NUR 301 - Week 11 - Gastrointestinal and Hepatobiliary(1)

Gastrointestinal & Hepatobiliary Nursing Care

• Course: NUR 301: Adult & Older Adult Health

Objectives

• Apply knowledge of pathophysiology for evidence-based assessment of patients with gastrointestinal and hepatobiliary abnormalities.

• Discuss diagnostic tests and therapies related to gastrointestinal and hepatobiliary systems.

• Apply nursing interventions for gastrointestinal and hepatobiliary diseases and diagnoses.

• Identify lifestyle modifications to reduce risks of complications and demonstrate patient/family teaching.

Anatomy & Pathophysiology Review

• Overview of gastrointestinal system structure: mouth, esophagus, liver, stomach, gallbladder, pancreas, large and small intestines, anus.

GI/Hepatobiliary Assessment

• Assessment questions:

  • Current symptoms

  • Pain evaluation

  • Bowel/elimination patterns

  • Family history

• Techniques:

  • Auscultation

  • Palpation (checking for tenderness/rebound tenderness)

  • Inspection

GI/Hepatobiliary Diagnostics

• Laboratory Tests:

  • WBC count, CMP (includes liver function tests), fecal occult and stool testing.

• Radiology:

  • CT scans, GI series (barium swallow/enema).

• Endoscopy Procedures:

  • Colonoscopy, EGD, ERCP, capsule endoscopy.

GI/Hepatobiliary Diseases

• Gastrointestinal Diseases:

  • Gastroesophageal Reflux Disease (GERD)

  • Gastritis

  • Irritable Bowel Syndrome (IBS)

  • Gastrointestinal Obstruction

  • Diverticulitis

  • Appendicitis

• Hepatobiliary Diseases:

  • Hepatitis

  • Cirrhosis

  • Pancreatitis

Gastroesophageal Reflux Disease (GERD)

• Assessment Findings:

  • Dyspepsia, radiating pain, pyrosis, throat irritation, burping, wheezing.

• Diagnostics/Treatments:

  • EGD, esophageal pH monitoring, swallow studies.

  • Medications: PPIs

  • PPIs, antacids, histamine receptor agonists.

• Nursing Care:

  • Assessments, vital signs, medication teaching, dietary education.

• Complications:

  • Aspiration pneumonia, esophageal complications, Barrett's esophagus, esophageal cancer.

Gastritis

• Assessment Findings:

  • Dyspepsia, abdominal pain, hematemesis, black tarry stools.

• Lab Findings/Treatments:

  • CBC, H. Pylori testing, medications (PPIs, antibiotics).

• Nursing Care:

  • Monitor for anemia, dietary modifications, medication teaching.

• Complications:

  • GI bleeding, gastric outlet obstruction.

Gastrointestinal Obstruction

• Assessment Findings:

  • Obstipation, high-pitched bowel sounds, abdominal distention, nausea.

• Lab Findings/Treatments:

  • Imaging (CT, X-ray), NG tube insertion, potential surgery.

• Nursing Care:

  • Assessments, IV fluids, NPO status, oral care.

• Complications:

  • Electolyte imbalances, tissue necrosis.

Irritable Bowel Syndrome (IBS)

• Assessment Findings:

  • Abdominal pain, bloating, diarrhea/constipation.

• Lab Findings/Treatments:

  • Typically normal lab tests, hydrogen breath testing.

• Nursing Care:

  • Encourage hydration, low FODMAP diet.

• Complications:

  • Social isolation, anxiety.

Diverticulitis

• Assessment Findings:

  • Acute LLQ pain, fever, abdominal distention.

• Lab Findings/Treatments:

  • WBC count increase, imaging studies, antimicrobials.

• Nursing Care:

  • GI rest, increase fluid intake.

• Complications:

  • Perforation, peritonitis.

Appendicitis

• Assessment Findings:

  • Periumbilical pain, rebound tenderness, nausea.

• Lab Findings/Treatments:

  • WBC increase, CT scan.

• Nursing Care:

  • NPO status, perioperative care.

• Complications:

  • Perforation, sepsis.

Hepatitis

• Types A, B, C, D, E:

  • Transmission via fecal-oral route (A, E) or through blood/body fluids (B, C, D).

• Assessment Findings:

  • Jaundice, dark urine, abdominal pain.

• Lab Findings/Treatments:

  • LFTs, antibody testing, supportive care.

• Complications:

  • Chronic hepatitis, liver failure.

Cirrhosis

• Assessment Findings:

  • Fatigue, jaundice, ascites, confusion.

• Lab Findings/Treatments:

  • LFTs, imaging studies, potential liver biopsy.

• Nursing Care:

  • Monitor fluid balance, dietary modifications, pain management.

• Complications:

  • Hepatic encephalopathy, bleeding.

Pancreatitis

• Assessment Findings:

  • Severe epigastric pain, jaundice, N/V.

• Lab Findings/Treatments:

  • Amylase increase, imaging (CT), opioid analgesics.

• Nursing Care:

  • NPO status, hydration status monitoring, lifestyle modifications.

• Complications:

  • Hypovolemia, multisystem organ failure.

Summary

• Utilize pathophysiology understanding for patient assessment.

• Discuss relevant diagnostic tests and therapies.

• Apply effective nursing interventions tailored to disease processes.

• Identify necessary lifestyle changes to minimize complications.