Nursing GI and Renal Disorders: Diagnostics, Care, and Complications

Fecal Occult Blood Test (FOBT) Foods to Avoid

Red meats, radish, beets, mushrooms, broccoli, cauliflower, apples, bananas, cantaloupe, and melons

Barium Swallow

An upper GI X-ray examination that visualizes the esophagus and upper tract using swallowed barium contrast

Barium Enema

A lower GI X-ray examination where a barium contrast mixture is administered via the rectum to outline the colon

Esophagogastroduodenoscopy (EGD)

An endoscopic procedure to view the esophagus, stomach, and duodenum; requires informed consent, NPO status, and a post-procedure gag reflex check

Endoscopic Retrograde Cholangiopancreatography (ERCP)

An endoscopic procedure passed through the mouth to visualize and treat conditions within the bile ducts and pancreatic ducts

Colonoscopy

A visual examination of the entire large intestine; requires a 24-hour clear liquid diet with laxatives/enemas, and positioning on the left side

Liver Biopsy

The excision of a small piece of liver tissue via needle aspiration; highly critical to monitor for post-procedure hemorrhage and bleeding

Gastric Ulcer Pain Pattern

Pain occurring when fasting or 1/2 to 1 hour after eating (PC), which is typically relieved by vomiting; most common in individuals 50 years and older

Duodenal Ulcer Pain Pattern

Pain occurring 2 to 3 hours after eating (PC), frequently causing early morning awakening, and is relieved by food; most common in individuals 30 to 60 years old

Gastrointestinal Ulcer Medications

Antibiotics (for H. pylori), antacids, H2 blockers, proton pump inhibitors (PPIs), and mucosal healing agents

Gastrectomy Complications

Surgical removals of stomach tissue (like Vagotomy, Billroth I, Billroth II) that put the patient at high risk for B12 Deficiency Anemia

Dumping Syndrome Symptoms

Weakness, dizziness, vertigo, diaphoresis, tachycardia, abdominal cramping, and epigastric fullness occurring 15-30 minutes after eating

Dumping Syndrome Dietary Management

Eat small frequent meals, consume no fluids with meals, and strictly avoid high-carbohydrate foods like bread and potatoes

Mechanical Bowel Obstruction Causes

Physical barriers blocking intestinal flow including hernias, tumors, strictures, adhesions, intussusception, and volvulus

Non-mechanical Bowel Obstruction Causes

Functional obstructions due to neurogenic or vascular issues, such as paralytic ileus, spinal injuries, and mesenteric artery occlusion

Intussusception

A mechanical obstruction cause where a portion of the bowel invaginates or slips inside an adjacent part (telescoping)

Volvulus

A mechanical obstruction cause characterized by the physical twisting of a loop of bowel pathologically obstructing flow

Bowel Obstruction Clinical Signs

Abdominal pain, abdominal distension, nausea and vomiting, and significant alterations or absence of bowel sounds

Bowel Obstruction Management

Keeping the patient NPO, providing IV fluid hydration, inserting an NG tube connected to suction, and preparing for surgical intervention if necessary

Crohn's Disease Characteristics

An inflammatory bowel disease known as "Regional Enteritis" featuring right lower quadrant (RLQ) pain, a "cobblestone" intestinal appearance, and patterns of remission and exacerbations

Ulcerative Colitis Characteristics

An inflammatory bowel disease of unknown etiology primarily characterized by left lower quadrant (LLQ) pain and bloody diarrhea

Inflammatory Bowel Disease (IBD) Management

Bowel rest (NPO status), IV fluids/electrolytes, parenteral nutrition, low-residue/high-protein/high-calorie/low-fat diet, and ostomy care

Colostomy Care Assessment Focus

Evaluating the stoma color/integrity, monitoring drainage amount, identifying the character of the stool, and addressing body image issues

Normal Urine Color & Clarity

Straw-colored yellow and clear with no presence of sediments

Normal Urine pH Range

A normal physiological range between 5 and 8

Normal Urine Specific Gravity

A concentration range between 1.010 and 1.030

Normal Urinalysis Chemical Screen

Negative results for blood, protein, glucose, leukesterase, and nitrites

Mammogram Patient Preparation

Typically indicated starting at 40 years old; patients must not apply creams, lotions, powders, or deodorants to the underarms or breasts on the test day

Creatinine Clearance Test Components

Recording patient height and weight for BMI, a venous blood draw, and a complete 24-hour urine collection performed at home

Intravenous Pyelography (IVP)

A diagnostic urinary tract X-ray procedure performed after injecting an intravenous contrast dye to visualize the kidneys, renal pelvis, ureters, and bladder

Cystoscopy

An invasive diagnostic and therapeutic procedure to view the bladder; requires informed consent, NPO status as ordered, and strict post-procedure I&O checks

Pyelonephritis

An upper urinary tract infection specifically localizing in and affecting the kidneys

Ureteritis

An infection localized within the ureters

Cystitis

A lower urinary tract infection specifically localized inside the urinary bladder

Urethritis

An infection localized inside the urethra

Prerenal Failure Cause

Acute kidney injury triggered by a sudden decrease in renal tissue perfusion or blood flow to the kidneys

Intrarenal Failure Cause

Acute kidney injury triggered by direct damage to the kidney tissue, often due to toxic substances or nephrotoxic medications

Postrenal Failure Cause

Acute kidney injury triggered by a mechanical obstruction of urine outflow downstream from the kidneys

RIFLE Classification

A classification system used to grade Acute Kidney Injury severity using GFR and Urinary Output criteria: Risk, Injury, Failure, Loss, and End-Stage Kidney Disease (ESKD)

Renal Failure Conservative Management

Implementing specific dietary changes, avoiding all known nephrotoxic substances, and managing fluid balance

Peritoneal Dialysis Phases

Infusion / Instillation Phase (fluid enters), Dwell Phase (fluid stays in abdomen), and Drain Phase (fluid exits with wastes)

Peritoneal Dialysis Nursing Assessments

Monitoring strict Intake and Output (I&O), recording daily weights, measuring abdominal girth, and assessing for site infections or peritonitis

Peritoneal Dialysis Complications

Peritonitis, bowel perforation, hyperglycemia (due to glucose in dialysate), protein loss, and constipation (which impedes fluid drainage)

Hemodialysis Access Types

Subclavian catheter, Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and temporary dialysis catheters

Hemodialysis Access Arm Precautions

Strictly no blood pressures, no venipunctures/blood draws, and no restrictive clothing or heavy lifting on the extremity with the dialysis access

Hemodialysis Care Priorities

Keep a tourniquet at the bedside, hold blood pressure medications prior to the procedure, and continuously monitor for Disequilibrium Syndrome

Disequilibrium Syndrome

A serious neurological complication of hemodialysis caused by rapid shifts of solutes and fluids, requiring immediate assessment for headache, mental status changes, and seizures