Adult Nursing: Digestive System Diseases and Disorders PDF

Adult Nursing Digestive system diseases and disorders Instructor: Karzan M. Khursheed Kalar Technical institute Nursing Dept. Lecture : 2 theory Digestive system The digestive system is essential for breaking down food, absorbing nutrients, and eliminating waste. Digest...

Adult Nursing Digestive system diseases and disorders Instructor: Karzan M. Khursheed Kalar Technical institute Nursing Dept. Lecture : 2 theory Digestive system The digestive system is essential for breaking down food, absorbing nutrients, and eliminating waste. Digestive diseases and disorders can affect any part of this system, causing a wide range of symptoms, from mild discomfort to severe complications. The gastrointestinal (GI) system consists of a series of hollow organs that form a long, continuous passage from the mouth to the anus. Anatomy and function of the gastrointestinal (GI) system: Mouth: The starting point of digestion, where food is chewed and mixed with saliva. Esophagus: A tube that transports food from the mouth to the stomach. Stomach: Produces acid and enzymes to break down food into a semi-liquid form. Small Intestine: The main site for nutrient absorption, divided into three parts: the duodenum, jejunum, and ileum.  Large Intestine: Absorbs water and forms solid waste (stool). Rectum and Anus: Store and expel waste from the body. Accessory Organs: – Liver: Produces bile to aid in fat digestion. – Gallbladder: Stores bile and releases it into the small intestine. – Pancreas: Secretes digestive enzymes and hormones like insulin.  Common Gastrointestinal Disorders 1. Functional Disorders: These disorders affect the function of the digestive system but do not have a specific underlying cause, such as Irritable Bowel Syndrome (IBS). 2. Inflammatory Disorders: These disorders involve inflammation of the digestive tract, such as Inflammatory Bowel Diseases (IBD). 3. Structural Disorders: These disorders involve physical changes in the digestive system, such as ulcers, diverticulitis, and tumors. 4. Malabsorption Disorders: These disorders involve the inability to properly absorb nutrients from food, such as Celiac disease and lactose intolerance.  Common conditions affecting adults A. Irritable Bowel Syndrome (IBS): A functional gastrointestinal disorder that leads to abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). ❖ Symptoms can vary from person to person and may fluctuate in severity over time.  Diagnosis: 1.Patient history: Based on symptoms duration and severity. 2.Stool tests and colonoscopy: To rule out other conditions. 3.Blood tests: To check for celiac disease or infections. 4.Exclusion of red-flag symptoms: Like weight loss or rectal bleeding, to ensure IBS is the correct diagnosis.  Treatment: Medications: A. Laxatives for constipation. B. Antidiarrheal agents like loperamide. C. Antispasmodics for pain. D. Antidepressants to alleviate pain and bowel dysfunction. Probiotics: For gut health improvement. Behavioral therapy: Cognitive-behavioral therapy (CBT) and stress management.  Nursing Interventions: 1. Monitor daily weights. 2. Avoid foods that exacerbate symptoms. 3. Encourage small meals. 4. Encourage participation in diet planning. 5. Assess and monitor pain. 6. Provide non-pharmacological interventions for pain control. 7. Monitor vital signs. 8. Educate on condition, treatment, and outcomes. 9. Provide emotional support for individual and family. B.Inflammatory Bowel Disease (IBD): Includes Crohn’s disease and ulcerative colitis, which cause chronic inflammation of the gastrointestinal tract. 1.Crohn's Disease: This chronic condition affects any part of the digestive tract, from the mouth to the anus. Inflammation can be found in patches throughout the digestive tract, often causing narrowing or thickening of the affected area. 2. Ulcerative Colitis: This chronic condition primarily affects the colon, specifically the inner lining. It causes inflammation and ulcers in the lining of the colon, leading to diarrhea, abdominal pain, and rectal bleeding. Symptoms: Symptoms of IBD can vary depending on the severity and location of the inflammation. They may include abdominal pain, diarrhea, rectal bleeding, weight loss, fatigue, and fever. Diagnosis: Diagnosis involves a combination of medical history, physical examination, blood tests, imaging studies, and endoscopy with biopsy.  Nursing Diagnosis 1. Acute Pain related to inflammation and ulceration in the gastrointestinal tract secondary to ulcerative colitis. 2. Diarrhea related to inflammation and altered bowel function in ulcerative colitis. 3. Imbalanced Nutrition: Less Than Body Requirements related to malabsorption, dietary restrictions, and increased metabolic demands in ulcerative colitis. 4. Risk for Impaired Skin Integrity related to frequent bowel movements and potential skin irritation in ulcerative colitis. 5. Disturbed Sleep Pattern related to abdominal pain, urgency, and nocturnal bowel movements in ulcerative colitis. 6. Risk for Infection related to compromised immune function and the use of immunosuppressive medications in ulcerative colitis. 7. Risk for Deficient Fluid Volume related to diarrhea and increased metabolic demands in ulcerative colitis. C.Gastroesophageal Reflux Disease (GERD): A chronic condition where stomach acid flows back into the esophagus, leading to heartburn, regurgitation, chest pain, and difficulty swallowing. and discomfort. Diagnosis of GERD 1. Clinical History: Assessment of symptoms like heartburn, regurgitation, and response to acid-reducing medications. 2. Upper GI Endoscopy: Visual examination of the esophagus to detect inflammation or abnormalities. 3. Esophageal pH Monitoring: Measures acid levels in the esophagus over 24-48 hours to confirm acid reflux. 4. Esophageal Manometry: Tests esophageal muscle function and lower esophageal sphincter strength. 5. Barium Swallow (X-ray): Assesses structural issues like strictures or hiatal hernias.  Common nursing diagnoses for GERD include: 1. Acute Pain related to esophageal irritation from acid reflux as evidenced by reports of heartburn, chest pain, or discomfort after eating. 2. Impaired Swallowing related to esophageal inflammation or strictures as evidenced by difficulty swallowing (dysphagia). 3. Risk for Aspiration related to regurgitation of gastric contents into the esophagus or mouth, especially when lying down. 4. Imbalanced Nutrition: Less than Body Requirements related to difficulty swallowing or avoidance of food due to pain. 5. Deficient Knowledge related to the need for lifestyle modifications and medication adherence to manage GERD symptoms. 6. Risk for Impaired Skin Integrity related to acid regurgitation, potentially causing irritation of the mucosa or skin. 7. Disturbed Sleep Pattern related to nighttime reflux symptoms as evidenced by reports of difficulty sleeping or waking up due to heartburn. D. Peptic Ulcers: Sores that develop on the inner lining of the stomach, upper small intestine, or esophagus due to the erosion caused by stomach acid. This can cause burning pain, nausea, and internal bleeding. Causes: 1. Helicobacter pylori (H. pylori) infection: A bacterial infection that weakens the stomach lining. 2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Long-term use of drugs like ibuprofen or aspirin that can erode the stomach lining. 3. Excessive stomach acid: Often due to conditions like Zollinger-Ellison syndrome or stress. 4. Smoking: Increases stomach acid and slows healing. 5. Alcohol consumption: Irritates and erodes the stomach lining.  Diagnosis 1. Medical History and Symptom Assessment: The doctor will ask about symptoms such as burning stomach pain, nausea, and food-related discomfort. 2. Endoscopy: A flexible tube with a camera is inserted through the mouth to examine the stomach lining and detect ulcers. A biopsy may be taken to test for H. pylori infection or rule out cancer. 3. H. pylori Testing: This can be done through blood tests, breath tests, stool tests, or biopsy during endoscopy to detect Helicobacter pylori infection. 4. Upper GI Series (Barium X-ray): The patient swallows a barium solution, and X-rays are taken to identify ulcers or other abnormalities in the stomach and duodenum.  Nursing diagnosis Acute Pain related to mucosal irritation. Imbalanced Nutrition: Less than Body Requirements related to pain with eating. Risk for Deficient Fluid Volume related to potential bleeding. Anxiety related to fear of complications. Knowledge Deficit regarding ulcer management. Risk for Ineffective Coping related to chronic pain. E. Gallstones: Solid particles that form in the gallbladder, leading to blockages in the bile ducts and causing sharp pain, nausea, and even infection. F. Celiac Disease: An autoimmune disorder where ingesting gluten damages the small intestine, leading to malabsorption, weight loss, and fatigue. G. Diverticulitis: is inflammation of irregular bulging pouches in the wall of the large intestine. This leads to pain, fever, and digestive disturbances. H. Hepatitis: Inflammation of the liver caused by viruses, alcohol use, or other factors. This can lead to liver damage, jaundice, and chronic liver disease. Complication of GIT Disease 1. Gastrointestinal Bleeding: Can occur in conditions like ulcers or inflammatory bowel disease. 2. Perforation: A hole in the gastrointestinal tract, leading to peritonitis, often seen in severe ulcers or diverticulitis. 3. Obstruction: Blockage of the intestines, which can result from tumors, strictures, or adhesions. 4. Malnutrition: Due to poor absorption of nutrients in conditions like celiac disease or Crohn's disease. 5. Dehydration: Resulting from diarrhea or vomiting associated with many digestive disorders. 6. Sepsis: A serious infection that can occur if bacteria enter the bloodstream due to perforation or severe inflammation. 7. Fistulas: Abnormal connections between organs, often seen in severe inflammatory conditions. Nursing interventions for GIT diseases include: Monitoring: Vital signs, abdominal assessment, fluid/electrolyte balance. Symptom Management: Pain relief, antiemetic for nausea/vomiting, antidiarrheal or laxatives as needed. Nutritional Support: Diet modifications, hydration, enteral or parenteral nutrition. Infection Control: Hand hygiene, isolation for infectious cases. Patient Education: Medication adherence, lifestyle changes (diet, avoiding irritants), recognizing warning signs. Psychosocial Support: Emotional support for chronic conditions.