Nursing Management: Gastritis and Peptic Ulcers

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Questions and Answers

What is the primary focus of nursing management for a patient with gastritis?

  • Administering strong analgesics
  • Promoting physical activity
  • Increasing caffeine intake
  • Reducing anxiety (correct)

What minimum fluid intake is recommended for a patient with peptic ulcer management?

  • 2 L/day
  • 3 L/day
  • 1.5 L/day (correct)
  • 1 L/day

Which of the following should be discouraged in patients with gastritis?

  • Ice chips
  • Clear liquids
  • Caffeinated beverages (correct)
  • Herbal teas

Which action should be taken for a patient preparing for appendicitis surgery?

<p>NGT insertion (C)</p> Signup and view all the answers

What position is recommended for a patient after surgery for intestinal obstruction?

<p>High-Fowler position (A)</p> Signup and view all the answers

How often should a patient be encouraged to use an incentive spirometer while awake after surgery?

<p>Every 2 hours (C)</p> Signup and view all the answers

Which of the following is NOT an important aspect of nursing management for patients recovering from intestinal obstruction?

<p>Encouraging heavy lifting (A)</p> Signup and view all the answers

What should be monitored closely when managing a patient with a nasogastric tube?

<p>Nasogastric output (B)</p> Signup and view all the answers

Which signs indicate improvement in a patient being treated for a gastrointestinal condition?

<p>Passage of flatus or stool (A)</p> Signup and view all the answers

What should be the focus when managing pain in patients with peptic ulcers?

<p>Correct use of medications (D)</p> Signup and view all the answers

What is the primary goal for administering analgesic agents in nursing interventions for patients with inflammatory bowel disease?

<p>To relieve pain (C)</p> Signup and view all the answers

Which intervention is essential for maintaining normal elimination patterns in patients?

<p>Keeping the bathroom environment clean and odor-free (B)</p> Signup and view all the answers

In managing patients with hemorrhoids, which practice should be avoided to prevent exacerbation of symptoms?

<p>Encouraging excessive straining during defecation (C)</p> Signup and view all the answers

What is a specific nursing intervention when monitoring for complications in patients with inflammatory bowel disease?

<p>Monitoring for indications of perforation (A)</p> Signup and view all the answers

Which dietary approach is recommended for patients with inflammatory bowel disease when oral foods are tolerated?

<p>Small, frequent meals high in protein and low in fat (D)</p> Signup and view all the answers

When preparing a patient for surgery due to inflammatory bowel disease, which intervention is crucial?

<p>Recording the frequency and consistency of stools (C)</p> Signup and view all the answers

Which is NOT a common symptom of hemorrhoids?

<p>Increased abdominal pain (A)</p> Signup and view all the answers

What aspect of nursing care focuses on reducing anxiety for a patient with inflammatory bowel disease?

<p>Promoting rest (D)</p> Signup and view all the answers

What is a key component of managing health for patients with hemorrhoids?

<p>Using sitz baths for relief (C)</p> Signup and view all the answers

When assessing a patient for signs of toxic megacolon, which symptom should be monitored?

<p>Abdominal distention (A)</p> Signup and view all the answers

Flashcards

Gastritis Nursing Management

Reducing anxiety, promoting optimal nutrition, and managing symptoms with NPO (IV fluids), ice chips progressing to fluids and then solids. Monitor I&O (fluid intake and output). Avoid caffeine, alcohol, and smoking.

Peptic Ulcer Nursing Management

Promoting fluid balance (monitoring I&O, 1.5L minimum fluid intake) and electrolyte balance; relieving pain by avoiding irritating foods/drinks; correct medication use.

Appendicitis Before Surgery

IV fluids, antibiotics, analgesia, and NGT (nasogastric tube) insertion are common procedures. Enemas are avoided to prevent perforation.

Post-appendectomy Nursing

High Fowler's position, incentive spirometer use, monitor urine output, encourage ambulation. Avoid heavy lifting.

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Intestinal Obstruction Post-op Management

Post-surgery, prioritize high Fowler's position, incentive spirometer, oral fluids (as tolerated), monitoring, and analgesia. Encourages early ambulation and avoids heavy lifting.

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Non-surgical Intestinal Obstruction Management

Maintaining NGT function, measuring NGT output, monitoring fluids & electrolytes, assessing nutritional status, observing for improvement, monitoring bowel sounds, distension, pain, and passage of stool. Reports are necessary.

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Monitoring I&O (Input & Output)

Tracking fluid intake and output. Crucial in identifying early signs of dehydration or fluid imbalances.

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NGT (Nasogastric Tube) Management

Monitoring and maintaining the function of a nasogastric tube, assessing and measuring the output, and identifying potential fluid and electrolyte imbalances.

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Pain Management in Ulcers

Avoidance of foods and beverages that could irritate the ulcers. Effective medications are crucial for relieving pain.

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Discharge Teaching

Instructing patients on self-care, medication management, and potential complications to ensure successful recovery at home.

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Nursing interventions for worsening IBD

Maintaining optimal nutrition (parenteral nutrition, monitoring fluid I&O and daily weight, blood glucose monitoring, oral feedings if tolerated, restricted activity), promoting rest, and reducing anxiety are essential nursing interventions for worsening inflammatory bowel disease.

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Nursing interventions for maintaining normal elimination

Assessing stool, ensuring bathroom access, administering antidiarrheal medications as prescribed, and recording stool frequency and consistency are nursing interventions to maintain normal elimination patterns.

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IBD nutrition management

Maintain optimal nutrition through parenteral nutrition, careful I&O monitoring and weight control, frequent, high-protein, low-fat, low-residue feedings if oral foods are tolerated. Activity levels restricted to conserve energy.

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Hemorrhoids definition

Dilated veins in the anal canal.

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Hemorrhoid symptoms

Rectal bleeding, pain, itching, fullness, and soiling of underwear; bulging tissue from the rectum.

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Nursing intervention for pain relief

Administer analgesic agents, position changes, local heat application (as prescribed), diversional activities, and preventing fatigue.

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Hemorrhoid management

Good hygiene, avoiding straining during bowel movements, high-fiber diet, increased fluids, warm compresses, sitz baths, and analgesics (ointments/suppositories) help with hemorrhoids.

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Monitor for IBD complications

Monitor for obstruction, toxic megacolon (abdominal distention, decreased/absent bowel sounds, change in mental status, fever, tachycardia, hypotension, dehydration, and electrolyte imbalances), and perforation (acute abdominal pain, rigid abdomen, vomiting, and hypotension).

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Fluid intake measurement

Measure both fluid intake and output (I&O) along with daily weights to monitor fluid balance.

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Hemorrhoid treatment options

Rubber-band ligation, Nd:YAG laser, and hemorrhoidectomy are surgical options for severe hemorrhoids.

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Study Notes

Gastritis Nursing Management

  • Reduce Anxiety: Address patient anxiety.
  • Optimal Nutrition: Encourage a nutritious diet.
  • Initial NPO (IV fluid): Fasting with intravenous fluids until symptoms improve.
  • Progressive Diet: Transition from ice chips to clear liquids to solid foods.
  • Fluid Monitoring: Track fluid intake and output.
  • Avoidance: Limit caffeinated beverages, alcohol, and smoking.

Peptic Ulcer Nursing Management

  • Fluid Balance: Monitor daily fluid intake and output for dehydration.
  • Minimal Intake: Maintain a minimum of 1.5 liters of fluid daily, 0.5 mL/kg/h minimal output.
  • Electrolyte Monitoring: Check electrolyte levels.
  • Pain Relief: Avoid irritating foods and beverages.
  • Medication Adherence: Ensure correct medication use.
  • Home and Community Care: Support patient self-management at home.

Appendicitis Nursing Management

  • Pre-Surgery Care: Administer intravenous fluids, prescribe antibiotics, and offer analgesia.
  • NGT Insertion: Use a nasogastric tube, as necessary.
  • Enema Avoidance: Prevent enema use, as it may cause perforation.

Intestinal Obstruction Nursing Management

  • Post-Surgery Care: Place patient in a high-Fowler position, promote deep breathing.
  • Incentive Spirometer: Encourage frequent use, at least every 2 hours while awake.
  • Oral Fluids: Offer oral fluids as tolerated.
  • Diet: Provide food as desired and tolerated.
  • Analgesics: Administer morphine sulfate as needed.
  • Urine Output Monitoring: Record urine output.
  • Early Ambulation: Encourage early movement.
  • Lifting Restrictions: Avoid heavy lifting.

Nursing Management (Conditions Not Requiring Surgery)

  • NGT Function: Maintain nasogastric tube function.
  • NGT Output Assessment: Assess and measure nasogastric output.
  • Fluid/Electrolyte Balance: Evaluate for imbalances.
  • Nutritional Status: Monitor nutritional status.
  • Improvement Assessment: Assess for improvement by evaluating: bowel sounds, abdominal distention, abdominal pain/tenderness, flatus/stool passage.
  • Discrepancies: Address discrepancies in intake/output, worsening pain, abdominal distention, and increased nasogastric output.
  • Surgical Referral: Prepare for surgery if condition does not improve.

Inflammatory Bowel Disease (IBD) Nursing Interventions

  • Optimal Nutrition: Maintain a nutritious diet and record I&O and daily weight.
  • Parenteral Nutrition: Use parenteral nutrition as needed, and record I&O and daily weight.
  • Weight Gain: Aim for 0.5 kg daily weight gain.
  • Blood Glucose Monitoring: Monitor blood glucose levels every 6 hours.
  • Oral Feeding: If tolerated, consume small, frequent, high-protein, low-fat, low-residue meals.
  • Activity Restriction: Reduce activity to conserve energy.
  • Promoting Rest: Encourage rest.
  • Anxiety Reduction: Manage patient anxiety.

Hemorrhoids Nursing Interventions

  • Coping Measures: Enhance coping skills.
  • Skin Breakdown Prevention: Prevent skin damage.
  • Potential Complications Management: Monitor for and address potential complications.
  • Serum Electrolytes: Monitor serum electrolyte levels daily.
  • Perforation Monitoring: Watch for signs of perforation (increased abdominal pain, rigid abdomen, vomiting, hypotension).
  • Obstruction/Toxic Megacolon Monitoring: Monitor for obstruction and toxic megacolon (abdominal distention, decreased/absent bowel sounds, mental status changes, fever, tachycardia, hypotension, dehydration, electrolyte imbalances).
  • Home/Community/Transitional Care: Support patient self-management at home.

Hemorrhoids - General Information

  • Hemorrhoids: Dilated veins in the anal canal
  • Symptoms: Rectal bleeding, anal pain, itching, fullness, soiling
  • Management: Hygiene, straining avoidance, high-fiber diet, increased fluids, warm compresses, sitz baths, ointments/suppositories, bed rest, rubber-band ligation, Nd:YAG laser, hemorrhoidectomy.

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