Download Assessment of a patient with a GI disorder

Assessment of a patient with a
GI disorder
By
Gabie Gomez
Assessment (subjective)
• Past history: smoking, alcohol use,
medication abuse, recent travel, food intake.
• Pain (oral, tongue,throat, abdominal)
• Appetite
• Pyrosis
• Dysphagia
• Dyspepsia (nausea, eructation, distention)
• Weakness
• Diarrhea or Constipation
Assessment (objective)
• Vitals signs
• Feel for hard spots/distention(palpitate 4
quadrants)
• Skin color
• Edema
• Abdomen distention
• Wheezing
• Weight Loss
• Stool color, consistency, presence of ascites,
frequency, blood, and last BM
• Hematemesis
Outcomes/Planning
• Relief pain and discomfort
• Stabilization of fluid and electrolyte
imbalance
• Having no complications
• Resume normal activity
• If possible return to normal pancreatic and
liver function
• Patient will feel rested and assist in ADL’s.
Implementation
• Assessment
• Monitor nutritional status
• Administer medication
• Relieving pain
• Managing fluid and electrolyte imbalance
• Prevent wound infections
• Eliminate smoking, and excessive alcohol
abuse
• Promote normal bowel elimination
• Stoma care
Meds
• Antacids ( maalox, mylanta, titrialac)
Action: Neutralizes gastric acid.
Side Effects: Constipation, chalky taste,
diarrhea, increased thirst, stomach cramps
Nursing Implication: Monitor electrolyte with
long tem use
Intervention: Do not take antacids if you have
signs of appendicitis or an inflamed bowel.
Meds
• Antiemtic: (Dramamine, Compazine,
Promethazine,Reglan)
Action: Blocks central vomiting center.
Side Effects: Drowsiness, dry mouth, constipation
Nursing Implication: Avoid the use with other CNS
depressants and alcohol.
Intervention: They may may produce hypotension
when used with antihypertensives, nitrates, or acute
ingestion of alcohol.
Meds
• H2 receptor blockers (Zantac, Pepcid, axid,
Tagamet)
Action: decrease acid by blockingthe production of
gastric acid, used to heal ulcers and relieve the
symptoms of pain
Side Effects: confusion, headache, constipation,
diarrhea.
Nursing Implications: Increases serum levels, effects
anticoagulants
Interventions: Do not give histamine receptor
antagonist within 2 hours of antiacids.
Meds
• Antibacterial therapy (Flagyl, tetracycline,
biaxin, prilosec)
Action: kills or prevents the growth of certain
bacteria and protozoa (single cell animals).
Side Effects:clumsiness, dizziness, or unsteadiness
fever or chills, sore throat, numbness, tingling, pain
or weakness in the hands or feet, seizures
(convulsions) skin rash, itching
Nursing Implications: Smoking should be eliminated
Interventions:Dietary modifications are necessary,
foods and beverages irritating to the pt. should be
avoided .
Meds
• Proton pump inhibitor: ( Zantac, Pepcic,
Nexium)
Action: antisecretory agent that inhibits secretion of
gastrin by the parietal cell of the stomach.
Side effects: Headache, dizziness, abdominal pain,
nausea, vomiting, bone marrow suppression(rare).
Nursing Implications: Inhibits hepatic metabolism of
warfarin, phenytonin and other drugs.
Interventions: Do not chew or crush capsule contents
Meds
• Mucosal healing agents (Carafete)
Action: Heals ulcers without antisecretory
properties, possibly by adhering to the proteins in
the ulcer base.
Side effects: Constipation, hypophosphatemia
Nursing Implication: Take Carafate 2 a other drugs
can interfere with absorption.
Intervention:If Carafate is taken with certain other
drugs, the effects of either could be increased,
decreased, or altered.
Meds
• Antisecretory and cytoprotective: (Cytotec)
Action: prostaglandin (hormone-like substance),
reduces the production of stomach acid and
protects the stomach lining against NSAID
induced ulcers.
Side effects:Constipation, gas, indigestion,
headache, heavy menstrual bleeding, cramps,
paleness, stomach or intestinal bleeding, vomiting
Nursing Implications: Avoid with the use of alcohol or
sedatives
Interventions: To reduce the risk of diarrhea, take
Cytotec with food and avoid taking it with a
magnesium-containing antacid
THE END
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