Esophageal Disorders and Nursing Care

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Questions and Answers

Which of the following is NOT a complication of esophageal issues?

Esophageal ulcer

Pulmonary aspiration

Esophageal stricture

Heartburn (correct)

What dietary practice should be followed to manage gastroesophageal reflux?

Consume full-fat dairy products

Avoid eating late at night (correct)

Incorporate more spicy foods

Eat large meals twice a day

Which of the following is a risk factor for gastroesophageal reflux?

High fat diet (correct)

Increased hydration

Regular physical activity

Low caffeine intake

What nursing diagnosis is related to dysphagia?

Lack of knowledge Signup and view all the answers

What is the primary purpose of care for patients with gastroesophageal reflux?

To ensure adequate feeding and manage weight Signup and view all the answers

Which nursing intervention helps prevent complications in patients with gastroesophageal reflux?

Using recommended antacids Signup and view all the answers

Which of the following conditions is associated with the development of esophageal varices?

High portal pressure Signup and view all the answers

Diverticula are defined as formations in the esophageal wall containing how many layers?

Two or more Signup and view all the answers

What is a primary goal of treatment for chronic pancreatitis?

To control pain and endocrine insufficiency Signup and view all the answers

Which of the following conditions may lead to the development of chronic pancreatitis?

Alcohol consumption Signup and view all the answers

What dietary recommendation is typically given to patients with chronic pancreatitis?

Low-fat or fat-free diet Signup and view all the answers

Which symptom is NOT commonly associated with chronic pancreatitis?

Infertility Signup and view all the answers

What type of analgesics is primarily administered to relieve pain in chronic pancreatitis?

Non-addictive analgesics Signup and view all the answers

What is a common diagnostic test for evaluating chronic pancreatitis?

Blood glucose test Signup and view all the answers

What care measure is implemented due to complications associated with bed rest in patients?

Use of pressure-relieving devices Signup and view all the answers

What physical condition often occurs alongside respiratory issues in patients with chronic pancreatitis?

Ascites Signup and view all the answers

What is a primary nursing intervention for managing acute pain due to diverticulitis?

Administer antibiotics and analgesics as indicated Signup and view all the answers

Which nursing diagnosis is related to the risk of malnutrition in patients with chronic inflammatory diseases?

Underfeed due to dietary restrictions Signup and view all the answers

What is a common symptom of Whipple's Disease?

Severe weight loss Signup and view all the answers

How often should vital signs and pain be evaluated in a patient with diverticulitis?

Every 4 hours Signup and view all the answers

Which of the following interventions helps to maintain skin integrity in patients with chronic inflammatory diseases?

Monitoring skin turgor Signup and view all the answers

What is a psychological nursing diagnosis associated with diverticulitis and chronic inflammation?

Anxiety due to unknowns Signup and view all the answers

Which treatment is commonly used for Whipple's Disease?

Large-spectrum antibiotics Signup and view all the answers

What nursing intervention is crucial for reducing anxiety in patients with chronic inflammatory diseases?

Doing anxiety-reducing applications Signup and view all the answers

Which factor is commonly associated with acute pancreatitis?

Gallstones Signup and view all the answers

What is a common symptom of cholera?

Rice-water stool Signup and view all the answers

Which of the following medications can exacerbate acute pancreatitis?

Thiazide Signup and view all the answers

What is the primary cause of food poisoning described in the content?

Contaminated food Signup and view all the answers

What is a key clinical finding in diagnosing acute pancreatitis?

High levels of serum amylase Signup and view all the answers

Which of the following bacteria is not mentioned as causing food poisoning?

E. coli Signup and view all the answers

What condition can develop due to severe fluid loss in cholera patients?

Shock Signup and view all the answers

Which age group is most commonly affected by acute pancreatitis?

Adults aged 60-70 Signup and view all the answers

What is the primary indication for prescribing tetracycline or amoxicillin?

To treat helicobacter pylori infection Signup and view all the answers

Which nursing diagnosis relates to a lack of information about the patient's condition?

Lack of knowledge about disease Signup and view all the answers

What is one of the aims of care for a patient with gastritis?

To evaluate daily pain with a pain scale Signup and view all the answers

Which of the following symptoms is commonly associated with a peptic ulcer?

Burning in the upper abdomen after meals Signup and view all the answers

Which medication-related nursing intervention is important for a patient with gastritis?

Monitor the effects and side effects of drugs Signup and view all the answers

What is a common non-pharmacological approach to manage anxiety in patients with gastritis?

Taking initiatives to reduce anxiety Signup and view all the answers

Which diagnostic method is commonly used to confirm the presence of a peptic ulcer?

Barium radiography or endoscopy Signup and view all the answers

Which of the following factors is NOT considered a primary cause of peptic ulcers?

Dietary fiber Signup and view all the answers

What is a common source of transmission for Hepatitis A?

Fecal-oral route Signup and view all the answers

Which group is specifically recommended for Hepatitis A vaccination?

Nursery staff and children Signup and view all the answers

What is the incubation period for Hepatitis A?

15-50 days Signup and view all the answers

Which intervention is NOT recommended for preventing Hepatitis A infection?

Consuming raw or undercooked shellfish Signup and view all the answers

What is the duration of protection provided by the Hepatitis A vaccine?

8-10 years Signup and view all the answers

What symptom is commonly managed with antiemetics in Hepatitis A patients?

Nausea Signup and view all the answers

Which method is advised for hygiene in a household with a Hepatitis A patient?

The patient's toilet should be disinfected frequently Signup and view all the answers

In which settings is Hepatitis A most commonly observed?

Developing countries with poor health conditions Signup and view all the answers

Study Notes

Course Information

Course title: NURS402 Graduation Internship
Professor: Dr. Ufuk Kaya
Academic year: 2024-2025
Term: Fall

Digestive System Diseases and Nursing Care

Diagram of the digestive system with labels for various parts: mouth, esophagus, stomach, small intestine, large intestine, liver, pancreas, gall bladder, appendix etc.
General information on digestive system disorders requiring nursing care

Oral Cavity and Salivary Gland Diseases

Diagram of the oral cavity and salivary glands with labels for various parts like mouth, palate, tongue, teeth, salivary glands etc.
Information on diseases affecting oral cavity and salivary glands

Acute Ulcers

Short-term, painful lesions caused by trauma, immunological causes, and infections.
Most common areas are the tongue, cheeks, and lips.
Can be caused by viruses.

Aphthous Ulcers

Painful, erythematous lesions with pale centers.
May be singular or aggregated.
Mouthwashes with lidocaine and steroids can provide symptomatic relief.

Viral Infections-01

Primary acute gingivitis, usually due to herpes simplex virus, affecting the lips and oral mucosa.
Lesions quickly turn into painful ulcers.
Symptoms include weakness, bad breath, and cervical lymphadenopathy.
Recovery usually takes 10-14 days.
Oral acyclovir solutions for pain and discomfort.

Viral Infections-02

Oral lesions from chickenpox are usually accompanied by skin lesions.
Resolves within two weeks.
Herpes Zoster lesions, typically unilateral, affecting the cheek, tongue, and palate.
Painful, resolving on their own.

Viral Infections-03

Epstein-Barr virus causes malaise, sore throat, mild fever.
Lymphadenopathy, gingival hemorrhages, and diffuse petechiae of the palate.
Lesions heal spontaneously.
HIV infection can lead to gingivitis.

Bacterial and Fungal Infections-01

Acute Necrotizing Gingivitis (Vincent's Angina): painful, edematous gum lesions with ulceration and necrosis foci.
Spicy and acidic foods are avoided.
Mouthwashes for symptomatic treatment.
Alcohol and smoking are discouraged.
Treated with broad-spectrum antibiotics.

Bacterial and Fungal Infections-02

Oral infections are common, including syphilis, treated with penicillin.
Tuberculosis ulcers have irregular edges and are seen on the tongue, tonsils, and soft palate.
Fungal infections appear as white spots on the oral mucosa.
Antifungal solutions or tablets are recommended.

Neoplastic Diseases

Squamous cell cancer is more common in men than women.
Tobacco use is strongly associated with a 80% chance of this condition.
Typically develops on tongue, lips, oropharynx, and floor of the mouth.
Initial appearance as a red macule evolving into pitted, hard, chronic ulcers.

Nursing Diagnoses in Oral

Oral mucosal change due to infection, mechanical, or chemical issues.
Nutritional change/malnutrition due to insufficient or malabsorbed nutrients.
Anxiety/fear related to disease or appearance alterations.
Body consciousness challenges due to appearance modifications.
Pain due to oral lesions or treatment.
Lack of verbal communication skills due to disease or treatment.
Risk of infection due to the disease/treatment.

Main Purpose of Care

Improving the condition of the oral mucous membrane and improving food intake.
Promoting a positive body image.
Managing pain and establishing proper communication.
Preventing infections and providing patient education on the disease and treatment.

Health Education Topics

Balanced diet and hydration are crucial.
Regular oral hygiene is important, including brushing teeth twice daily with a soft-bristled brush. And maintaining a 45-degree angle between teeth and gums while brushing.
Discourage alcohol and smoking.
Regular oral and dental check-ups every six months.
Prompt medical evaluation for mouth lesions not resolving within two weeks.

Esophagus Diseases

Information about diseases affecting the esophagus, including the different parts of the esophagus.

Common Symptoms-01

Dysphagia: Difficulty or discomfort when swallowing.
Odynophagia: Painful swallowing.
Pyrosis: Burning sensation perceived as more than pain, relieved by antacids.

Common Symptoms-02

Regurgitation: Passing gastric contents into the mouth without nausea.
Rumination: Re-swallowing material in the mouth.
Esophageal Colic: Discomfort, severe reflux, excessive motor activity causing severe pain in esophageal muscles.

Common Symptoms-03

Hematemesis: Vomiting blood.
Halitosis: Bad breath.
Sialorrhea: Increased saliva secretion as a reflex.

Achalasia-01

Cardioesophageal sphincter cannot relax fully.
Lack of peristaltic movements in the lower two-thirds of the esophagus.
Seen equally between men and women between ages of 25-60.
Chronic and progressive disease of unknown cause.

Achalasia-02

Difficulty swallowing, feeling of obstruction in the lower esophagus, retrosternal pain, pyrosis, and pulmonary complications.
Treatment: Eat slowly, take fluids. Pneumatic dilation is performed.
Patient should be given analgesics and tranquilizers before.
Risk of perforation during procedure, resulting in abdominal pain.

What is Achalasia Cardia?

A rare disorder where food and liquid have difficulty passing from the esophagus to the stomach due to a weakened esophageal sphincter.

Scleroderma

Connective tissue disease with extensive esophageal involvement.
Absent or irregular peristaltic movements and contractions.

Common Spasm

Motor dysfunction affecting the esophagus.
More common among women around the age of 40.
Painful and difficult swallowing.
Diagnosis is done using barium film.
Treatment: Eat little and often.
Dilation and esophagomyotomy are potential procedures.
Diffuse esophageal spasm is a further issue that is sometimes encountered.

Gastroesophageal Reflux-01

Acute and chronic inflammatory changes due to regurgitation of stomach contents or alkaline intestinal secretions into the esophagus.
Hydrochloric acid and pepsin are common causes.
Commonly seen in the postprandial supine position.

Gastroesophageal Reflux-02

Symptoms: Burning, dysphagia, odynophagia, regurgitation, belching, and bitter-sour taste along the breastbone.
Diagnosis: Endoscopy, barium film, or scintigraphy with technetium.
Complications: Esophageal stricture, esophageal ulcer, pulmonary aspiration, upper gastrointestinal system bleeding.

Gastroesophageal Reflux-03

Treatment and care include avoiding overfilling the stomach, eating small portions frequently, and remaining upright after meals.
Avoiding fatty, sour, and spicy foods, smoking, and alcohol.
Losing excess weight.
Taking antacids after meals and before bedtime.
H2 receptor blockers as part of medical treatment.

Gastroesophageal Reflux-04

Risk factors: Obesity, overweight, pregnancy, smoking, chewing tobacco, high-fat diet, theophylline, caffeine, chocolate, high estrogen, and progesterone levels.

Gastroesophageal Reflux-05

Nursing diagnoses include "feeding more than body needs" due to dysphagia, lack of knowledge, pain, and aspiration risk.

Gastroesophageal Reflux-06

Purpose of care: Ensure adequate feeding and weight, relieving pain, preventing complications, and educating the patient.

Gastroesophageal Reflux-06

Nursing interventions include using recommended antacids, increasing patient awareness, explaining dietary guidelines, promoting health education, and encouraging proper chewing and taking small bites.

Esophageal Varices

Varicose veins in the esophagus due to increased portal pressure.
Usually asymptomatic until bleeding occurs.
Bleeding caused by Valsalva maneuvers (vomiting, coughing, or straining), poorly chewed food, or torn, ulcerated, or swollen veins.
Serious condition requiring immediate treatment.
Options for treatment: Sclerotherapy, ligation, or balloon.

Diverticulum

Formations containing one or more layers of esophageal wall.
Associated with symptoms like fullness in the neck, difficulty swallowing, and regurgitation.

Chemical Burns-01

Esophageal burns resulting from accidentally or intentionally ingested chemicals.
Immediate intervention based on the severity of the burn.
IV line established; no oral intake.

Chemical Burns-02

Nasogastric tube insertion to prevent esophagus contact with toxic substance during vomiting.
Steroids and antibiotics for prophylactic treatment to prevent scar tissue and inflammation.
Antidote (if available) should also be administered.
Dilatation therapy for preventing scar tissue.

Foreign Bodies

Insertion of foreign objects (fish bones, needles, teeth) into the esophagus causing dysphagia and pain.
Treated endoscopically or surgically after visualization.

Mallory-Weiss Syndrome

Severe condition with esophageal mucosa ruptures due to recurrent persistent vomiting.

Gastritis-01

Gastric mucosa inflammation.
Classifications: Erosive/hemorrhagic gastritis, specific gastritis.
Symptoms: Abdominal discomfort, headache, nausea, anorexia, vomiting, wheezing, Vitamin B12 deficiency, loss of appetite, burning sensation, sour taste.
Diagnosis: X-ray, endoscopy, urease test.

Gastritis-02

Treatment approach focusing on the cause, avoiding irritating foods and beverages, and establishing a non-irritating diet for oral intake.
Parenteral fluids if oral intake is insufficient.
Neutralizing treatment for acid or alkali-related gastritis, using antacids, lemon juice against alkali, and diluted vinegar against acid. General precaution: bed rest, analgesics, and sedatives. If Helicobacter Pylori detected: Tetracycline or amoxicillin as antibiotics.

Gastritis-03

Nursing diagnoses in gastritis include anxiety, dietary change, risk of fluid deficiency, pain, lack of knowledge, and risk of tissue integrity disruption.

Gastritis-04

Aim of care: Reduce anxiety, avoid irritating foods, establish adequate nutrition and fluid balance, evaluate daily pain, make treatment adjustments, and facilitate patient expression.

Gastritis-05

Nursing interventions: pain assessment and pain reduction, medication administration monitoring, anxiety reduction, dietary recommendations, lifestyle adjustment education, and support on smoking and alcohol issues. Education about appropriate foods and medicines, and avoidance of antacids with sodium or magnesium to those with heart failure.

Peptic Ulcer-01

Loss of tissue beyond the muscular mucosa in the stomach, duodenum, or esophagus.
Gastric ulcer: Stomach; duodenal ulcer: duodenum; esophageal ulcer: esophagus.

Peptic Ulcer-02

Today's most important known factors in peptic ulcer are NSAIDs, smoking, and Helicobacter pylori.
Symptoms: mild indigestion and potential burning in the upper abdomen or hunger 1-3 hours after meals or at night.

Peptic Ulcer-03

Diagnosis: Barium radiography of the upper gastrointestinal tract or gastroduodenoscopy.
Endoscopy provides more reliable information.
Complications: Bleeding, perforation, and gastric obstruction.

Peptic Ulcer-04

Purpose of treatment: Pain relief, ulcer healing promotion, prevention of disease recurrence, and ensuring that side effects are minimal, with patient compliance and adequate nutrition.

Peptic Ulcer-05

Treatment: Exclude foods irritating to the patient, total cessation of alcohol during the acute phase, and avoiding coffee given its stimulation of acid secretion. Smoking cessation due to its link to relapses. Avoiding aspirin and NSAIDs.

Peptic Ulcer-06

Medication: Antacids, histamine H2-receptor antagonists, anticholinergic drugs, proton pump inhibitors, and sometimes antibiotics and bismuth salts.

Irritable Bowel Syndrome-01

Most common motility problem of the colon.
Persistent or recurrent abdominal pain and changes in defecation habits (diarrhea or constipation).
Excessive response of the gastrointestinal system to stimuli.

Irritable Bowel Syndrome-02

Symptoms: Abdominal pain and discomfort eased by defecation.
Variability in stool frequency, consistency, and form (hard, soft, or watery).
Difficulty or urgency in defecation and relaxation post-defecation.
Mucus in the stool and abdominal bloating.

Irritable Bowel Syndrome-03

Treatment and care, including diet regulation, antispasmodics, avoiding beverages such as coffee, tea, and cola, consuming plenty of fluids, regular defecation habits with the toilet at the same time daily, eating slowly, avoiding consumed foods, non-consumption of carbonated drinks, non-chewing of gum, psychotherapy, hypnosis, and behavioral therapy.

Inflammatory Bowel Diseases

Classifications: Colitis Ulcerosa and Crohn's Disease.

Colitis Ulcerosa

Acute, superficial lesions restricted to the anus.
Unknown etiology.
Complications: Perforation, malignancy.
Symptoms: Rectal bleeding, diarrhea, fever, weight loss, abdominal pain.
Treatment: Sulfasalazine, pyridine-acetylsalicylic acid derivatives, antibacterials, antispasmolytics, corticosteroids, and sedatives.

Crohn's Disease

Occurs in the gastrointestinal tract from the mouth to the anus.
Unknown etiology.
Symptoms: Mild onset diarrhea, pain with colic, regional obstruction symptoms, and sometimes a palpable mass in the right lower quadrant.
Treatment: First-line treatment is corticosteroids, and the intestines rest through feeding with mild hyperalimentation.
Complications: Malabsorption, bleeding, and sepsis.

Ischemic Colitis

Ischemia-related problems seen in older adults due to progressive atherosclerosis.
Symptoms: Acute ischemia accompanied by localized abdominal pain, tenderness, rectal bleeding, fever, and hypotension.

Diverticulitis-01

Diverticulum formation found most commonly in the sigmoid colon.
Similar symptoms to appendicitis.
Complications: Bleeding and abscess.

Diverticulitis-02

Nursing diagnoses: acute pain, risk of infection (abscess and perforation), and anxiety due to unknowns.
Purpose of treatment: Reduce pain, abscess and perforation risk, and anxiety.

Diverticulitis-03

Nursing interventions: Rest during painful periods; administering antibiotics and analgesics as needed.
Evaluation of vital signs, pain levels, and abdominal tenderness every 4 hours.
Patient education and anxiety reduction.

Nursing Diagnoses in Chronic Inflammatory Diseases

Diarrhea, pain due to inflammatory process, fluid volume deficiency, underfeeding due to dietary restrictions or malabsorption, activity intolerance, anxiety, and inadequate individual coping.
Risk of compromised skin integrity and ineffective control of the disease and its treatment.

Nursing Interventions in Chronic Inflammatory Diseases-01

Purpose: To facilitate normal intestinal elimination, reduce abdominal pain and cramps, maintain fluid-electrolyte balance, prevent fatigue and anxiety, maintain ideal body weight, and protect skin integrity.

Nursing Interventions in Chronic Inflammatory Diseases-02

Pharmacological and non-pharmacological pain management, sufficient fluid intake, monitoring of skin turgor, adequate nutrition, providing adequate rest, anxiety-reducing measures, and skin protection measures.

Whipple's Disease

Lymphatic system disease seen in gastrointestinal small intestines.
Typically seen in men and progressing with severe weight loss, abdominal pain, arthritis, fever, peripheral lymphadenopathy, and anemia.
Untreated, it can lead to death.
Treated with large-spectrum antibiotics.

Hemorrhoids-01

Common problem of enlarged veins in the anorectal region.
Symptoms: Pain, bleeding, and palpation of external hemorrhoids.

Symptoms of Hemorrhoids

Difficulty with bowel movement cleaning.
Bulging tissue around the rectum.
Soiling of underwear.
Anal and rectal itching.
Rectal bleeding.
Anal pain.

Hemorrhoids-02

Treatment and care include applying local treatment and dietary changes.
Cold or hot Sitz baths for pain relief, especially for thrombosed hemorrhoids.
Use of local anesthetics for pain relief.

Hemorrhoids-03

Steroid pomades for inflammation.
High-fiber diet and increased fluid intake for regular intestinal movements.
Avoidance of spicy and hot foods and alcohol may assist.
Surgery if symptoms do not resolve within 3-5 days or recur frequently.

Infectious Diseases of the Intestines

Introduction to infectious diseases of the intestine.

Amoebic Dysentery

Infection caused by Entamoeba histolytica.
Transmitted by contaminated food.
Bloody-mucous diarrhea, abdominal pain, fever, nausea, and vomiting.
Treatment with drugs effective against amoeba like chloroquine, emetine, or tetracycline.
Patient education on hygiene, fluid-electrolyte balance, and disease management.

Symptoms of Amoebic Dysentery

Diarrhea (bloody or mucous).
High fever.
Nausea and vomiting.
Upset stomach.

Bacillary Dysentery

Shigella infection, waterborne, environmental, and foodborne.
Incubation period, 3 days post-incubation.
Sudden abdominal pain, diarrhea, vomiting, fever, and weakness.
Treatment with appropriate antibiotics.

Symptoms of Bacillary Dysentery

Diarrhea (containing blood or mucous).
High fever.
Nausea and vomiting.
Abdominal cramping.

Typhoid

Infection from fecal route.
Symptoms: Increasing fever, spleen enlargement, leukopenia, skin rashes.
Treatment with chloramphenicol.
Replenishing fluids and a liquid diet if oral not tolerated.
Avoid enemas due to potential perforation.

Symptoms of Typhoid Fever

High fever, chills, loss of appetite, abdominal pain, skin rashes, cough, muscle aches, headache, nausea, vomiting, and diarrhea or constipation.

Food Poisoning

Acute disease caused by contaminated food.
Causative bacteria: Staphylococcus aureus, Clostridium perfringens, Vibrio parahaemolyticus, Campylobacter jejuni, Yersinia enterocolitica, Shigella, Botulism.

Cholera

Serious infection transmitted through infected water.
Incubation period up to five days.
Mild vomiting evolving to diarrhea with rice-water stools.
Severe fluid loss can lead to shock.
Treatment with tetracycline, chloramphenicol, and erythromycin.

How to Prevent Infection in Places Where Cholera is Found

Drinking treated water.
Thoroughly cooking food.
Peeling fruits and vegetables by individuals
Avoiding raw food, ice, and street food.
Frequent and thorough handwashing.

Vibrio Cholerae

Diagram explaining the bacterium and its effect on the body.

Pancreatitis

Information about pancreatitis, including the different parts of the pancreas, digestive system.

Acute Pancreatitis-01

Edema, self-digestion, necrosis, bleeding are the characteristics of this disease.
Common causes: Alcoholism and gallstones.
Usually occurs between 60-70 years of age.
Alcohol-induced pancreatitis more common in men; gallstone-related pancreatitis more common in women.

Acute Pancreatitis-02

Etiology: Stones, tumors, spasms, parasitic infections of the bile duct, duodenal pathologies, medicines (thiazide, furosemide, procainamide, tetracycline, sulfonamides), toxic agents (alcohol), and trauma/infections.
Metabolic factors (liver disease, hyperlipidemia, diabetes, hypercalcemia), hormonal factors, are also important causes.

Acute Pancreatitis-03

Symptoms: Severe pain (nausea and vomiting) waking the patient in the middle of the night, continuous pain in the epigastric or left upper quadrant, ileus, high fever, confusion, and tachycardia.
Diagnosis: Rapid increase in serum amylase; serum lipase increase and level sustained.

Acute Pancreatitis-04

Symptoms: Leukocytes, elevated liver enzymes, presence of hypertriglyceridemia, hypocalcemia.
Sever cases present with fever (38-40 C), weakness, palpitations, cold sweats, and decreased blood pressure.
30-50% of patients: Initial elevation of blood sugar, altered calcium level, and hypocalcemia.

Acute Pancreatitis-05

Complications: Shock (hypotensive, septic, hemorrhagic), pulmonary insufficiency, atelectasis, kidney failure, metabolic disorders (hypocalcemia and acidosis), abscess, necrosis, portal and splenic vein thrombosis, bleeding into/around the pancreas.

Acute Pancreatitis-06

Nursing diagnoses: Acute pain, fear/anxiety due to change in health and pain, respiratory change, insufficient breathing, and change in nutrition/undernutrition.

Acute Pancreatitis-07

Nursing diagnoses: Lack of knowledge, risk of injury/damage, and ineffective coping (alcohol addiction).

Acute Pancreatitis-08

Nursing interventions: Meperidine for pain relief, correcting volume imbalance, nasogastric aspiration, preventing pancreas irritation with antacids and anticholinergics when indicated, stopping oral nutrition, initiation of parenteral nutrition, prescribing a low-fat, caffeine-free diet, and antibiotic use to prevent infection.

Acute Pancreatitis-09

Nursing interventions: Insulin use based on blood sugar levels. Insertion of a central venous catheter for monitoring central venous pressure and urine monitoring. Ensuring that pain and anxiety are alleviated. Implement peritonial dialysis and surgical intervention if conditions warrant it.

Acute Pancreatitis-10

Nursing interventions: patients remain on bed rest to avoid complications. Respiratory failure evaluation due to issues of movement and pain from ascites. Implementing respiratory hygiene methods. Educating patient on the specific conditions of the individual case where needed. Patient awareness regarding endocrine parameters.

Chronic Pancreatitis-01

Chronic inflammation, fibrosis, dilatation of pancreatic ducts, and tissue damage.
Occurs equally across all genders and age groups.
Etiology: Alcohol, nutrition, trauma, metabolic diseases, genetic causes, and benign or malignant obstructions.

Chronic Pancreatitis-02

Symptoms: Pain radiating to the epigastric region and lower back; excessive weight loss, malabsorption, and jaundice due to diabetes or occlusions.

Chronic Pancreatitis-03

Treatment and care: Controlling pain with non-addictive analgesics, possibly switching to narcotics if needed; administering high doses of additional pancreatic enzymes; treatment of the etiological issue (e.g., alcohol cessation, diabetic management, surgical resolution of obstructions); low-fat or fat-free diets; addressing any diabetes that might have developed.

Gallstones (Cholelithiasis)-01

Etiology: Age (40+), multiple births, contraceptive drugs, gender (2-3 times more in women), race, advanced obesity, cystic fibrosis, rapid weight loss, cholesterol density issues, bile stasis, cirrhosis, and chronic hemolytic diseases lead to gallstones.
Symptoms: Bile colic, nausea, vomiting, abdominal pain, feeling of fullness, jaundice, and pancreatitis infection.

Types of Gallstones

Cholesterol stones: Imbalanced bile composition or improper gallbladder emptying; yellow-green in color.
Pigment stones: Conditions producing excess bilirubin; dark brown or black in color.

GallStones (Cholelithiasis)-02

Complication: Gallbladder perforation leading to peritonitis.
Purpose of treatment: Controlling pain, preventing nausea and vomiting, maintaining fluid/electrolyte balance, and preventing infection.
Treatment options for cholesterol stones: Laparoscopic procedures, oral administration of ursodoxycholic acid, and lithotripsy.

GallStones (Cholelithiasis)-03

Nursing interventions: Dolantin and Demerol are preferred pain relievers. Nasogastric decompression is employed to reduce nausea and pain. IV fluids to replace lost fluids.
Large-spectrum antibiotics to prevent complications.
Complete explanation of applied treatment course, issues involved, and treatment plan to help resolve anxieties.

Acute Cholecystitis

Inflammation of the gallbladder, often due to a stone blocking the cystic duct.
Sedentary lifestyle and obesity increase risk.
Symptoms: Sudden onset pain, jaundice, nausea, local tenderness, fever, and Murphy's sign (pain on deep inspiration in the right upper quadrant).
Treatment and Care: Hospitalization, antibiotic administration, and follow-up care are critical.

Chronic Cholecystitis

Similar to acute cholecystitis, but pain and other signs are less severe.
Lower temperatures and leukocyte counts.
Supportive treatment with low-fat diets, antacids, anticholinergics, and sedatives.
Weight loss may also be recommended when necessary.
Cholecystectomy may be needed.

Acute and Chronic Hepatitis

Introduction to acute and chronic hepatitis, including the five types of viruses: hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV), and hepatitis G (HGV).

Hepatitis A-01

Common infection worldwide, mostly affecting children and young adults.
Transmitted through fecal-oral route.
Doesn't become chronic.
Important source of transmission are individuals with acute infection.
Common in developing countries and communities.
Incubation period: 15-50 days (average 30 days).

Hepatitis A-02

Treatment and care involve rest.
Preventing contamination that include handwashing, ensuring separate water supplies, glasses, and counters.
Disinfection of toilets used by infected individuals.
Normal diet and antiemetics as needed for nausea.

Hepatitis A-03

Immunization with inactive vaccines injected into the deltoid muscle.
Protection lasts 8-10 years.
Administered to children, nurses, soldiers, gay individuals, and travelers to endemic areas.

Hepatitis A-04

Transmission: Eating vegetables and fruits washed with contaminated water, consuming poorly cooked dishes, washing utensils (spoons, pans etc.) with dirty water, or with hands of individuals preparing the food.

Hepatitis A-05

High-risk groups: Children in schools, travelers to areas with poor sanitation, healthcare personnel, military personnel, prisoners, and those receiving blood transfusions or hemodialysis.

Hepatitis A-06

Prevention: Avoid tap water with suspicious cleanliness, do not use potentially contaminated water for ice or brushing teeth. Maintain suitable cleanliness, wash hands, avoid unpeeled fruits, salads, uncooked vegetables, and raw seafood.

Hepatitis A-07

Prevention: Avoid eating or drinking in potentially contaminated areas (e.g., street food vendors).
Ensure appropriate hygiene measures regarding shared items and adequate cleaning in household situations.

Hepatitis B-01

Infectious liver disease caused by HBV.
Incubation period with HBV: 28-180 days (average 70-80 days).
HBV infection becomes chronic in 10% of adults, but in newborns it is 100%.
Transmission modes: Parenteral, sexual, perinatal, and horizontal.

Hepatitis B-02

Risk Groups: Babies born to mothers with HBV, people who have sex with 1+ person, people who share razors or toothbrushes, and people who have had multiple sexual partners. People who use IV drugs or share needles, and those undergoing hemodialysis.

Hepatitis B-03

Diagnosis: Serological indicators, such as HBsAg. If the HBsAg presence lasts longer than six months, the infection becomes chronic .

Hepatitis B-04

Symptoms: Extreme weakness, fatigue, lack of appetite, nausea and vomiting, yellowing of the skin and whites of eyes, tea-colored urine, and abdominal pain with tenderness in the liver area.

Hepatitis B-05

Treatment and care: Rest is essential
Patients may need to be hospitalized due to excessive nausea, vomiting, and the presence of co-existing illnesses.
Supportive measures in hospital may involve antiviral drug treatment.

Hepatitis B-06

Prevention: HBV vaccine for health professionals, blood bank workers, individuals with compromised immune systems, hemodialysis patients, patients with chronic conditions requiring frequent blood products, mothers with positive HBsAg, prisoners, sex workers, and gay people.

Hepatitis C-01

Similar routes of transmission with HBV: parenteral, sexual, horizontal, and vertical.
Common mode: Blood transfusions, and blood products.
High-risk groups: Hemodialysis patients, IV drug addicts, organ transplant recipients, and those using blood products.
Healthcare workers also at risk, but lower than for other risk groups.
Incubation period: Shorter than that from HBV.

Hepatitis C-02

Diagnosis: Anti-HCV ELISA antibody tests, PCR tests, and determining the presence of HCV-RNA.
Treatment and care: Supportive; high rate of chronicity

Hepatitis C-03

Protection measures concern blood transfusions, screening donor blood, purifying blood products from HCV, screening organ donors, and educating high-risk groups.

Hepatitis D-01

HDV cannot replicate without HBV.
Primary transmission method is parenteral.
Incubation period: 15-80 days.
Diagnosis involves initial HBV testing, followed by HDV testing with elevated transaminases indicating worse prognosis and an estimated 70% chronicity
Treatment and care are the same as for HBV.

Fatty Liver

Factors: Genetic inheritance, obesity, rapid weight loss, and diabetes-related problems.
High-fat levels in the blood may also be involved.
Side effects of medications.

Hepatitis E-01

Similar epidemiological features to HAV.
Less contagious than HAV.
More common in young and middle-aged adults.
Incubation period: 15-75 days (average 36).
Diagnosis: Detection through anti-HEV.
Treatment and care: Supportive only.
Prevention: Plasma immunoglobulin.

Hepatitis G-01

New form of hepatitis (not A, B, or C).
Incubation period: 14-145 days.
Risk factors same as for HCV.

Nursing Diagnoses in Hepatitis

Activity intolerance, tiredness, inability to move physically, undernutrition, anxiety, deterioration in tissue integrity, lack of knowledge about the infection, risk of acquiring an infection (for healthcare workers), and risk for transmission of infection (for patients).

Aim of Care

Ability to perform daily activities.
Ensure adequate balanced nutrition.
Reduce anxiety levels.
Prevent disruption of tissue integrity

Nursing Interventions in Hepatitis

Helping with daily tasks for patients who cannot perform them themselves.
Limiting activities related to complications from prolonged bed rest.
Providing adequate nutrition.
Educating the patient about the condition, treatment, and possible complications.
Managing itching symptoms.

Liver Cirrhosis-01

Hepatocellular necrosis and fibrosis with regeneration characterized as a progressive, irreversible process.
Etiology: Alcohol use, HBV/HCV, drugs, toxins, autoimmune hepatitis, biliary cirrhosis, chronic liver congestion, genetic metabolic diseases, and cryptogenic causes are potential factors.
Diagnosis: USG, CT, endoscopy, peritonoscopy, and liver biopsy.

Stages of Liver Damage

Diagram showing the progression from a healthy liver to fatty liver, liver fibrosis, and finally cirrhosis.

Cirrhosis of the Liver

Diagram demonstrating the physical characteristics of a healthy liver versus a cirrhotic liver.
Key symptoms include jaundice, confusion (encephalopathy), spider angiomas, loss of body hair, muscle wasting, widened blood vessels, ascites, and red palms.

Liver Cirrhosis-02

Alcoholic cirrhosis: Linked to alcohol use, gender, and genetic factors; fatty liver, a common early change.
Biliary cirrhosis: Damage and cholestasis to intrahepatic bile ducts.
Cardiac cirrhosis: Liver congestion due to heart issues.
Wilson's cirrhosis: Copper accumulation within the liver.
Post-necrotic cirrhosis: Due to liver damage from conditions such as Hepatitis B and C.

Liver Cirrhosis-03

Treatment: Generally symptomatic, focused on managing complications.

Liver Cirrhosis-04

Nursing diagnoses: Fatigue (muscle wasting, blood loss), dietary change (anorexia/flu-like symptom), liquid volume excess (related to aldosterone, albumin, and acid issues), ineffective breathing (acid buildup, immobility), skin integrity issues (malnutrition and jaundice), itching (jaundice), risk of infection (immune system suppression), and ineffective coping with a major health problem. Risk of injury (reduced metabolic function), deterioration in body consciousness, disruption in self-esteem.

Liver Cirrhosis-05

Nursing interventions: Using bed rest in acute phase, encouraging gradual increased activity, administering a balanced diet with careful adjustments for protein and sodium intake. Providing adequate vitamins/calories. Soft diet.

Liver Cirrhosis-06

Nursing interventions: Giving antiemetics for nausea, assisting with oral care, ensuring meals consume in small quantities and environment must be clean, cool, & comfortable.
Monitoring of patient weight and abdominal circumference.

Liver Cirrhosis-07

Nursing interventions: Monitoring of daily fluid intake and output, and applying fluid restrictions if needed. Administering diuretics as needed.
Explaining rationale for sodium and protein restrictions.
Regularly evaluating skin condition to maintain dryness and cleanliness.

Liver Cirrhosis-08

Nursing interventions: Administering prescribed antihistamines, avoiding hot water in bathrooms, monitoring for signs of infection, applying sterile technique for invasive procedures, and facilitating coughing, deep breathing, and positioning changes for pulmonary and respiratory hygiene.

Liver Cirrhosis-09

Nursing interventions: Monitoring patients for urinary, intestinal, skin, and mucous membrane bleeding.
Regularly monitoring the patient's vital signs every 4 hours.
Applying pressure to injection sites for 5 minutes.
Administration of Vitamin K as needed.
Ensuring the use of a soft-bristled toothbrush.

Liver Cirrhosis-10

Nursing interventions for prevention of falling, promotion of environmental safety, actively encouraging patience/self-expression concerning bodily changes, encouraging social role performance and performance of daily duties, and family involvement.

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Description

Test your knowledge on esophageal disorders, including complications, risk factors, and nursing interventions. This quiz covers topics related to gastroesophageal reflux, dysphagia, and treatment practices. Enhance your understanding of patient care in cases of esophageal issues.