Esophogeal diverticulum (zenkers diverticulum is a name for it)
What is pt teaching for pts with esophageal reflux?
-keep upright for at least 2 hours
-always elevate the bed if pt is bedfast
-dont eat irritating foods such as caffiene, alchohol (ange would die :) ), milk ,mint etc.
-take medications such as pepcid or zantac
What clinical manifestations indicate the need for an EGD?
-suspected upper gi bleed
what are some complications of a NG tube?
The following sypmtoms:
-dull gnawing pain
-pain is relieved when pt eats
-sharp localized pain
-bleeding and tarry stools may occur
-*some pts are asymptomatic
would be caused by?
a peptic ulcer
What is the pathopysiology of the peptic ulcer?
an excavation formed in the mucosal wall of the stomach, pylorus, duodenum, or esophagus. It is associated with H-pylori bacteria, chronic use of NSAIDS, alcohol, excessive smoking and high stress.
What is Zantac (Ranitidine)?
medication that reduces the production of HCL and blocks histamine on histamine receptor of parietal cells in the stomach.
what is the criteria for selection of pts for bariatric surgery?
- BMI greater than 30
-100 lbs over IBW
-failure to lose weight by other methods(must be documented)
What is a gastrectomy?
a surgery preformed to treat cancer and perforations of the stomach wall. Removes part of the stomach. somtimes used in severe cases of duodenal ulcers
What are some complications from gastrectomy surgery ?
Vitamins and mineral difiencies such as:
- loss of the intrinsic factor so Vitamin B12 absorption is interrupted and pernicious anemia can occur. Regular Vit B12 shots are given.
- Also dumping syndrome can be a big problem with absorption of needed nutrients, so the pt will need to eat small meals.
The stomach rapidly empties into the duodenum, 15 minutes after eating, can cause hypoglycemia.
Pt teaching for dumping syndrome would be?
no fluids with meals
no high carbs or concentrated sugars
can cause vitamin deficency
What is the cause of chronic gastritis?
prolonged inflammation (h-pylori)
smoking is a risk factor
diet and medication such as NSAIDS can be harmful to the stomach
What medication would cause you to avoid these types of food?
-milk and dairy products
can also cause photosensivity so wear sunscreen.
What would the stool look like in a pt with ulcerative colitis?
Watery with blood and mucus
What is pt teaching in the pt with ulcerative colitis?
Take an antidiarrheal med, diet needs to be bland low residue, high in protien, calories and vitamins.Supplement vitamins, iron, and electolytes
Clincal manifestations such as :
-crampy wavelike pain
-may pass blood or mucus but noe fecal matter
-tounge and mucus membranes become parched
Are s/sx of what?
Small bowel obstruction
In a colostomy, stoma assessment what is normal?
Red and beefy!
abnormal would be any other color, like purple which would mean compromised circulation
What is management for chronic constipation?
-increase fluid intake
-include high fiber in diet
-if laxitive is necassary use bulk forming agents and osmotic agents, lubricants and fecal softeners
These s/sx would cause you to think your pt has what?
-Pain at mcburrneys point
Where is mcburrnys point?
just above the appendix, pain is present if pt has appendicitis
What is medical managment for divertiulitis?
-high fiber, low fat diet
-administering bulk preperations such as metamucil, stool softeners, warm oil enemas and evacuant suppositories
-administer antibiotics if needed
What is nutritional therapy for pts with IBD? (Irritable Bowel disease)
-oral fluids and low-residue, high-protien, high-calorie diet with supplemental vitamin therapy and iron replacement .
-fluid and electrolyte imbalance
-cold foods and smoking are avoided
-IV therapy if indicated
Chronic use of alchohol can cause ?
mucus membranes are all spots you can check for?
Jaundice. also lab draw if needed
Increased abd girth and weight gain
fluid in the abd.
What are the dietary restrictions for a pt with ascitites?
use diuretics if pt does not respond to the sodium restrictions.
restrict fluid intake
Hepatitis B is transmitted through what?
Bodily fluids such as blood, urine, and mucus and who is at greater risk for this ? none other then US !! health care workers with frequent exposure to blood. (or if you have multiple sexual partners or recent history of STD)
What are complications from a cholecystectomy ?
Bile ducts can get plugged resulting in the bile being forced back into the liver and the blood stream which will cause jaundice.
Low calicum can result in ?
Tetany*** which can be caused from hypoparathyroidism or if the parathyroid was disturbed during a thyroidectomy. so check calcium levels postoperativly