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Nutritional- Metabolic Patterns / Responses to Altered Nutrition
( ASYNCHRONOUS ASSIGNMENT)

1. Disturbances in Ingestion
 Gastroesophageal Reflux(GERD)
 Hiatal Hernia
 Achalasia
  
2.Disturbances in Digestion
 Nausea and Vomiting
 Gastrointestinal bleeding
 Gastritis
 Peptic Ulcer Disease
 
Common
GIT
Disorders Liver Cirrhosis
Liver Cancer
Stomatitis

Hepatitis

Esophageal
Cancer GERD
Hiatal Hernia
Cholecystitis
Cholelithiasis
Gastric Cancer

Crohn’s Gastritis
Disease
Peritonitis
Appendicitis Pancreatitis Peptic Ulcer
Pancreatic
Cancer

Inguinal Hernia Ulcerative Diverticulitis Irritable Hirschsprung’s

Hemorrhoids Colitis Bowel Disease
Syndrome
Crohn’s Disease (Regional Enteritis)
Crohn’s Disease

 Small bowel
 Ileum and ascending colon
 With perianal involvment
 May have fistulas
 Colicky RLQ pain
 Pain after eating
 (+) Steatorrhea
Ulcerative Colitis
Ulcerative colitis

 Large bowel
 Lower colon and rectum
 Classical sign: bloody purulent diarrhea – 20-30 stools/day
 Tenesmus
 Hyperactive BS
 Pain - predefecation
Management

 High CHON, Calories; low fat/ fiber

 TPN

Complications:
 K and Na deficit
Diverticulitis
Diverticulitis

 Risk factors: low fiber diet, chronic constipation, obesity  increased

intraluminal pressure
 Sigmoid colon
 S/Sx:
 LLQ abdominal cramps
 Irregular BM – alternating
 Low grade fever, leukocytosis
 Dx: Sigmoidoscopy, Barium enema ( C/I to pt with ACUTE cases)
 High fiber diet, NO LARGE seeds or nuts
 Stool softeners
 Low residue diet
 Antibiotics
 DOC: Metamucil
 Nsg alert: facilitate normal BM
 • Due to stress and
irritants
• R/t sensitivity to
motor activity and
distention
• CRAMPY LOWER
ABDOMINAL PAIN
• Relieved by
defecation
• Pain increases 1-2
Irritable Bowel hrs after meal
• Alternating C & D
Syndrome
Hirschsprung’s Disease
HIRSCHSPRUNG’S DISEASE
(Aganglionic Megacolon)
• Absence of ganglionic innervation to the muscle of a section of
the bowel – lower portion of the sigmoid colon just above the
anus.
Assessment:
• Chronic constipationor Ribbon-like stools
• Abdominal distention, poor feeding habits
Diagnostic:
1. Digital Examination: (+) hard, caked stool
2. Barium Enema: narrow, nerveless, distended bowel
3. Biopsy: lack of innervation
4. Anorectal manometry: decreased pressure in the sphincter
HEMORRHOIDS

• Vascular masses in
lower rectum or anus
• Visible/palpable
• Constipation
• Itching
• BRIGHT RED blood in
the stool
• Dx: Barium enema,
sigmoidoscopy
• Tx: sitz bath, stool
softener
• High fiber diet
• Surgery
Strangulated or incarcerated
 • Sudden, severe and
diffuse abdominal pain
• RIGID abdomen
• Rebound tenderness
• NPO
• Massive antibiotics
• Ex-lap

Peritonitis
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Nutritional – Metabolic Patterns/ Responses to Altered Endocrine Functions

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PTV
1. Hyperfunction

2. Hypofunction

 Thyroid gland

 Parathyroids

 Adrenal glands

 Pituitary Glands

 Pancreas- Diabetes Mellitus

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