abdominal assessment inspection
jaundice
distended (fluid, stool, air)
scars on abdomen
drains, ostomy
what kind of sedation do patients get for sigmoidoscopy
no sedation
colostomy vs ileostomy
colostomy - formed stool
ileostomy - liquid stool (skin care is important)
what organ has a big effect on the gi tract
pancreas
upper gi
esophagus, stomach, small intestine
propofol
watch respirations, bp
what labs are important with GI system
liver function tests
urine bilirubin
fecal occult blood test, stool samples
for fecal occult blood test, med restrictions 7 days prior include
anticoags, NSAIDS, vit c rich foods, red meat chicken and fish
what kind of sedations do patients get for endoscopy
conscious sedation
endoscopies become routine after age
50 and 40y/o with high risk or family history
complications of scopes
oversedation, poor respiratory, abnormal bp
what happens when a pt has a perforated gi tract
high risk for infection because of bacteria leaving and going into the body where it shouldnt be
contributing factors to GERD
fatty/fried foods, chocolate, caffeine, alcohol, peppermint, spicy food, tomato, citrus
sx of GERD
burping, pyrosis that goes away with sips of water, pain that worsens when laying flat, tooth erosion, pain after eating and lasts 20 min to 2 hrs
meds for GERD
omeprazole, pantoprazole, esomeprazole, lansoprazole
aluminum hydroxide, magnesium hydroxide, calcium carb, sodium bicarb
nursing considerations for GERD
monitor electrolytes, long term use of PPIs places them at risk for fractures
how much time should be between histamine2 and antacid
at least 1 hr
histamine2 meds
ranitidine, famotidine, aizatidine
nursing considerations for famotidine
take one hr before meals
esophageal varices
usually linked to alcohol (cirrhosis of liver causes congestion causing veins to surface)
alcohol
natural blood thinner
sx of esophageal varices
may be no sx until varices begin to bleed, but hematemesis maybe coffee ground appearance, melena stools (bloody stool), mental status change
why does mental status change occur with blood loss
because most blood goes to heart and brain so if brain isnt getting enough, theyre going to feel like theyre going to pass out
things that precipitate bleeding
bearing down, lifting heavy objects, coughing/sneezing, alcohol consumption
nursing interventions for esophageal varices
get IV access with large needle, vital signs, hct and hgb, get blood type for possible blood transfusions, monitor stool for blood
what is peptic ulcer disease caused by
infection from h. pylori
what med promotes ulcers in the gi tract
steroids
usually when prescribed, they will also get a gi protector to go along with it
peptic ulcer H2 receptor meds
ranitidine, famotidine
pernicious anemia
body cant absor vit b12
acute and chronic gastritis causes
autoimmune disease or bacterial infection
nursing care for gastritis
i&o, electrolytes, small frequent meals, avoid irritants (alcohol, caffeine), reduce stress
nonmechanical cause of obstruction
ileus - gi tract just stops functioning - maybe nc of anesthesia