohydrates disaccharidases
Enzymes for proteins dipeptidases and
aminopeptidases
Enzyme for lipids intestinal lipase
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The GIT ANATOMY
The Large intestineApproximately 5 feet long, with parts:
1. The cecum widest diameter, prone to rupture
2. The appendix
3. The ascending colon
4. The transverse colon
5. The descending colon
6. The sigmoid most mobile, prone to twisting
7. The rectum
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The GIT Physiology
Absorbs water
Eliminates wastes
Bacteria in the colon synthesize Vitamin K
Appendix participates in the immune system
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The GIT Physiology
SYMPATHETIC
Generally INHIBITORY!
Decreased gastricsecretions
Decreased GIT motility
But: Increased sphincteric
tone and constriction ofblood vessels
PARASYMPATHETIC
Generally EXCITATORY!
Increased gastric secretions
Increased gastric motility
But: Decreased sphincterictone and dilation of blood
vessels
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ANATOMY AND PHYSIOLOGY
Upper alimentary canal
Mouth
Pharynx (throat)
Esophagus
Stomach
1st
half of duodenum
GASTROESOPHAGEAL REFLUX
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GASTROESOPHAGEAL REFLUX
DISEASE
-Excessive reflux of hydrochloric acid into the
esophagus.
Predisposing Factors:
1.Incompetent LES
2.Pyloric Stenosis3.Other Esophageal disorder:
GASTROESOPHAGEAL REFLUX
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GASTROESOPHAGEAL REFLUX
DISEASE
Signs and Symptoms:
Pyrosis
Dyspepsia
Regurgitation
Dysphagia
Odynophagia Heart-attack like symptom
GASTROESOPHAGEAL REFLUX
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GASTROESOPHAGEAL REFLUX
DISEASE
Diagnostics:
EGD esophagogastroduodenoscopy
24 hr pH monitoring
Esophagoscopy
GASTROESOPHAGEAL REFLUX
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GASTROESOPHAGEAL REFLUX
DISEASE
Nursing Management:
1.Administer Medications as ordered
2.HT
-Avoid irritants such as spicy or acidic foods,
alcohol, caffeine, and tobacco.
-avoid food or drink 2 hours before bedtime orlaying down after eating.
Elevate the head of the bed on 6-8in blocks
3. Assist in surgery. Nissen fundoplication -
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PEPTIC ULCER DISEASE
Involves ulceration, circumscribed breaks in the
mucosa, occurring in the duodenum
(duodenal ulcer), the stomach (gastric ulcer),
and less commonly, the distal esophagus andthe jejunum.
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PEPTIC ULCER DISEASE
Predisposing Factors:
1.Helicobacter Pylori
2.Hereditary
3.Psychological Factors (Stress, Anxiety, Type A)
4.Smoking and Alcohol use
5.Use of Ulcerogenic drugs6.Increased intake of caffeine, soda, choco, tea
7.Irregular Diet
8.Zollinger Ellison Syndrome
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PEPTIC ULCER DISEASE
PATHOLOGY
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PEPTIC ULCER DISEASEDUODENAL ULCER
Age 30-60
M:F 2:1 / 80%
Duodenal Bulb
Hypersecretion of HCL
Wt Gain Pain is Burning, aching, gnawing in
the right epigastrium; 2-3 hours p
eating; relieved by eating. 12-3am
Vomiting Uncommon
Bleeding less likely; Melena
Malignancy is rare
Complications: Perforation
GASTRIC ULCER
Age 50 and above
M:F 1:1 / 15%
Antrum/ Pylorus
Normal HCL
Wt loss Pain is Burning, aching, gnawing in
the upper epigastrium; 30 mins to 1
hour p eating;unrelieved by eating.
Vomiting Common
Bleeding more likely; Hematemesis
Malignacy occurs occasionally
Complications: G-CA, Hemorrhage
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PEPTIC ULCER DISEASE
Diagnostics:
Barium swallow shows an ulcerated area
Endoscopy identifies the inflammatory
changes, ulcers and lesions.
Biopsy determines the presence of H. Pylori/
Urease test
Gastric Analysis determines Normal/Increased
gastric acid secretion
Occult blood test
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PEPTIC ULCER DISEASE
Nursing Management:
Administer Medications as ordered:
Give bland diet and small frequent meals
(no hot/cold, meat, alcohol, caffeine,
milk/products)
Provide teaching on stress reduction and
relaxation techniques
Monitor for complications of PUD
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PEPTIC ULCER DISEASE
Nursing Management:
Assisst in Surgery
1.Vagotomy Severing of the vagus nerve.
Decreases gastric acid by diminishing
choinergic stimulation to the parietal cells,
making them less responsive to gastrin.
2.Pyloroplasty a longitudinal incision is made
into the pylorus and transversely sutured
closed to enlarge outlet and relax the muscle.
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PEPTIC ULCER DISEASE
ANTRECTOMY
1.Billroth 1 removal of the lower portion of
the antrum of the stomach (which contains
the cellls that secrete gastrin) as well as asmall portion of the duodenum and pylorus.
The remaining segment is anastomosed to the
duodenum. (Gastroduodenuostomy)2.Billroth 2 Lower portion of the antrum is
anatomosed to the jejunum.
(Gastrojejunostomy)
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PEPTIC ULCER DISEASE
SURGICAL PROCEDURES FOR PUD
Post-operative Nursing management
1. Monitor VS2. Post-op position: FOWLERS
3. NPO until peristalsis returns
4. Monitor for bowel sounds
5. Assess surgical dressing
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Conditions of the Stomach
Post-operative Nursing management
6. Monitor I and O, IVF
7. Maintain NGT8. Diet progress: clear liquid full
liquid six bland meals
9. Watch Out for Complication
DUMPING SYNDROME
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DUMPING SYNDROME
DUMPING SYNDROME
A condition of rapid emptying of the gastric
contents into the small intestine usually after
a gastric surgery
Symptoms occur 30 minutes after eating
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
PATHOPHYSIOLOGY
Foods high in CHO and
electrolytes must be diluted inthe jejunum before absorption
takes place.
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
PATHOPHYSIOLOGY
The rapid influx of stomach
contents will cause distention ofthe jejunum early symptoms
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
PATHOPHYSIOLOGY
The hypertonic chyme will draw
fluid from the blood vessels todilute the high concentrations
of CHO and electrolytes
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
Later, there is increased blood
glucose stimulating the
increased secretion of insulin Then, blood glucose will fall
causing reactive hypoglycemia
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
DUMPING SYNDROME
ASSESSMENT FINDINGS: early symptoms
1. Nausea and Vomiting 2. Abdominal fullness
3. Abdominal cramping
4. Palpitation
5. Diaphoresis
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
DUMPING SYNDROME
ASSESSMENT FINDINGS: LATE
symptoms: 6. Drowsiness
7. Weakness and Dizziness 8. Hypoglycemia
COMMON GIT SYMPTOMS AND
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COMMON GIT SYMPTOMS AND
MANAGEMENT
DS NURSING INTERVENTIONS
1. Advise patient to eat LOW-carbohydrate HIGH-fat and HIGH-protein diet
2. Instruct to eat SMALL frequent
meals, include MORE dry items. 3. Instruct toAVOID consuming
FLUIDS with meals
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COMMON GIT SYMPTOMS AND
MANAGEMENT
DS NURSING INTERVENTIONS
4. Instruct to LIE DOWN after
meals 5. Administer anti-spasmodic
medications to delay gastric
emptying
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ANATOMY AND PHYSIOLOGY
II. Middle Alimentary canal Function: for
absorption
- Complete absorption large intestine
2nd half of duodenum
Jejunum
Ileum
1st half of ascending colon
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APPENDICITIS
Appendicitis is inflammation of the vermiformappendix.
Male>Females
Ages 10 and 30 years Predisposing Factors (Obstruction):
a. Fecalith
b. Kinking of appendix
c. Inflammation
d. Neoplasm
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APPENDICITIS
Obstruction
Fecalith, Kinked appendix,inflammation, neoplasm
Inflammatory response
Increased Intraluminal Pressure
WBC Infiltration
Pus formation
Necrosis
Perforation
Edema
Peritonitis
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APPENDICITIS
Signs and Symptoms:
Acute abdominal pain, RLQ
Nausea and vomiting
Low-grade fever
Constipation or Diarrhea
Board-like abdomen or abdominal rigidity ifappendix ruptured.
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APPENDICITIS
Diagnostics:
CBC Leukocytosis
UTZ reveals enlarged/inflammed appendix
X-ray reveals enlarged appendix
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CONDITIONS OF THE LARGE INTESTINE
NURSING INTERVENTIONS
1. Preoperative care
NPO
Consent
Monitor for perforation and
signs of shock
C S
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APPENDICITIS
Nursing Management:
1.Obtain VS
2.Assist in surgical procedure (appendectomy)
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APPENDICITIS
NURSING INTERVENTIONS
1. Preoperative care
Monitor bowel sounds, fever and hydration
status POSITION of Comfort: RIGHT SIDELYING in
a low FOWLERS
Avoid Laxatives, enemas & HEATAPPLICATION
APPENDICITIS
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APPENDICITIS
2. Post-operative care
Monitor VS and signs of surgical
complications Maintain NPO until bowel function
returns
If rupture occurred, expect drains
and IV antibiotics
APPENDICITIS
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APPENDICITIS
2. Post-operative care
POSITION post-op: RIGHT side-
lying, SEMI- FOWLERS to decreasetension on incision, and legs flexed
to promote drainage
Administer prescribed pain
medications
PERITONITIS
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PERITONITIS
Is acute or chronic inflammation of theperitoneum.
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PERITONITIS
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PERITONITIS
Predisposing Factors:
1.E. coli/ streptococcus faecalis infection of the
peritoneum
2.Chemical irritation: ruptured appendix,
bladder, bile spillage-gallbladder
3.Contamination of peritoneal cavity with
surgical glove powder, particles from suturematerials, lint from surgical drapes
4.Penetrating abdominal wound or bowel
stran ulation
PERITONITIS
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PERITONITIS
PATHOLOGY
PERITONITIS
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PERITONITIS
Signs and Symptoms:
Severe localized or diffused abdominal pain
Paralytic ileus produces abd distention
Nausea and vomiting
Bowel sounds are decreased or absent
Fever, tachycardia, and chills >>> sepsis Shallow, guarded respirations suggest
diaphragmatic involvement
Signs of dehydration and acidosis are late
PERITONITIS
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PERITONITIS
DIAGNOSTICS:
CBC Leukocytosis
Paracentesis identifies the causative organism
X-ray reveals the location of the perforation
PERITONITIS
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PERITONITIS
Nursing Management:
Administer Medications
Monitor respiratory status closely
Minimize pain. Position the client to maximize
comfort
Maintain aseptic technique
ANATOMY AND PHYSIOLOGY
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ANATOMY AND PHYSIOLOGY
III. Lower Alimentary Canal Function:elimination
2nd half of ascending colon
Transverse
Descending colon
Sigmoid
Rectum
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTION
Exists when blockage prevents the normal flowof intestinal contents through the intestinal
tract.
2 Types
1.Mechanical Obstruction intraluminal
obstruction fro pressure on the intestinal wall
occurs.2.Functional Obstruction the intestinal
musculature cannot propel the contents along
the bowel.
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTION
MECHANICAL OBSTRUCTION:
Adhesion loops of intestine become adherent
to areas that heal slowly or scar after
abdominal surgery.
Intussusception one part of the intestine slips
into another part located below it.
Volvulus bowel twists and turns on itself.
Hernia Protrusion of intestine through a
weakened area in the abdominal muscle or
wall.
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTIONSmall Bowel Obstruction
Crampy abdominal pain that
is wavelike and colicky
Pass out blood and mucus
but no feces or flatus
Vomiting*
Reverse peristaltic waves
Dehydration (Thirst,
drowsiness, weakness, dry
mucous membranes)
Abdominal Distention
Large Bowel Obstruction
Constipation
Altered stool shape
Weakness
Weight Loss Anorexia
Abdominal Distention
Large bowel is visibly
outlined in the abd wall Crampy lower abd pain
Fecal Vomiting
Dehydration
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTION
Diagnostics:
Abdominal Xray CT, and MRI reveals abnormal
quantities of gas and/or fluid, distended
intestine and site of obstruction.
Laboratory studies reveals electrolye
imbalances
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTION
Nursing Management:
1. Maintain NGT decompression of the bowel
2. Assess NGT output
3. Monitor I&O strictly4. Assess for Improvement: Return of bowel sounds,
decreased abd distention, abd pain, and passage of
flatus or stool.
5. Report to AP if there is discrepancies in I&O,
worsening of pain and abd distention, & increased
ngt output.
6. Assisst in Surgery
INTESTINAL OBSTRUCTION
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INTESTINAL OBSTRUCTION
Surgical Management:
Surgical Mgt depends on the cause of
intestinal obstruction.
Ileostomy, Cecostomy, Colostomy
Colonoscopy untwist and decompress the
bowel.
Surgical resection
DIVERTICULOSIS AND DIVERTICULITIS
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Diverticulosis
Abnormal out-pouching of the intestinal
mucosa occurring in any part of the LI most
commonly in the sigmoid
Diverticulitis
Inflammation of the diverticulosis
DIVERTICULOSIS
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DIVERTICULOSIS
PATHOPHYSIOLOGY
Increased intraluminal pressure, LOW volume
in the lumen and Decreased muscle strength
in the colon wall herniation of the colonicmucosa
DIVERTICULOSIS
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DIVERTICULOSIS
ASSESSMENT findings for D/D
1. Left lower Quadrant pain
2. Flatulence
3. Bleeding per rectum
4. nausea and vomiting
5. Fever 6. Palpable, tender rectal mass
CONDITIONS OF THE LARGE INTESTINE
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CONDITIONS OF THE LARGE INTESTINE
DIAGNOSTIC STUDIES
1. If no active inflammation, COLONOSCOPY
and Barium Enema
2. CT scan is the procedure of choice!
3. Abdominal X-ray
CONDITIONS OF THE LARGE INTESTINE
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CONDITIONS OF THE LARGE INTESTINE
NURSING INTERVENTIONS 1. Maintain NPO during acute phase
2. Provide bed rest
3. Administer antibiotics, analgesics likemeperidine (morphine is not used) and anti-spasmodics
4. Monitor for potential complications likeperforation, hemorrhage and fistula
5. Increase fluid intake
CONDITIONS OF THE LARGE INTESTINE
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CONDITIONS OF THE LARGE INTESTINE
NURSING INTERVENTIONS
6. Avoid gas-forming foods or HIGH-roughage
foods containing seeds, nuts to avoid
trapping
7. introduce soft, high fiber foods ONLY after
the inflammation subsides
8. Instruct to avoid activities that increaseintra-abdominal pressure
CHRONIC INFLAMMATORY BOWEL
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DISEASE
REGIONAL ENTERITIS (Crohns Disease) - Is asubacute and chronic inflammation that
extends through all layers of the bowel wall
from the intestinal mucosa.
ULCERATIVE COLITIS is an inflammatory
disease of the submucosal layer of the colonand rectum characterized by continuously
occuring ulcerations of intestinal epithelium.
CIBD
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CIBD
Cause: UNKNOWNIncidence Rate: Age 15&30; 50&70
M:F 1:1
Predisposing Factors:
Hereditary/ Family History
Pesticides, Food additives, Tobacco, Radiation
Race: Caucasians and Jewish Heritage
NSAIDs
CIBD
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Crohns Disease
Course is prolonged,variable
Transmural thickening
Location: Ileum, ascendingC
Bleeding is unsual; if yes,tends to be mild.
Perianal involvement is
common
Fistulas are common
Rectal involvement 20%
Diarrhea is less severe
Ulcerative Colitis
Exacerbations andremissions
Mucosal Ulceration
Rectum, descending colon
Bleeding is common andsevere
Perianal involvement is
rare-mild
Fistulas are rare
Rectal involvement 100%
Diarrhea is severe
CIBD
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CIBD
ASSESSMENT findings for CD1. Fever
2. Abdominal distention
3. Diarrhea4. Colicky abdominal pain
5. Anorexia/N/V
6. Weight loss7. Perianal fistulas and abscesses
CIBD
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CIBD
ASSESSMENT findings for UC1. Anorexia
2. Weight loss
3. Fever4. SEVERE diarrhea with Rectal bleeding,
containing pus, and mucosa.
5. Anemia6. Dehydration
7. Abdominal pain and cramping
CIBD
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CIBD
Diagnostics (CD):
Barium study of upper GIT reveals string sign
Barium enema shows ulceration and
cobblestone appearance
Colonoscopy reveals ulceration separated by
normal mucosa
CIBD
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CIBD
Diagnostics (UC):
Barium enema shows mucosal irregularities,
shortening of the bowel and dilatation of
bowel loops. Colonoscopy reveals friable mucosa with
pseudopolyps or ulcers in the
descending/sigmoid colon Stool analysis is positive for blood.
NURSING INTERVENTIONS for CD and
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UC
1. Maintain NPO during the active phase
2. Monitor for complications like severe
bleeding, dehydration, electrolyte imbalance
3. Monitor bowel sounds, stool and bloodstudies
4. Restrict activities, promote intermittent rest
and BR to minimize pain
5. Administer IVF, electrolytes and TPN if
prescribed
NURSING INTERVENTIONS for CD and
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UC
6. Instruct the patient to AVOID gas-forming foods,MILK products and foods such as whole grains, nuts,RAW fruits and vegetables especially SPINACH,pepper, alcohol and caffeine
7. Diet progression- clear liquid LOW residue, highprotein diet
8. Administer drugs-
9. Assist in surgery
CIBD
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CIBD
Surgery:
1.Total colectomy with Ileostomy.
2.Total colectomy with continent ileostomy
3.Total colectomy with ileo-anal anastomosis
IRRITABLE BOWEL SYNDROME
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IRRITABLE BOWEL SYNDROME
Is a common functional disorder ofgastrointestinal motility not associated with
anatomic changes.
Predisposing Factors:1.Psychologic Stress
2.Pre-diverticular disease with changes in the
bowel wall3.Low-fiber diet/ high in stimulating/irritating
food
4 Alcohol consumption and smoking
IRRITABLE BOWEL SYNDROME
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IRRITABLE BOWEL SYNDROME
TRIAD S & Sx:
1.Abdominal Pain
2.Altered bowel habits
3.Absence of detectable disease
IRRITABLE BOWEL SYNDROME
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IRRITABLE BOWEL SYNDROME
Diagnosis:
Barium enema and colonoscopy reveals
spasm, distention, or mucus accumulation in
the intestine. CBC normal
Stool analysis is normal
IRRITABLE BOWEL SYNDROME
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IRRITABLE BOWEL SYNDROME
Nursing Management:
Administer Medications
Teach the client on stress reduction and
relaxation techniques
Eat a well balanced diet, high-fiber diet,
Adhere to a schedule of regular work and rest
periods
Drink six to eight glasses of h2o/day not with
meals to prevent constipation
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THANK YOU