Nursing Management of Gastritis and Oral Cancer

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Questions and Answers

What is the primary cause of Gastritis?

Viral infection of the stomach

Acute inflammation of the stomach lining

Bacterial infection of the stomach

Chronic irritation of the stomach lining (correct)

Which of these is NOT a common clinical manifestation of Gastritis?

Changes in color of stool

Epigastric pain

Increased appetite (correct)

Nausea and vomiting

Which of these is a medical management technique used to diagnose Gastritis?

Urine test

MRI

Blood test

Endoscopy (correct)

What is a common surgical treatment for Gastritis?

Vagotomy (C) Signup and view all the answers

Which of these is a potential complication of TPN?

Fluid overload (D) Signup and view all the answers

What is the purpose of flushing an NG tube before and after medication administration?

All of the above (D) Signup and view all the answers

What is the primary purpose of a residual check for an NG feeding?

To monitor the patient's tolerance to the feeding (B) Signup and view all the answers

What is a potential complication of a misplaced or dislodged feeding tube?

Aspiration (A) Signup and view all the answers

What is a rare but severe complication of radiotherapy for oral cancer?

Trismus (B) Signup and view all the answers

Which of the following is NOT a nursing diagnosis for a patient with oral cancer?

Impaired Skin Integrity (D) Signup and view all the answers

What is the primary focus of nursing interventions for a patient with oral cancer?

Managing symptoms and improving quality of life (B) Signup and view all the answers

Which of the following is NOT an assessment performed by nurses during the management of oral cancer?

Monitoring the patient's blood pressure (B) Signup and view all the answers

What is the role of a nutritional consult for a patient with oral cancer?

To assess the patient's nutritional needs and recommend a suitable diet (C) Signup and view all the answers

What is a significant goal for nurses when evaluating care outcomes for patients with oral cancer?

Reducing the patient's risk factors for oral cancer (D) Signup and view all the answers

Which of the following is a nursing intervention aimed at managing a patient's airway with oral cancer?

Maintaining emergency bedside equipment (B) Signup and view all the answers

What is the primary goal of providing aspiration precautions to a patient with oral cancer?

To prevent them from getting a lung infection (C) Signup and view all the answers

What is the name of the surgical procedure involving the removal of hemorrhoids?

Hemorrhoidectomy (D) Signup and view all the answers

Which of the following is NOT a common complication of surgical management of hemorrhoids?

Constipation (C) Signup and view all the answers

Which diagnostic tests are used for hemorrhoid diagnosis?

Digital examination, Anoscopy, Sigmoidoscopy (D) Signup and view all the answers

Which type of medical management is used for hemorrhoids?

Symptom relief (C) Signup and view all the answers

What are the main clinical manifestations of hemorrhoids?

Bleeding, Itching, Irritation, Pain (D) Signup and view all the answers

What are the possible nursing diagnoses for a patient with hemorrhoids?

Acute pain, Knowledge deficit, Risk for altered bowel elimination, Risk for bleeding/fluid volume deficit (B) Signup and view all the answers

What is the percentage of people with hemorrhoids that are asymptomatic?

40% (A) Signup and view all the answers

What is the best way to diagnose hemorrhoids?

Digital examination, Anoscopy, and Sigmoidoscopy (B) Signup and view all the answers

What is the initial stage in the progression of gastric cancer?

Chronic gastritis (B) Signup and view all the answers

Which symptom is commonly associated with advanced gastric cancer?

Vague epigastric pain (A) Signup and view all the answers

Which diagnostic procedure is least invasive for diagnosing gastric cancer?

Barium x-ray (C) Signup and view all the answers

Which medication class is used for managing symptoms associated with gastric cancer?

Antiemetics (A) Signup and view all the answers

What is a common complication that may arise after surgical management of gastric cancer?

Dumping syndrome (B) Signup and view all the answers

Which nursing diagnosis is appropriate for a patient with gastric cancer and significant weight loss?

Imbalanced nutrition, less than body requirements (D) Signup and view all the answers

Which assessment is critical for monitoring a patient post-gastric surgery?

Hematocrit and hemoglobin (C) Signup and view all the answers

What is the most likely cause of an abdominal mass in advanced gastric cancer?

Tumor growth (C) Signup and view all the answers

Which type of hernia management involves physical examination and herniography?

Medical Management (A) Signup and view all the answers

What is a common complication of hernia surgery that involves the intestine?

Strangulation of intestine (B) Signup and view all the answers

Which nursing diagnosis is associated with a patient's experience of discomfort from a hernia?

Acute pain (A) Signup and view all the answers

What is an appropriate nursing intervention to support a patient recovering from hernia surgery?

Administer pain medication (A) Signup and view all the answers

Which of the following is part of the evaluation for nursing management in hernia care?

Absence of infection (A) Signup and view all the answers

In intestinal obstruction, which of the following symptoms is associated specifically with small bowel obstruction?

Nausea and vomiting (C) Signup and view all the answers

Which type of intestinal obstruction is caused by a physical blockade?

Mechanical (C) Signup and view all the answers

What indicates a metabolic imbalance related to large bowel obstruction?

Metabolic acidosis (A) Signup and view all the answers

Which nursing intervention is essential during the preoperative period for a patient with appendicitis?

Keep NPO (C) Signup and view all the answers

What is a potential complication associated with colorectal cancer?

Infection (D) Signup and view all the answers

Which factor is NOT considered a risk factor for developing colorectal cancer?

High fiber diet (B) Signup and view all the answers

What is the purpose of using an incentive spirometer postoperatively in appendicitis patients?

To enhance lung expansion (A) Signup and view all the answers

Which of the following is a common clinical manifestation of colorectal cancer?

Change in bowel habits (C) Signup and view all the answers

After surgery, how many weeks may it take for a patient to resume normal activities following appendicitis?

2–4 weeks (C) Signup and view all the answers

Which diagnostic procedure is commonly used to assess for colorectal cancer?

Colonoscopy (D) Signup and view all the answers

What treatment option is NOT included in the surgical management of colorectal cancer?

Chemotherapy (B) Signup and view all the answers

Study Notes

Medical-Surgical Nursing: Coordinated Care for Patients With Oral and Esophageal Disorders

This chapter discusses medical-surgical nursing care for patients with oral and esophageal disorders.

Stomatitis

Pathophysiology: Inflammation and ulceration of the mouth lining.
- Primary: Painful oral ulcers (herpes simplex, traumatic ulcers).
- Secondary: Viral, bacterial, or fungal infections.
Risk Factors: Viral infections, bacterial infections, fungal infections, irritants (alcohol, tobacco, mouthwash), radiation, chemotherapy, allergic reactions, vitamin deficiency, and systemic diseases.
Medical Management - Diagnosis: Assessment of oral cavity before, during, and after chemotherapy and radiation.
Complications: Pain, inflammation.
Nursing Management - Assessment and analysis: Diagnosis is based on meticulous assessment. Determining the offending irritant is vital for treatment.
Nursing Diagnoses: Acute pain, risk for infection, imbalanced nutrition, impaired oral mucosa, knowledge deficit, and impaired swallowing.
Nursing Interventions - Assessments: Vital signs, oral mucosa, nutritional intake, weight, intake and output.
Nursing Interventions - Actions: Aspiration precautions, administer medications as prescribed, viscous lidocaine, administer water-soluble lubricants for the lips and mouth.
Nursing Interventions - Teaching: Mouth care after each meal, discourage use of alcohol-containing mouthwash, remove dentures, encourage regular dental check-ups, encourage saline mouth rinse every 4 hours, dietary choices.
Nursing Management - Evaluating care outcomes: Prompt recognition of clinical manifestations, stable vital signs, stable fluid status, and stable weight.

Oral Candidiasis

Image of oral candidiasis (white patches on the tongue) is included

Hiatal Hernia

Pathophysiology: A portion of the stomach protrudes upward through the esophageal hiatus of the diaphragm.
- Type 1 (Sliding): Lower esophageal sphincter (LES) is displaced.
- Type 2 (Paraesophageal): Gastroesophageal junction (GEJ) is displaced.
Risk Factors: Western countries, obesity, pregnancy, and smoking are risk factors
Complications: Gastroesophageal reflux, supradiaphragmatic volvulus.
Medical Management - Diagnosis: Upper abdominal x-ray, endoscopy, barium swallow with fluoroscopy, and Esophagogastroduodenoscopy.
Medical Management - Medications: Antacids, proton pump inhibitors, H2-receptor antagonists, complimentary medicine.
Surgical Management: Hernia repair.
Nursing Management - Assessment and analysis: Lifestyle changes can help reduce clinical manifestations.
Nursing Diagnoses: Impaired swallowing, anxiety, pain, and knowledge deficit.
Nursing Interventions - Assessments: Dysphagia, GERD clinical manifestations, nausea and vomiting, iron-deficiency anemia.
Nursing Interventions - Actions: Medication management, position patient supine on right side, elevate the head of the bed (HOB) after meals.
Nursing Interventions - Teaching: Limit foods like spicy, caffeine, chocolate, carbonated, acidic, peppermint, alcohol, and medications, eat meals 2 hours before lying supine, wear nonrestrictive clothing, maintain normal weight, proper positioning after eating, and postoperative education.
Nursing Management - Evaluating care outcomes: Being free from pain and adequate nutrition

Gastroesophageal Reflux Disease (GERD)

Pathophysiology: Retrograde flow of gastrointestinal (GI) contents into the esophagus, causing inflammation.
Risk Factors: Lower esophageal sphincter (LES) hypotension, loss of esophageal motility, increased compliance of the hiatal canal, increased states of gastric secretion, delayed emptying of gastric contents, obesity, pregnancy, ascites, tight belts/girdles, presence of a nasogastric tube.
Complications: Barrett's epithelium, strictures.
Medical Management - Diagnosis: 24-hour ambulatory esophageal pH monitoring, esophagogastroduodenoscopy, esophageal manometry.
Medical Management - Medications: Antacids, histamine receptor antagonists, prokinetic medications, and proton pump inhibitors.
Surgical Management: Laparoscopic Nissen fundoplication.
Nursing Management - Assessment and analysis: Clinical manifestations are due to gastric material irritating the esophagus.
Nursing Diagnoses: Acute/chronic pain, risk for aspiration, impaired swallowing, imbalanced nutrition.
Nursing Interventions - Assessments: Signs of Barrett's esophagus, dental caries, water brash, eructation, flatulence/bloating, nausea, globus, pH of gastric aspirate, dysphagia.
Nursing Interventions - Actions: Administer medications as ordered, position patient on right side with HOB elevated (6-12 inches), and provide small, frequent meals.
Nursing Interventions - Teaching: Limit irritating foods, avoid smoking/alcohol, eat meals 2 hours before lying supine, wear nonrestrictive clothing, maintain ideal body weight.
Nursing Management - Evaluating care outcomes: Maintain quality of life and prevent complications.

Oral Cancer

Pathophysiology: Primarily squamous cell carcinoma.
Clinical Manifestations: Oral bleeding, raised area on the lip/mouth, oral ulcer with poorly defined margins, mucosal lesions/nodules in oral cavity, increasing pain radiating to the neck, dysarthria, dysphagia, difficulty chewing, oral odor, regional lymph node involvement, weight loss, and poor-fitting dentures.
Medical Management - Diagnosis: Complete blood count, chemistry profile, liver function test, CT scan, MRI, and chest x-ray.
Medical Management - Treatment: Airway management, removal of source of irritation, radiotherapy, chemotherapy, chemoradiation, surgical removal, retinoids, beta-carotene.
Complications: Infection, facial edema, weight loss, difficulty communicating, dysphagia, rare but severe complications (hearing loss, osteoradionecrosis, trismus, carotid artery rupture).
Nursing Management - Assessment and analysis: Clinical manifestations affect daily functions and eating.
Nursing Diagnoses: Risk for ineffective airway clearance, imbalanced nutrition, impaired verbal communication, acute or chronic pain, anxiety.
Nursing Interventions - Assessments: Ability to swallow, fluid intake, nutritional intake, weight, albumin & total protein, oral mucosa irritation/infection, lymph nodes, and psychosocial adjustment.
Nursing Interventions - Actions: Airway management, aspiration precautions, maintain emergency equipment, provide oral care, administer steroids, provide cool mist, and nutritional consult.
Nursing Interventions - Teaching: Aspiration precautions, avoid tobacco/alcohol intake, provide nutritional education, oral hygiene, management of xerostomia, frequent sips of water/saliva substitutes.
Nursing Management - Evaluating care outcomes: Prevention by decreasing risk factors

Esophageal Cancer

Pathophysiology: Rapidly growing cancer. Spreads to lymph nodes within esophageal lumen. More than 50% of cases demonstrate metastasis
Risk Factors: Barrett's esophagus, GERD, lye strictures, malnutrition (deficiencies in molybdenum, zinc, and vitamin A), esophageal diverticula, achalasia, tylosis, obesity (associated with hiatal hernia and GERD)
Clinical Manifestations: Progressive dysphagia, hemoptysis, burning sensation in middle of chest, painful swallowing, vomiting, weight loss, anorexia, hoarseness, and melena.
Medical Management - Diagnosis: Screening, diagnostic tests (Barium swallow, CT scan, PET scan, endoscopy, and thoracoscopy)
Surgical Management: Esophagectomy.
Complications: Dysphagia, strictures, dumping syndrome, stomatitis, nausea and vomiting, and diarrhea
Nursing Management - Assessment and analysis: Manifestations are related to esophageal lumen obstruction
Nursing Diagnoses: Impaired swallowing, imbalanced nutrition, acute/chronic pain, ineffective coping, and compromised family coping.
Nursing Interventions - Assessments: Nausea and vomiting, painful swallowing, dysphagia, weight loss, hematocrit and hemoglobin, serum calcium levels, liver enzymes, and psychosocial adjustment.
Nursing Interventions - Actions: Maintain HOB greater than 30 degrees, collaborate with nutritionist, provide six small meals per day, and collaborate with speech.
Nursing Interventions - Teaching: Lines, tubes, incisions, preoperative care, coughing, deep breathing, incentive spirometry, q2 turn, early ambulation, pain management, enteral/parenteral feeding, dental screening, and postoperative education.
Nursing Management - Evaluating care outcomes: Lifestyle choices and enhancement of quality of life.

TEN vs TPN

TEN (Total Enteral Nutrition): Oral, nasogastric (NG), percutaneous endoscopic gastrostomy (PEG), or jejunostomy (J-) tube feedings.
PPN (Peripheral Parenteral Nutrition): Peripheral IV or central line.
TPN (Total Parenteral Nutrition): Central line only.

Gastritis

Epidemiology: Chronic stress to stomach lining, caused by chronic ingestion of irritating foods, pathogens, overuse of aspirin/NSAIDs, and stress
Pathophysiology: Prolonged irritation of the stomach lining from the mentioned causes.
Clinical Manifestations: Epigastric pain, nausea and vomiting, decreased appetite, color changes in stool (can be dark or bloody)
Medical Management - Diagnosis: Biopsy, upper GI x-ray series, and urea breath testing.
Medical Management - Treatment: Supportive care (relieving clinical manifestations), and reducing the cause of discomfort.
Surgical Management: Vagotomy and gastrectomy for severe cases.
Nursing Management - Assessment and analysis: Epigastric pain, nausea, vomiting, decreased appetite, weight loss, color changes in stool
Nursing Diagnoses: Acute pain, anxiety, deficient knowledge, risk for deficient fluid volume.
Nursing Interventions - Assessments: Vital signs, history of presenting signs and symptoms, laboratory assessment (serum electrolytes), and intake and output
Nursing Interventions - Actions: Administer IV fluids, administer medications exactly as prescribed, and report hematemesis
Nursing Management - Evaluating outcomes: Full recovery and return of appetite

Gastroenteritis

Pathophysiology: Inflammation of the mucous membranes of the stomach and intestinal tract due to a viral or bacterial infection.
Clinical Manifestations: Nausea, vomiting, diarrhea, abdominal cramping, dehydration
Fecal-oral transmission and handwashing is key to prevention

Peptic Ulcer Disease

Pathophysiology: Damage to the gastric mucosa caused by corrosive action of gastric acid
Clinical Manifestations: Pain triggered or worsened by eating, ulcers can cause symptoms or be asymptomatic
Medical Management – Diagnosis: Upper GI endoscopy
Medical Management - Treatment: Antacids, H2-receptor antagonists, Proton pump inhibitors, mucosal barrier agents.
Surgical Management: Indicated in nonhealing and bleeding ulcers, endoscopic procedures (example: vagotomy, and pyloroplasty)
Complications: GI hemorrhage, abdominal or intestinal infarction, perforation, penetration into attached structures, obstruction, and peritonitis
Nursing Management - Assessment and analysis: Comprehensive physical exam to exclude other diseases
Nursing Diagnoses: Acute or chronic pain, deficient knowledge, risk for deficient fluid volume
Nursing Interventions - Assessments: Vital signs, gastric pH, alcohol/medication use, serum electrolytes, and pain levels
Nursing Interventions - Actions: Administer IV fluids, as ordered, administer medications, assist with gastric lavage, prepare for endoscopy.
Nursing Interventions - Teaching: Take medications as prescribed, avoid eating 2 hours of bedtime, avoid risk factors.
Nursing Management - Evaluating outcomes: Increased comfort, controlled pain, tolerance of diet

Gastric Cancer

Pathophysiology: Begins as chronic gastritis. Progresses to atrophy,intestinal metaplasia, dysplasia, then adenocarcinomas.
Clinical Manifestations: Often asymptomatic until late disease. Indigestion, anorexia, weight loss, vague epigastric pain, vomiting, and abdominal mass.
Medical Management - Diagnosis: Barium x-ray, endoscopy, and cytology
Medical Management - Treatment: Antiemetics, opioid analgesics, gastric resection
Complications (after surgery): Dumping syndrome, wound infections, leaking of anastomotic sites, strictures, and internal bleeding.
Nursing Management - Assessment and analysis: Minimal early clinical manifestations, manifestations related to tumor growth.
Nursing Diagnoses: Pain, anxiety, fear, nutritional imbalances, and motility issues.
Nursing Interventions - Assessments: Physical exam, hematocrit and hemoglobin, serum electrolytes, bilirubin and alkaline phosphatase, modified oral glucose tolerance tests, comprehensive pain assessments, early dumping syndrome signs, and end of life care.
Nursing Interventions - Actions: Small, frequent meals, verbalize feelings and concerns, prepare for surgery.
Nursing Interventions - Teaching: Medication information, pain and precipitating factors, high-calorie/high-protein meals, nutritional supplements, main signs of dumping syndrome, and relaxation techniques
Nursing Management – Evaluating care outcomes: Absence of infection, weight stability, reduced anxiety, adequate nutrition, pain relief, and adjusting to diagnoses

Hernias

Pathophysiology: Protrusion of the intestines through an abdominal wall opening.
Causes: Straining (lifting heavy objects, sudden twists/pulls), muscle strain, weight gain, and chronic coughing. Reducible vs incarcerated.
Risk Factors: Obesity, smoking, excessive wound tension, malnutrition, pregnancy, and medications.
Clinical Manifestations: Bulge/visible swelling (ventral, umbilical, inguinal, femoral).
Medical Management - Diagnosis: Physical examination, and herniography.
Surgical Management: Hernia repair, complications (strangulation of intestine, recurrences).
Nursing Management - Assessment and analysis: Clinical manifestations are related to hernia location and type
Nursing Diagnoses: Acute pain, and knowledge deficit
Nursing Interventions – Assessments: Vital signs, pain, intake and output, and surgical site.
Nursing Interventions – Actions: Deep breathing exercises, pain medications, ice packs, advance diet as tolerated
Nursing Interventions – Teaching: Coughing, heavy lifting, pain management, observe incisions
Nursing Management – Evaluating care outcomes: Return to normal functioning, stable vital signs, absence of infection, and normal bladder/bowel functions

Intestinal Obstruction

Types: Mechanical (blockage), and Nonmechanical (ileus, etc)
Problems: Blockage & distention, hypovolemia & electrolyte imbalances, and strangulation.
Symptoms (small bowel): Pain, peristaltic waves, upper GI distention, nausea/vomiting, fluid and electrolyte imbalances, metabolic alkalosis.
Symptoms (large bowel): Lower abdominal cramping, lower GI distention, metabolic acidosis.
Diagnosis: Labs, ultrasound, CT scan/MRI, and endoscopy.
Nonsurgical Management: NPO, NG tube, IV fluids, motility medications, pain management, and antibiotics.
Surgical Management: Colon resection, exploratory laprotomy (pre-op, operative-laparascopic/open approach), and post-op NG tube

Hemorrhoids

Pathophysiology: Swollen or dilated veins in the anorectal area, internal or external hemorrhoids
Clinical Manifestations: 40% asymptomatic, bleeding, itching, irritation, and pain.
Medical Management - Diagnosis: Digital examination, anoscopy, sigmoidoscopy.
Medical Management - Treatment: Symptom relief, and medication regimens.
Surgical Management: Rubber band ligation, bipolar, infrared and laser coagulation, sclerotherapy, cryosurgery, and hemorrhoidectomy
Complications: Infection, pain, urinary retention, fecal impaction, damage to sphincter, bleeding, and abscess formation.
Nursing Management - Assessment and analysis: Clinical manifestations possibly with bleeding.
Nursing Diagnoses: Acute pain, knowledge deficit, altered bowel elimination, and risk for bleeding/fluid volume deficit.
Nursing Interventions - Assessments: Vital signs, visual inspection of rectal area, frequency and character of bowel movements, bowel habit post-operatively, and pain level.
Nursing Interventions - Actions: Analgesia prior to first bowel movement, local anesthetics, corticosteroids, cold packs/sitz baths, laxatives, and apply local heat.
Nursing Interventions - Teaching: Care of surgical site, constipation prevention measures, avoid straining, avoid stimulant laxatives, nonpharmacologic pain reduction methods, and when to contact a healthcare provider.
Nursing Management – Evaluating care outcomes: Return to normal functioning, appropriate pain management, and avoidance of constipation.

Irritable Bowel Syndrome (IBS)

Pathophysiology: Unknown cause, abdominal pain, and altered bowel habits.
Subtypes: IBS-D (diarrhea), IBS-C (constipation), IBS-A (alternating), and IBS-M (mixed).
Clinical Manifestations: Diarrhea, constipation, flatulence, and abdominal pain.
Medical Management - Diagnosis: Rome IV diagnostic criteria.
Medical Management - Treatment: Medications, dietary modifications, and complementary/alternative therapies.
Complications: Social isolation, spasm, constipation, diarrhea, fluid volume deficit, and hypokalemia.
Nursing Management - Assessment and analysis: Clinical manifestations include abdominal distention and altered bowel habits.
Nursing Diagnoses: Chronic pain, ineffective coping, and ineffective health maintenance.
Nursing Interventions - Assessments: Vital signs, intake and output, serum electrolytes , pain levels, bowel pattern, weight, and psychosocial assessment.
Nursing Interventions - Actions: Administer ordered IV solutions, establishing a trusting relationship, avoid foods that exacerbate symptoms, establish regular bowel routine, and implement complementary/alternative medicines.
Nursing Interventions - Teaching: Avoid trigger foods, keep food diary, consume regular meals/water, encourage regular exercise, and smoking cessation.
Nursing Management – Evaluating care outcomes: Stable vital signs & weight, decrease in clinical manifestations, and understanding/adherence to nutrition/activity recommendations.

Inflammatory Bowel Disease

Pathophysiology: Unknown cause, inappropriate response, in intestinal tract resulting in inflammation.
Clinical Manifestations: Persistent diarrhea, abdominal pain and cramps, fever, weight loss, fluid imbalance, malnutrition, mouth ulcers, and anemia
Medical Management - Diagnosis: Colonoscopy, sigmoidoscopy, and barium enema
Medical Management – Treatment: Fluid electrolyte management, rest, and medications
Surgical Management: Colectomy and ostomy creation
Complications: Perineal abscess, fistula, and strictures
Nursing Management - Assessment and analysis: Frequent diarrhea leads to extreme fluid and electrolyte losses
Nursing Diagnoses: Deficient fluid volume, diarrhea, imbalanced nutrition, and ineffective coping.
Nursing Interventions - Assessments: Vital signs, nutritional intake, frequency and characteristics of stool, intake and output, daily weight, fluid and electrolyte status, and psychosocial assessments.
Nursing Interventions - Actions: Encourage smaller, more frequent meals, encourage rest periods, establish therapeutic relationship, make referrals to interprofessional team, pain management, and meticulous skin care
Nursing Interventions - Teaching: Importance of adequate nutrition, medications, regular follow-ups and annual colonoscopies

Diverticulitis

Pathophysiology: Outpouching of the intestinal wall that becomes inflamed.
Clinical Manifestations: Abdominal pain, fever, leukocytosis, and a palpable mass
Medical Management - Diagnosis: Abdominal x-ray, CT scan, and endoscopy.
Medical Management - Treatment: Broad-spectrum antibiotics, clear liquid diet, IV fluids, NPO and bowel rest.
Surgical Management: Indicated for perforation, obstruction, abscess formation, and fistula.
Complications: Perforation, microperforation, abscess, fistula formation, bowel obstruction, and bleeding.
Nursing Management - Assessment and analysis: Clinical Manifestations related to inflammation or infection, as well as GI manifestations.
Nursing Diagnoses: Acute pain and knowledge deficit Nursing Interventions - Assessments: Vital signs, serum potassium, intake and output, pain, and mental status.
Nursing Interventions - Actions: Administer IV fluids, administer ordered antibiotics, use nasogastric (NG) tube for intermittent suction, and provide oral care.
Nursing Interventions - Teaching: Dietary recommendations, avoid straining, bending, lifting, weight reduction, and complete antibiotic therapy.
Nusring Management - Evaluating care outcomes: Free from abdominal pain, free from fever.

Appendicitis

Pathophysiology: The opening to the appendix becomes blocked. The mucosa secretes fluid. There is venous engorgement, and restricted blood flow
Clinical Manifestations: Periumbilical abdominal pain, anorexia, nausea, and vomiting.
Medical Management - Diagnosis: Clinical presentation, ultrasound, and CT scan
Surgical Management: Appendectomy.
Complications: Rupture and sepsis
Nursing Management - Assessment and analysis: Clinical manifestations related to inflamed appendix progressing to gangrene or rupture if untreated.
Nursing Diagnoses: Acute pain, risk for deficient fluid volume, and knowledge deficit
Nursing Interventions – Assessments: Vital signs, intake and output, pain, rebound tenderness, and WBC count.
Nursing Interventions - Actions: NPO, IV fluids, prepare patient for OR, provide comfort measures, position supine with elevated HOB, and advance diet as tolerated.
Nursing Interventions - Teaching: Turning, coughing, deep breathing, incentive spirometer, early ambulation, take full course of antibiotics, and wound care
Nursing Management – Evaluating care outcomes: Resume normal activities, stable vital signs, CBC within normal limits, and demonstrated understanding of postoperative teaching

Colorectal Cancer

Pathophysiology: Most are adenocarcinomas originating in glandular cells of internal organs. Metastasize to adjacent organs.
Risk Factors: Family history, inflammatory bowel disease for 10 or more years, physical inactivity, obesity high red meat diet
Clinical Manifestations: Pain, change in bowel habits, anemia, and fatigue
Medical Management - Diagnosis: Colonoscopy and laboratory studies.
Medical Management - Treatments: Chemotherapy and radiation therapy
Surgical Management: Colectomy, hemicolectomy, and abdominoperineal resection.
Complications: Fatigue, infection, anemia, and anastomoses
Preoperative Patient Nursing Management - Assessment and analysis: Clinical manifestations closely associated with tumor location.
Preoperative Patient Nursing Management - Nursing Diagnoses: Knowledge deficit, and fear
Preoperative Patient Nursing Interventions - Assessments: Vital signs, serum electrolytes and CBC, and current knowledge of disease
Preoperative Patient Nursing Interventions - Actions: Bowel prep, establish therapeutic relationships, and ensure surgical consent form is signed.
Preoperative Patient Nursing Interventions - Teaching: Ostomy care, and pain management.
Postoperative Patient Nursing Management - Assessment and analysis: Vital signs, LOC, pain, bowel sounds, and stoma (if applicable)
Postoperative Patient Nursing Management - Nursing Diagnoses: Acute pain, potential for infection, risk for imbalanced fluid volume, knowledge deficit, and disturbed body image.
Postoperative Patient Nursing Interventions - Assessments: Vital signs, CBC values, nausea/vomiting, intake and output, stoma, abdominal/perineal dressing, and pain.
Postoperative Patient Nursing Interventions - Actions: IV fluids, NPO/advance diet as tolerated, NG tube, pain management, drain management, turning, coughing, deep breathing, incentive spirometry, early ambulation, perianal care
Postoperative Patient Nursing Interventions - Teaching: Postoperative complications, and ostomy care.
Nursing Management - Evaluating care outcomes: Stable vital signs, good CBC values, absence of infection, positive bowel sounds, demonstrated understanding, and controlled pain.

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Test your knowledge on the nursing management techniques for gastritis and oral cancer. This quiz covers causes, clinical manifestations, medical management, and nursing interventions. Assess your understanding of potential complications and the role of nutritional consultants in patient care.