Care of the Patient with a Gastrointestinal Disorder

Anatomy and Physiology of the GI System, Disorders of the GI System, Intestinal Obstruction and Fecal Incontinence.

1. Chapter 45 Care of the Patient With a Gastrointestinal Disorder

2. Lesson 45.1: Anatomy and Physiology of the Gastrointestinal System List in sequence each of the parts or segments of the alimentary canal and identify the accessory organs of digestion. Discuss the function of each digestive and accessory organ. Discuss the laboratory and diagnostic examinations associated with the gastrointestinal system. Identify nursing interventions associated with disorders of the gastrointestinal tract. 2

3. The Digestive System Consists of the digestive tract A muscular tube that extends from the mouth to the anus Consists of the mouth, pharynx, esophagus, stomach, small intestine, large intestine, and anus Accessory organs aid in digestion 3

4. Organs of the Digestive System Mouth Pharynx Esophagus Stomach Small intestine Large intestine Anus 4

5. Accessory Organs of the Digestive System Liver Gallbladder Pancreas 5

6. Laboratory and Diagnostic Examinations Upper gastrointestinal series (upper GI, UGI) Tube gastric analysis Esophagogastroduodenoscopy (EGD, UGI endoscopy, gastroscopy) Barium swallow Examination of stool for occult blood Colonoscopy Stool culture 6

7. Lesson 45.2: Disorders of the Gastrointestinal System (Part I) Explain the etiology and pathophysiology, clinical manifestations, assessments, diagnostic tests, medical-surgical management, and nursing interventions for the patient with disorders of the mouth, esophagus, stomach, and intestines. Identify nursing interventions for preoperative and postoperative care of the patient who requires gastric surgery. 7

8. Disorders of the Mouth Dental plaque and caries Candidiasis Carcinoma of the oral cavity 8

9. Disorders of the Esophagus Gastroesophageal reflux disease (GERD) Carcinoma of the esophagus Achalasia 9

10. Disorders of the Stomach Gastritis Peptic ulcer disease Cancer of the stomach 10

11. Gastric Surgery Medical management for cancer of the stomach Dumping syndrome is a possible complication Radiation Chemotherapy 11

12. Lesson 45.3: Disorders of the Gastrointestinal System (Part II) Compare and contrast the inflammatory bowel diseases of ulcerative colitis and Crohn’s disease. Identify nursing interventions for the patient with a stoma for fecal diversion. Discuss the etiology and pathophysiology, clinical manifestations, assessment, diagnostic tests, medical management, and nursing interventions for the patient with acute abdominal inflammations (appendicitis, diverticulitis, and peritonitis), for the patient with hernias, and for the patient with colorectal cancer. 12

13. Inflammatory Bowel Disease Ulcerative colitis Crohn’s disease 13

14. Nursing Interventions for the Patient with a Stoma Assess skin integrity Assess for allergies to powders or adhesive Provide education on changing pouch Assess peristomal area for infection 14

15. Acute Abdominal Inflammations Appendicitis Diverticulitis Peritonitis 15

16. Hernia External hernia Hiatal hernia 16

17. Colorectal Cancer Second leading cause of cancer deaths Most growths found in the sigmoid and rectal regions of the colon Cause remains unknown Risk factors include Adenomatous polyps Ulcerative colitis Diverticulitis Heredity Clinical manifestations are usually nonspecific 17

18. Lesson 45.4: Intestinal Obstruction and Fecal Incontinence Differentiate between mechanical and nonmechanical intestinal obstruction, including causes, medical management, and nursing interventions. Explain the causes, medical management, and nursing interventions for the patient with fecal incontinence. 18

19. Intestinal Obstruction Mechanical obstruction: caused by an occlusion of the lumen of the intestinal tract Nonmechanical obstruction: caused by something that decreases the muscle action of the bowel (may be neurologic or vascular disorders) Early phases of mechanical obstruction: auscultation of the abdomen reveals loud, frequent, high-pitched sounds In later stages, bowel sounds will likely be absent 19

20. Fecal Incontinence Has a variety of causes The external sphincter may be relaxed Voluntary control of defecation may be disturbed Distention of the rectum Paralysis 20