Focus guide exam 3
Gastrointestinal System
Disorders & Conditions
Celiac disease – diet
Foods to Avoid
Grains with gluten: Wheat, rye, barley, farina, graham flour, semolina, flour not labeled “gluten-free,” wheat starch/bran/germ, cracked wheat, hydrolyzed wheat protein, einkorn, emmer, spelt
Hidden sources of gluten: Emulsifiers, dextrin, mono- & di-glycerides, seasonings, caramel coloring, chips, processed meats (sausages), french fries, bouillon cubes, rice mixes, canned soups, sauces & dressings
Cross-contamination: Avoid foods prepared with shared utensils or cooking surfaces not confirmed gluten-free
Foods Recommended
Produce: Fruits & vegetables
Lean Protein: Chicken, turkey, beef, porkOther Proteins: Poultry, fish, seafood, beans, legumes, nuts
Dairy Products: Milk, cheese, yogurt
Safe Grains (gluten-free): Rice, millet, corn, chia, quinoa, chickpeas, pure wheatgrass/barley grass (must be pure & uncontaminated), amaranth, arrowroot, buckwheat, cassava, flax, soy, tapioca, oats (labeled gluten-free)
Beverages: Liquor (distilled), wine, hard ciders (check labels)
Cleft lip or palate – feeding method
The child will have to wear an elbow restraint to prevent scratching
Will be given special syringe or bottle until surgery is performed
Prevent child from crying/sucking (special bottle)
Fed with Medicine droppers
Dr. may apply bow to the upper lip to prevent injury
Cleft Palate: Special bottles/nipples like the Haberman Feeder or Pigeon Palate Nurser are recommended.
Chrons Disease- manifestations
S&S: RLQ abdominal pain & cramping, diarrhea (5 loose stools/day with mucus or pus), anorexia & weight loss, firm abdomen, steatorrhea (fatty stool), fever
The ulcerations are deep longitudinal in a cobblestone appearance and can leak the bowel contents to enter the peritoneal cavity
Protein loss is present
GERD – complications
Barrett’s Esophagus
Pre-malignant cells develop due to chronic reflux, leading to esophagitis
Prevention:
Teach pts how to reduce reflux (Ex. Bland diet, avoid spicy/fried foods)
Educate on the importance of managing GERD to prevent progression
GERD – lifestyle modifications
Do not eat foods that are offensive (no spicy or fried)
Don’t eat bigger meals
Sit up after eating
Avoid tight clothing
Lose weight (Overweight)
Elevating the bed on blocks (6-8 in)
Prevents reflux
Post op – nursing interventions – priority non-emergent (GERD)
Patient Education Post-Surgery
Assess cough and gag reflex first
DO NOT Eat: Offensive foods (spicy or fried) & bigger meals
Types of food: Fatty, dry, citrus
Drinks: Coffee, alcohol
Tomatoes, peppermint, chocolate
Prevent aspiration/reflux: Semi-Fowlers & elevating the bed on blocks (6-8 in)
Pts/clients that had a CVA (had a stroke) & a Hx of GERD are at HIGHER risk for aspiration
Risk Factors: Obesity, Older age (delayed gastric emptying & weakness LES tone), Sleep apnea, NG tube, NSAIDs
Barium Swallow: Look for problems in the GI tract
Hiatal hernia – symptom control
Instruct client to wear loose clothing
Eating smaller, more frequent meals and avoiding lying down after eating.
Antacids
PPI’s
Avoid heavy lifting
Avoid straining
Increase fiber, water intake
Hirschsprung’s disease – stool
Stools will become ribbon-like
Explosive stools
Severe constipation, even after OTC treatments
Can lead to intestinal obstruction, infection, or shock if untreated
Infectious = enterocolitis → fever, explosive diarrhea, weakness
Intussusception – manifestations
Happens after an infection
Cause: Internal bleeding & peritonitis (infection of abdominal lining)
S/S Starts: When pain begins
Most Common S/S: Onset of intermediate pain in a previously healthy child
Mistaken for colic (baby pulls knees to chest, cries loudly, acts very irritable)
PUD – causes
Helicobacter pylori (H. pylori) bacterial infection - most common
Use of NSAIDs (aspirin, ibuprofen)
Zollinger-Ellison syndrome (excessive acid secretion)
Smoking and alcohol
Physiologic stress from severe burns, trauma, or CNS injuries overstimulating acid production.
Hypersecretory disorders like mastocytosis or Zollinger-Ellison syndrome cause acid overproduction.
While H. pylori infection and NSAID use are the principal causative factors, other contributors include diet, genetic factors, and comorbidities impairing mucosal defenses.
PUD – risk factors
Risk Factors: NSAIDs, H. Pylori, Bile reflux
UC – manifestations
UC – stool
Assessment & Findings
Pyloric stenosis – assessment finding
Thyroid assessment
Medications & Treatments
H. Pylori – medications for treatment
Sucralfate
Sucralfate and antacids
Procedures & Nursing Interventions
EGD – post-procedure nursing implementation
NPO for 12 hours
bite block