ASSESSMENT OF THE GASTROINTESTINAL SYSTEM

HEALTH HISTORY/ HISTORY TAKING

- A focused GI assessment begins with a complete history. Information about abdominal

pain, dyspepsia, gas, nausea and vomiting, diarrhea, constipation, fecal incontinence,
jaundice, and previous GI disease is obtained (Weber & Kelley, 2014).

COMMON SYMPTOMS

1. PAIN
2. DYSPEPSIA
3. INTESTINAL GAS
4. NAUSEA AND VOMITING

Nausea

- Is an unpleasant feeling of needing to vomit. People also may feel dizziness, vague
discomfort in the abdomen, and an unwillingness to eat.

Vomiting

- A forceful contraction of the stomach that propels its contents up the esophagus and out
the mouth.
- Severe vomiting can project stomach contents many feet (projectile vomiting).

Vomitus

- the material that is vomited up—usually reflects what was recently eaten. Sometimes it
contains chunks of food.

 Red- blood; hematemesis

 Yellow-green- bile

CAUSES

The most common causes of nausea and vomiting are

  Gastroenteritis (infection of the digestive tract)
 Drugs
 Toxins
 Eating disorders
 Lifestyle Choices

Nausea

The most common causes of nausea are intense pain — usually from an injury or illness — and
the first trimester of pregnancy. There are also several other relatively common causes,
including:

 motion sickness
 emotional stress
 indigestion
 food poisoning
 viruses
 exposure to chemical toxins

Vomiting in children

 severe motion sickness

 coughing
 high fevers
 overeating

Vomiting in adults

 Bacterial or viral infection

 Food poisoning

Chronic stomach conditions

 Diarrhea
 Constipation
 Stomach pain
 Celiac Disease
 Lactose intolerance
Warning signs

 Signs of dehydration (such as thirst, dry mouth, little or no urine output, and feeling weak
and tired)
 Headache, stiff neck, confusion, or decreased alertness
 Constant abdominal pain
 Tenderness when the abdomen is touched
 Distended (swollen) abdomen

DIAGNOSTIC TOOLS

 Physical Examination
 Pregnancy Test
 Blood and urine tests

TREATMENT/PREVENTION

Self-treatment for nausea

 Consume only light, plain foods, such as bread and crackers.

 Avoid any foods that have strong flavors, are very sweet, or are greasy or fried.
 Drink cold liquids.
 Avoid any activity after eating.

Self-treatment for vomiting

 Eat smaller, more frequent meals.

 Drink a large amount of clear fluids to remain hydrated, but consume it in small sips at a
time.
 Avoid solid foods of any kind until vomiting stops.
 Rest.
 Avoid using medications that may upset your stomach, such as nonsteroidal anti-
inflammatory drugs or corticosteroids.
 Use an oral rehydration solution to replace lost electrolytes.

MEDICAL CARE

- Conducting tests to confirm

- Medications
1. For vomiting caused by motion sickness: Antihistamines (such
as dimenhydrinate), scopolamine patches, or both
2. For mild to moderate symptoms: Prochlorperazine, promethazine, or metoclopramide
3. For severe vomiting (including vomiting caused by
chemotherapy): Dolasetron, ondansetron, or granisetron, or sometimes aprepitant

NURSING MANAGEMENT

- Nurse in a safe position to protect the airway and remove dentures

- Use appropriate infection control measures
- Maintain adequate ventilation and comfortable environmental temperature
- Observe for signs of dehydration
- Restrict or provide oral fluids and diet, as instructed
- Maintain an accurate fluid balance chart; measure and assess vomit
- Assist with mouth care and personal hygiene (change of clothes etc)
- Use appropriate infection control measures
- Administer antiemetics as prescribed, evaluate effectiveness and monitor for side-effects
- Provide vomit bowls and tissues, and replace promptly when used
- Administer intravenous fluid and electrolytes, as prescribed
- Maintain privacy and dignity and provide physical comfort. Hold vomit bowl and wipe
mouth
- Assist with the avoidance of food smells and strong odors

5. CHANGE IN BOWEL HABITS AND STOOL CHARACTERISTICS

PAST HEALTH, FAMILY, AND SOCIAL HISTORY

PHYSICAL ASSESSMENT