Gastrointestinal Disorders

Gastrointestinal Disorders

• Bowel Obstruction: Two types: mechanical (object) and non-mechanical (paralytic ileus). Small bowel obstruction causes cramping, nausea, vomiting, and mid-abdominal pain, with severe constipation. Large bowel obstruction is a medical emergency, with symptoms including lower abdominal pain, nausea, vomiting, diarrhea, or constipation, and lack of appetite. Nursing interventions include nothing by mouth (NPO), intravenous fluids, input/output monitoring, and nasogastric (NG) tube with low suction, and pain management.

• Colostomy: A surgical procedure where the colon is diverted to an opening in the abdominal wall, temporary or permanent. Nursing care includes assessing skin integrity, cleaning the stoma with water, preventing liquid stool from overflowing the bag, and teaching colostomy care.

• Dumping Syndrome: A condition after stomach surgery causing abdominal pain. Treatment involves consuming small meals, high protein and fat, and waiting one hour after meals before drinking fluids.

• Hiatal Hernia: A part of the stomach pushes through the diaphragm, leading to heartburn and abdominal pain. Nursing interventions include eating small, frequent meals, eliminating trigger foods, and having the patient sit upright for an hour after eating, and placing the patient in a Fowler or semi-Fowler position to reduce regurgitation.

• Peptic Ulcer Disease (PUD): A sore in the lining of the gastrointestinal tract often caused by H. pylori. Symptoms may include coffee-brown emesis (vomiting) and melena stool (dark, tarry stool). Nursing care involves monitoring stools for occult blood, providing medications for healing, and recommending small frequent meals.

• Gastroesophageal Reflux Disease (GERD): Stomach acid flows back into the esophagus, causing heartburn, difficulty swallowing, and chest pain. Triggers include spicy and fatty foods, caffeine, chocolate, citrus fruits. Treatment involves avoiding triggers, small, frequent meals, and medications such as H2 antagonists, PPIs, or antacids.

• Esophageal Varices: Enlarged veins in the esophagus due to blocked blood flow. Symptoms include difficulty swallowing (dysphagia), and potential rupture leading to hemorrhage. Management focuses on maintaining an open airway, monitoring for rupture, hemorrhage, and suctioning when needed, along with coagulants, vitamin K, and vasopressors.

• Stoma Care: A stoma is an opening on the abdomen. Healthy stomas are pinkish, while dark or dusky stomas may indicate poor blood supply (necrosis). Protruding stomas are a sign of prolapse.

Other Gastrointestinal Issues

• Crohn's Disease: Inflammation of the digestive tract. Low-fat, high-protein diets with no dairy or spicy foods are recommended. Nursing interventions include monitoring input/output, electrolytes, and weight, and educating the patient on avoiding alcohol, smoking, and caffeine.

• Ulcerative Colitis: Inflammation of the large intestine and rectum. Symptoms include blood and mucus in stools, abdominal pain, rectal bleeding, and anemia. Nursing care includes monitoring diet and bowel patterns, educating the patient about triggers.

• Cirrhosis: Liver damage due to scarring. Jaundice and a palpable liver are common symptoms. Drugs are processed slower with liver problems, so medication dosage needs to be adjusted. Monitoring fluid intake, output, and daily weight is crucial for liver disease. Avoiding actions that could cause bleeding is necessary.

• Hepatitis: Inflammation of the liver. Hepatitis A is often related to bowel issues, Hepatitis B and C are transmitted through blood and body fluids. Symptoms and treatments vary depending on the type of Hepatitis. Hepatitis C is more likely to become chronic than Hepatitis B.

• Pancreatitis: Digestive enzymes damage the pancreas. Symptoms include Cullen and Turner signs (discoloration of the umbilical area and bruising of the flanks). Treatment includes pain management, nothing by mouth (NPO), intravenous fluids, and possibly total parenteral nutrition (TPN) to give nutrients.

• Cholecystitis: Inflammation of the gallbladder, often due to gallstones. Symptoms include nausea, vomiting, right upper quadrant pain, radiating to the right shoulder blade, especially after eating fatty foods. Treatment involves NPO, IV fluids, antibiotics, and pain relief.

• Enema: Administering a solution into the rectum to stimulate bowel movements. Watch for signs of water intoxication (weakness, pallor, dizziness) and proper fluid balance.

This quiz covers key concepts related to gastrointestinal disorders, including bowel obstructions, colostomies, and dumping syndrome. Test your knowledge on the types, symptoms, and nursing interventions associated with these conditions. Perfect for nursing students and healthcare professionals seeking to reinforce their understanding.