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GASTROINTESTINAL SYSTEM
ORGANS OF GI 9 QUADRANTS
ORGANGS OF GI SYSTEM
FUNCTIONS IN SHORT
1. DUODENUM ,JEJUNUM &ILEUM(21FEET)
2. DIGESTION AND ABSORPTION OF END
PRODUCTS
SMALL INTESTINE:
3. BRUNNER,S GLAND IN SUBMUCOSA OF
DUDENUM SECRETES MUCUS
4. CRPTS OF LIBERKULIN SECRETION CONTAINS
DIGESTIVE ENZYMES.
1. CECUM,COLON,RECTUM,ANUS(5 FEET)
2. PRODUCTION OF BILE &SYNTHESIS OF
LARGE INTESTINE
3.
COAGULATION FACTORS
CONJUGATION &EXCRETION OF BILIRUBIN
4. STROAGE OF VIT A ,D ,B12 &IRON.
5. MTB OF FATS,CARBS &PROTEINS
6. CONJUGATION OF SEX HORMONES.
BARRIUM SWALLOW;
Colonoscopy: visualization of large
PRE TEST: intestine.
keep NPO(MNS)
Npo-8hrs
Explain procedure lasting for 45 min Laxatives for 1-3 days before
Explain about taste of test ,enema
barium(UNPLEASANT) Consent
Post test : increase fluid intake and taught
about white color stools
Low fat diet for one day before
Endoscopy: visualization of esophagus, test. High fiber for 3 days prior
stomach &duodenum Cholecystogram: Injection of a
Pre test: npo,local anesthetic spray ,remove radio opaque dye to visualize gall
dentures if any. bladder through x-ray
Post test: sore throat and hoarseness of
voice normal, later may develop perforation.
Pre-check for iodine sensitivity
If gag reflex returns then can start feeds
DIAGNOSTICS TESTS
Gastric analysis: requires the
passage of ng tube into stomach to PARACENTESIS:
aspirate gastric contents for Trans abdominal removal of fluid
anlaysis.(evry 15 min for
from the peritoneal cavity.
1hr).administer histamines to
stimulate gasrtic secretions.
Position fowlers
Npo
ERCP: Examination of hepatobiliary
Obtain vitals &weight
system.(Liver,Pancreas.Gallbladder Empty the bladder, and measuring
duodenum ,stomach). abdominal girth
Post test apply dressing
Percutaneous transheaptic Mention amount color of fluid.
cholongiography: with the help of
dye can visualize cystic duct,
common bile duct,gall bladder.
GERD
CAUSES SIGNS&SYMPTOMS
GERD.
INTERVENTIONS SUGICAL MANAGEMENT
GERD..
HERNIAS
Protrusion of an organ from its original
cavity through another opening or weak
area.
Types:
1. Reducible
2. irreducible
LOCATION
HERNIAS..
RISK FACTORS SIGNS & SYMPTOMS
Congenital Vomiting
Chronic constipation
Protrusion of involved
area
Chronic cough Crampy abdominal pain
Child birth Feeling of fullness
heavy weight lifting SOB
obesity constipation
MANGEMENT POST OP CARE
Manual reduction Assess for possible distended
bladder
Bowel surgery Discourage coughing 7
Herniprraphy/ encourage deep breathing
hernioplasty Asses to splint incision when
Use hernia belt cough or sneeze
Apply ice bags to scrotal
Support abdomen while area(inguinal repair)
coughing Avoid sternous
activities(6weeeks)
Report urinary retention or
difficulty in urination.
GASTRITIS
Inflammation of gastric mucosa or stomach.
Acute gastritis:
By ingestion of food contaminated with disease causing micro organisms or over use of
NSAIDS.
Chronic gastritis:
by benign or malignant or ny autoimmune ,may cause pernicious anemia due
decreased vit b12
CHRONIC
ACUTE GASTRITIS GASTRITIS
Abdominal Anorexia nausea
discomfort vomiting
Anorexia,nausea, Belching
vomiting Heart burn after
Headache eating
Hicupping Sour taste
reflux Vit b12 deficiency
INTERVENTIONS
Keep NPO until symptoms subside
Ice chips and clear liquids
Monitor signs of haemorragic
gastritis,hematemesis,tachycardia,hyp
otension.
Avoid irritating foods
Vit b12 defeciency,antibiotics.
antacids
PEPTIC ULCER DISEASE
Predisposing factors
Smoking
Alcohol
Stress
Drugs(steroid,salicylates.aspir
in)
Signs &symptoms
1. Pain in left epigastrium & radiate
to back
2. Pain occurs after meals (30-60
min)
3. Weight loss
4. Anemic
5. Normal gastric acidity
6. Relieved pain with antacid
GASTRIC ULCER DUODENAL ULCER
INTERVENTIONS
GASTRIC SURGERY
NURSING MANAGEMENT
COLOSTOMY CARE
Asses stoma for color and intactness
Prevent skin breakdown, use a skin barrier to protect skin around stoma
Avoid the use od adhesives
Monitor characteristics of stool
Record type, amount color of drainage
Cover wound with dry dressing use petroleum gauze
Change pouch or seal whenever neccesary
Empty or clean bag frequently
Avoid gas producing foods
Fecal matter should not touch the skin
Should not give supository
During colostomy irrigation maintain in high fowelers position if patient
in bed or use toilet
CHARACTERISTIC OF STOOLS IN COLOSTOMY
Mechanical intestinal
obstruction Paralytic ileus
Vascular obstruction
Straining defecation
streaks of blood
Portal hypertension Protrusing of
CIRRHOSIS OF LIVER
MEDICAL SURGICAL
Restrict: Paracentesis
Na to 200to 500mg /day Leveev shunt
Fliud 1lit-1.5/day
Peritoneal venous shunt
High calorie
Ligation of esophageal
Diuressis and gastric veinsto stop
High fowlers acute bleed.
Abdominal girth Spllenorenal sshunt
Inspect and palapate Mesocaval shunt
exttremities
Apply lotion on skin
MANAGEMENT
CHOLECYSTITIS
therapy
except morphine sulfate
s/s
Anticholinergics &
Epigastric pain antiemetics
After a heavy meal pain To releive prurities
Intolerance for fatty foods Provide small frequent
Pruritis easy bruising meals if oral allowed
Jaundice, morphys sign
SURGICAL MANAGEMENT
Cholecystectomy First 24 hrs:bile will
Choledochostomy
appaer brown to yelllow
ERCP
500-1000ml/day
Ph=7.8
Care of T- tube:
Stomach content gastric
Semi fowlers
Amount,color,consistency and odour juice-1500ml/day,ph1.0-
of drain. 3.0
If bile drain increase or fowl odor
report HCP
Avoid clamp,irriagte aspiarte of T-
tube
With dr.order clamp the tube
before the meal & observe for
abdominal discomfort & distension.
ACUTE CHRONIC
Shortness of breath Abdominal pain
Oliguria
,tendernesss
PANCREATITIS
INTERVENTIONS
Administer
analgesics,antacids,anticholinergics,OHA,h2
receptors as ordered
With hold food and fluids and eliminate odour
NG tube for continues drainage
High carb, high protein and low fat,
Complications
TPN Abdominal
distension
Avoid alcohol.caffeine Weight loss
Epigastric pain
Frothy /foul smelling
,bowel movement
Hyperthermia
irritability
ACUTE CHRONIC
Shortness of breath Abdominal pain
Oliguria
,tendernesss
PANCREATITIS