Intro to GI- lecture- student (1)

Concepts in GI Nursing

• Instructor: Brooklyn Derksen, BSN, RN, DTN, MN, ENC(C), Lecturer, University of Saskatchewan College of Nursing.

• Course: Nursing 332

Key Concepts

Elimination

• Fundamental GI function encompassing waste removal.

Nutrition

• Inherent to overall health, affecting recovery and disease management.

Fluid and Electrolyte Balance

• Essential for maintaining homeostasis within the body.

Pain

• Critical symptom influencing GI health and patient care.

Review: Anatomy and Physiology of the GI Tract

• Components:

  • Mouth, Esophagus, Stomach, Small Intestine, Large Intestine, Rectum.

  • Accessory organs: Salivary glands, Liver, Gallbladder, Pancreas.

Wall of the GI Tract

• Composed of several layers:

  • Serosa (outer layer)

  • Muscularis (muscle layers)

  • Submucosa (contains blood vessels and nerves)

  • Mucosa (inner lining)

Hepatobiliary Tree

• Components:

  • Liver, Gallbladder, Hepatic Duct, Cystic Duct, Bile Ducts, Pancreas, Duodenum.

Arterial Supply of the GI Tract

• Involves various arteries:

  • Celiac trunk, Superior Mesenteric Artery, Inferior Mesenteric Artery, etc.

• Supplies organs involved in digestion and absorption.

Overall Function of the GI Tract

• Key Functions:

  • Ingestion and propulsion of food

  • Secretion of mucous and enzymes

  • Digestion and nutrient absorption

  • Motility and elimination of waste products.

Review of GI Functions

Recognizing Cues: GI Assessment

Inspection

• Look for:

  • Distention, symmetry, bumps/bulges, discoloration/scarring.

Auscultation

• Assess bowel sounds in all quadrants.

Light Palpation

• Check for tenderness or masses, and when NOT to palpate (e.g., wounds, stomas).

Subjective Questions

• Pain, appetite changes, nausea, bowel patterns, weight changes.

Signs of Hemorrhage

• Kehr’s Sign: Pain in left shoulder.

• Cullen’s Sign: Periumbilical ecchymosis (bruising).

• Grey Turner’s Sign: Bruising to flank.

Cues: GI Diagnostics

Laboratory Tests

• CBC, Coagulation studies, Electrolytes, BUN, Serum Enzyme tests (liver panel, lipase & amylase), Helicobacter antibodies, stool samples, urinalysis.

Imaging and Other Diagnostics

• Abdominal X-ray, CT scan, MRI, Endoscopy, Colonoscopy, Ultrasonography.

Priorities in Nursing Care for GI Patients

• Focus on:

  • Pain management

  • Impaired Nutrition

  • Hypovolemia

  • Constipation/Diarrhea

  • Electrolyte Imbalances

  • Infection

Infection and Defense Mechanisms of the GI Tract

• The GI tract is not sterile but has mechanisms to ward off infections:

  • Saliva, gastric acid, mucosa (goblet cells), peristalsis, normal flora.

Peptic Ulcer Disease

• Risk Factors: NSAID use, toxic agents, infections like H. pylori, stress, and chronic diseases.

• Symptoms: Dyspepsia, pulsing pain, hematemesis, melena.

Treatment Approaches

• Medications: Antibiotics, Proton Pump Inhibitors, H2 Antagonists, Bismuth Subsalicylate, Antacids.

• Additional Instructions: Avoid alcohol and tobacco.

GI Bleeds Cues

• Occult Blood: Not visible, requires lab testing.

• Hematemesis: Bright red or "coffee grounds" (UGIB).

• Melena: Black, tarry stool (UGIB).

• Hematochezia: Bright red or maroon blood per rectum (LGIB).

Management of Acute GI Bleeds

• Remember ABCs:

  • Assess blood loss severity, resuscitate if necessary.

  • Interventions may include oxygen, IV fluids, blood transfusions, treating the underlying issue.

Obstruction in the GI Tract

• Types: Small bowel obstruction (mechanical/non-mechanical), paralytic ileus.

• Symptoms: Abdominal distension, rigidity, vomiting, fluid loss.

• Management: Fluid replacement, decompression, symptomatic therapy.

Common GI Diseases

• Conditions Covered:

  • Inflammatory Bowel Disease (IBD), Pancreatitis, Liver Cirrhosis, GI Cancers.