Professional Documents
Culture Documents
Prepared by:
John Gil B. Ricafort, RN
Objectives:
• Review of Digestive System
• Common Assessment Findings
• Common Diagnostic Tests/
Procedures
• Disturbances
1. Review of Digestive System
2. Common Assessment Findings
a. Pain
– a major symptom of GI disease
b. Indigestion
- refers to abdominal discomfort
or distress associated with eating
- most common symptom of GI
dysfunction
c. Intestinal Gas
d. Nausea and vomiting
e. Change in bowel habits
and stool characteristics
f. Jaundice
g. Pruritus
h. Increased bleeding
Common Diagnostic Tests
a. Stool Tests
b. Breath Tests
- Hydrogen Breath Test
-used to evaluate CHO
absorption and bacterial
overgrowth.
- Urea Breath Test
- detects the presence of H.
Pylori
Note: The person takes a capsule of
carbon labeled urea and then
provides breath sample 10 to 20
minutes after.
*AVOID antibiotics
*AVOID Sucralfate/ Omeprazole
*AVOID Tagamet/ Pepcid/ Zantac
c. Abdominal Ultrasonography
d. Upper GI Series (Barium
Swallow)
- it’s a fluoroscopic examination
of the upper GI tract to determine
structural problems and gastric
emptying time; Client must
swallow barium sulfate or other
contrast medium.
- sequential films taken as it moves
through the system.
f. Endoscopic studies
g. Liver Biopsy
- invasive procedure where a needle
is inserted into the liver to remove a
small piece of tissue for study.
Nursing Responsibilities: PRETEST
2. Ensure the client has signed the
consent form.
3. Keep NPO 6-8 hours pretest.
4. Instruct the client to HOLD BREATH
during the procedure.
Diagnostic Tests
Decreased Hgb and Hct
Barium enema shows narrowing with
areas of strictures
Medical Management
Diet: High Calorie, High vitamin, High
protein, Low residue, Milk free;
Supplementary iron
Pharmacologic Agent
Antimicrobials (Sulfasalazine)
Corticosteroids
Antidiarrheals
Anticholinergics
Surgery: Resection of the diseased
portion and ileostomy
Nursing Interventions
2. Provide appropriate nutrition while
reducing bowel motility.
3. Promote comfort/ rest.
4. Provide care for the client with bowel
surgery
Ulcerative Colitis
- inflammatory bowel disease
characterized by inflammation and
ulceration that starts in the
rectosigmoid area and spreads upward.
The mucosa of the bowel becomes
edematous, thickened with eventual
scar formation. The colon
consequently loses its elasticity and
absorptive capabilities.
- UNKNOWN cause
- occurs more often in women
- onset is usually 15-40 years
Clinical Manifestations
Severe diarrhea (15-20 liquid stools/
day containing mucus, blood and
pus)
Severe tenesmus
Weight loss
Anorexia
Weakness
Crampy discomfort
Decreased skin turgor
Dry mucous membrane
Low-grade fever
Abdominal tenderness
Diagnostic Tests
Decreased Hgb and Hct
Sigmoidoscopy reveals mucosa that
bleeds easily with ulcer development
Management
Mild to Moderate from
Diet: Low-roughage diet; NO milk
products
Pharmacologic Agents
Severe form
Diet: NPO with IVs and electrolyte
replacement, NG tube with suction,
Blood transfusion
Surgery
Factor CROHN’S ULCERATIVE
Course Prolonged, variable Exacerbations
Pathology
Early Transmural Mucosal
Late Deep Mucosal
Manifestation
Location Ileum, Right Colon Rectum, Left colon
Bleeding Usually not Common/severe
Fistulas Common Rare
Diarrhea Less severe Severe
Nursing Diagnoses
Types:
5. Laennec Cirrhosis
6. Postnecrotic Cirrhosis
7. Cardiac Cirrhosis
8. Biliary Cirrhosis
Clinical Manifestations
Intermittent fever
Spleenomegaly
Vascular spiders Weight loss
Abdominal pain Edema
Firm, enlarged liver Muscle wasting
Ascites Weakness
Jaundice
Epistaxis
Hypotension
Diagnostic Test:
Ultrasound
CT Scan
MRI
Laboratory Studies
Increased Liver enzyme
Medical Management
Management is based on the
presenting symptoms.
COLCHICINE
Nursing Interventions
1. Provide sufficient rest and comfort
2. Promote nutritional intake
a. encourage small frequent feeding
b. High calorie, low to moderate
protein, high carbohydrate, low-fat
diet, supplemental vitamin
3. Prevent infection
4. Monitor/ prevent bleeding
5. Administer diuretics
9. Cholelithiasis
- refers to stones in the gallbladder
Risk Factors:
Obesity
Multiple Pregnancy
Rapid weight loss
Estrogen therapy
Cystic Fibrosis
Diabetes Mellitus
Clinical Manifestation
Epigastric distress
Abdominal distention
Vague pain in the RUQ of the
abdomen
Pain and Biliary Colic
Jaundice
Vitamin Deficiency
Changes in urine and stool color
Diagnostic Findings:
Ultrasound
Abdominal X-ray
Medical Management
Nutritional and Supportive
Pharmacologic
Ursodeoxycholic Acid
Chenodeoxycholic Acid
Nonsurgical Removal of Stones
Dissolving Stones
(Methyl Tertiary Butyl Ether) MTBE
Lithotripsy
Surgical
Cholecystectomy
Nursing Interventions
2. Administer pain medications as
ordered.
3. Administer IV fluids as ordered
4. Provide small frequent meals
5. Provide care to relieve pruritus
10. Pancreatitis
- refers to inflammation of the
pancreas due to self-destruction.
- Severe abdominal pain is the
major symptom of pancreatitis
Diagnostic Finding
Based on history
Laboratory studies
Medical Management
Directed towards relieving the
symptom.
Parenteral Nutrition
Anti-ulcer drugs
Pain management (DEMEROL)
Respiratory Care