Podcast
Questions and Answers
Which of the following are common causes of nausea and vomiting?
Which of the following are common causes of nausea and vomiting?
Which of the following is the most common type of hernia?
Which of the following is the most common type of hernia?
A hernia that easily returns to the abdominal cavity is called reducible.
A hernia that easily returns to the abdominal cavity is called reducible.
True (A)
What is the most common type of hiatal hernia?
What is the most common type of hiatal hernia?
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Which of the following are symptoms of a strangulated hernia?
Which of the following are symptoms of a strangulated hernia?
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The surgical repair of a hernia is known as a herniorrhaphy.
The surgical repair of a hernia is known as a herniorrhaphy.
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What does GERD stand for?
What does GERD stand for?
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GERD is the most common upper GI problem seen in adults.
GERD is the most common upper GI problem seen in adults.
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Which of the following is NOT a symptom of GERD?
Which of the following is NOT a symptom of GERD?
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Achalasia is a condition in which the muscles of the lower part of the esophagus fail to relax, preventing food from passing into the stomach.
Achalasia is a condition in which the muscles of the lower part of the esophagus fail to relax, preventing food from passing into the stomach.
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Which of the following is an example of a lifestyle change that can be helpful for managing GERD symptoms?
Which of the following is an example of a lifestyle change that can be helpful for managing GERD symptoms?
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GERD is often caused by a weak lower esophageal sphincter.
GERD is often caused by a weak lower esophageal sphincter.
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What can be a serious complication of untreated GERD?
What can be a serious complication of untreated GERD?
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A truss is a device that helps to keep a hernia from protruding.
A truss is a device that helps to keep a hernia from protruding.
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After hernia repair, patients may have difficulty urinating.
After hernia repair, patients may have difficulty urinating.
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Study Notes
Gastrointestinal Problems: Nursing Care
- Nausea and vomiting are common, often co-occurring problems
- Prolonged nausea/vomiting can lead to weakness, weight loss, nutritional deficiencies, dehydration, and electrolyte/acid-base imbalances
- Common causes of nausea/vomiting include: drugs, GI tract infections/inflammation, intestinal obstruction, systemic infections, central nervous system lesions, food poisoning, emotional stress, early pregnancy, and uremia
Assessment Findings (Nausea/Vomiting)
- Clients may report an unpleasant feeling (nausea), loss of appetite, and refusal to eat
- Dehydration: Clients with vomiting often report excessive thirst and decreased/absent urine output
- Physical findings: Dry/dull eyes and oral mucosa, poor skin turgor (indicates fluid loss)
- History: Ingesting noxious substances (e.g., excessive alcohol, contaminated food, or drugs) can cause GI side effects
- Abdominal findings: Distended, tender, and firm abdomen may indicate intestinal obstruction when vomiting occurs
Hernia
- A hernia is the protrusion of a viscus (organ) through an abnormal opening or weakened area in the wall of the cavity that normally contains that organ
- Reducible hernias easily return to the abdominal cavity
- Types of hernias include inguinal, umbilical, and femoral.
- Inguinal hernia: Protrusion through a weak spot in the abdominal wall where the spermatic cord or round ligament emerges.
- Femoral hernia: Protrusion through the femoral ring into the femoral canal (below the inguinal ligament)
Hiatal Hernia
- Hiatal hernia is when a portion of the stomach moves into the esophagus through the esophageal hiatus in the diaphragm
- Types of hiatal hernias:
- Sliding hiatal hernia: Stomach slides into the thoracic cavity when supine, returning to the abdominal cavity in the upright position. This is the most common type.
- Paraesophageal hiatal hernia: The esophagogastric junction remains in its normal position, but the fundus and greater curvature of the stomach are pulled up through the diaphragm, creating a pocket beside the esophagus.
- Risk factors for hiatal hernias include: age, weakening of the diaphragm, obesity, kyphosis, or other factors like wearing girdles that increase intra-abdominal pressure
Clinical Manifestations (All Conditions)
- Hernia: Bulging at the herniated area when standing or straining, bulging disappears in supine position. Pain worsens with intra-abdominal pressure. Strangulated hernias show pain, vomiting, swelling of hernial sac, and signs of peritoneal irritation (fever).
- Hiatal/Esophageal diseases: Clinical symptoms vary widely, depending on the specific condition. The most common symptoms are heartburn (pyrosis), Dyspepsia (epigastric pain), hyper salivation
Diagnostic Studies (All Conditions)
- Barium swallows
- Endoscopy
- Biopsies and cytological specimens
Nursing Management (Nausea/Vomiting)
- Comprehensive medical, dietary, drug, and allergy history, including a list of symptoms (before, during, and after the episode), how long the problem existed, and frequency/type of vomitus.
- Assess general appearance, weight, vital signs.
- Monitor I&O; assess for fluid volume deficit.
- Administer clear fluids in small amounts to improve tolerance. Advance diet (as tolerated).
- Recommend over-the-counter fluids for electrolyte/fluid replacement
- Inform MD if urine output drops below 500mL/day or serum electrolytes are abnormal
Nursing Management (Hernias)
- Assess for signs of skin irritation from a truss (if applicable)
- Observe for a distended bladder if the patient has difficulty voiding
- Accurate I&O
- Support for scrotal edema (if applicable)
- Deep breathing and repositioning encouraged
Nursing Management (GERD)
- Educate clients about diet and lifestyle modifications that reduce reflux symptoms (e.g., eliminate alcohol, caffeine, high-fat foods)
- Encourage weight loss if needed
- Elevate head of bed
- Cessation of smoking
- Food/drink restrictions before bed
- Explain importance of maintaining the reflex by medication in severe cases
- Encourage small, frequent meals to prevent gastric distension
- Explain the rationale behind high protein/low fat diets.
- Teach the patient to avoid lying down for 2–3 hours after eating.
Care Plan (All conditions)
- A generalized care plan is not outlined in the document. Individual care plans would be developed based on specific assessment findings, diagnosis, and patient's needs.
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Description
This quiz focuses on the nursing care related to common gastrointestinal problems such as nausea and vomiting. It covers assessment findings, causes, and implications of prolonged gastrointestinal distress. Test your understanding of nursing interventions and patient assessments in this critical area of care.
