GI/Billary

Abdominal Paracentesis (nursing actions)

Empty bladder prior to procedure

Position high fowlers

Monitor vitals and output

Assess for signs hypovolemia

Abdominal surgery (s/s of post-op complications)

Fever

Increased WBC

Redness/swelling at incision

Puralent drainage

Absent bowl sounds

Abdominal distension

Pain

Acute Gastritis (discharge teaching, consume a glucose- electrolyte solution, priority data findings)

Avoid NSAIDs/ alcohol

Clear liquids then advance as tolerated

Glucose/ Electrolyte solution may be used for dehydration

Monitor for hematemesis (vomiting of blood) and melena (black tarry stool)

Alcohol Use Disorder/ Cirrhosis- S/S

Nosebleeds, petechiae, jaundice, ascites (abdominal build up of fluid, spider angiomas, gynecomastia (swollen male breast)

Areas of body to monitor for Jaundice

Sclera of eyes, mucus membranes, and skin

Cholelithiasis w/ inflammation and obstruction (expected findings on assessment)

RUQ pain (radiates to shoulder)

Nausea and vomiting

Murphys sign

Clay colored stool

Dark urine

Jaundice

Chronic Cholecystitis/ Billary Colic (type of diet)

Low fat diet

Avoid fried and fatty foods

Avoid gas forming foods

Chronic ulcerative disease and anemia

Due to GI bleeding

Monitor for fatigue, pallor, low H&H

Colectomy w/ colostomy placement (priority findings to report to provider)

Report: purplish dusky stoma (indicates poor perfusion)

Teaching: clean stoma w/ mild soap and water

Change appliance and monitor output

Correct way to insert NG tube

High fowlers position

Measure tube from ear to tip of nose then lubricate

Insert w/ swallowing water

Confirm placement ( X-ray or aspirate pH)

Crohn’s Disease (definition)

Autoimmune, inflammatory bowel disease affecting any Gi segment, often terminal

Diverticular Disease (where to expect abdominal pain)

LLQ abdominal pain

Diverticulitis (what foods to recommend, type of diet to help prevent)

Acute: clear liquids & low fiber

Prevention: high fiber, avoid seeds/nuts of advised

Gallstones (what causes the problem)

Cholesterol stones or bile pigment imbalance

Higher risk: 4 F’s (female/fat/fertile/ forty)

Gastric Ulcer (sign of perforation into peritoneal space)

Sudden severe epigastric pain, rigid board-like abdomen, hypotension

GI Bleed (priority symptom to report to provider)

Report black tarry stool (melena)

Hematemesis (vomiting of blood)

Hypotension

Gastrostomy Tube w/ continuous enteral feedings (nursing interventions/care)

Elevate HOB

Check placement and residual flush before and after meds/feeds

Prevent aspiration

GERD (contributing factors, how to minimize effects during sleep, food choices to minimize GERD, foods to avoid, and patient teaching)

Contributing factors: obesity, smoking, fatty foods, caffeine

Avoid: citrus, chocolate, mint, spicy foods

Sleep: elevate HOB, don’t lie flat post meals, eat small frequent meals

Hepatitis A (mode of transmission)

Fecal oral route (contaminated foods/water)

Hepatitis B (s/s, nursing actions)

S/S: fatigue, anorexia, jaundice, RUQ pain

Actions: rest periods and teach transmission prevention

Hepatitis C (risk factors for contributing)

IV drug use

Blood transfusions pre- 1992

Unprotected sex

Hiatal Hernia (dietary recommendations and patient teaching)

Small frequent meals

Avoid reclining after eating

Low fat

No caffeine or alcohol

Ileostomy post-op teaching

Output is liquid

Risk for dehydration

Skin care essential

Avoid foods that cause blockage

Interventions for patients w/ continuous GI decompression using an NG tube

Verify tube placement

Keep suction at prescribed level

Monitor for electrolyte imbalance

Laparoscopic Cholecystectomy (post-op nursing actions)

Monitor for shoulder pain (CO2 used)

Early ambulation

Wound care

Advanced diet as tolerated

Liver Cirrhosis w/ ascites (s/s, nursing interventions)

S/S: abdominal distention, weight gain, dyspnea, decreased urine output

Interventions: low sodium diet, diuretics, measure girth, paracentesis (fluid is removed from the abdominal cavity)

Pancreatitis (risk factors)

Alcohol use

Gallstones

Trauma

Meds (thiazides)

High triglycerides (high level of fat in the blood)

Patient teaching for patient w/ T-Tube

Drainage should be green

Bile

Empty and record output

Clamp before meals (if ordered)

Report s/s

Patient with C-Diff (nursing actions)

Contact precautions

Hand hygiene (soap and water)

Disinfect surfaces

Monitor for dehydration

Peptic ulcer disease

Pain: burning epigastric, often with empty stomach

Signs of perforation: sudden/ severe pain

Cause: H.pylori, chronic NSAID use, use of corticosteroids

TX: PPI, antibiotics

Risks: smoking/alcohol, stress

Post-op GI patient ( nursing actions for abdominal distention and flatus)

Encourage ambulation

NPO until flatus present

Assess bowl sounds

Priority finding in patient with new pouch ileostomy

Report no output (obstruction)

Black/dusky stoma

Dehydration symptoms

Small bowel obstruction (nursing care)

NPO

NG decompression

Monitor fluids/electrolytes

Prepare for surgery if needed

Total gastrectomy (teaching regarding pernicious anemia, what supplements to take)

Requires lifelong B12 injections or high dosed oral supplements for pernicious anemia

Ulcerative colitis (definition, treatment)

Inflammatory bowel disease affecting rectum

TX: inflammatories, immunosuppressants, surgery if severe

Viral Hepatitis (nursing actions, preventions)

Provide rest periods, nutrition, prevent transmission

Avoid hepatotoxins (alcohol)