GI Bleeding/Perf
What are s/s of GI bleed?
Melena/Hematemesis
Hypotension/Tachycardia
Pallor/Fatigue
Is perforation a medical emergency
YES
Define peritonitis
Inflammation of the lining of the peritoneum (abdominal cavity)
What type of shock can happen r/t fluid shift into abdominal cavity?
risk hypovolemic shock
Appendicitis s/s
Sharp pain at McBurney's point
N/V
Rebound Tenderness
Low-grade fever
What are the diagnostics for GI bleed?
EGD
Fecal Occult Blood
What happens when there is a perforation?
The ulcer erodes all the way through stomach/duodenum
What are 2 causes of peritonitis?
perforation of abdominal organs
or
trauma
What are the nursing considerations for peritonitis?
Fluid and electrolyte replacement
Nasogastric suction
Antibiotic therapy
Pain management
Surgical repair
Appendicitis diagnostics
CT Scan/Ultrasound
Labs: WBC, CRP
Rovsing’s sign (tenderness in RLQ when palpating left lower quad)
What is the treatment for GI bleed?
Gastric lavage
and
Endoscopy
What causes the peritonitis from perforation?
caused by stool and partially digested food spilling into peritoneal cavity
What is seen on abdominal x-ray in peritonitis?
Air and fluid in abdomen seen on x-ray
What are the surgical treatments of peritonitis?
Exploratory laparotomy (open)
Gastric resection with anastomosis
Colectomy with anastomosis
Colectomy with colostomy placement (Temporary or permanent)
Appendicitis nursing considerations
IV fluids/Broad spectrum Abx
NPO for bowel rest
pain management (morphine)/Avoid heat
assess for s/s of perf
prep for poss sx
What are the nursing considerations of G bleed?
Frequent VS/O2 therapy
IV fluids
Strict I/O's
Assess Hgb (transfuse if <7)
Supportive care
What are the 2 surgical treatments for severe PUD prevention or perforation called?
Gastrodudenostomy aka Billroth I
Gastrojejunostomy aka Billroth II
What are the 2 symptoms associated with "board like" abdomen?
Abd distention
and
Rigidity
What is appendicitis and what can it lead to?
Inflammation of the appendix due to incomplete emptying or becoming occluded
appendicitis can lead to:
infection and/or possible perforation
what is done to prepare for surgery?
written consent
NPO
possible same day surgery
What are the s/s of perforation
SEVERE, sharp abd pain
Abd tenderness
N/V
What is being done in the surgical treatments billroth I & II?
Gastric resection with anastomosis
What are s/s of peritonitis
fever
widespread pain, with time localizes and increase intensity
diminished/absent BS
Rigid board-like abdomen
Rebound tenderness
What age range is appendicitis mostly seen in?
True or false:
Appendicitis is the #1 reason for abd surgery
10-30 y/o
What are the s/s of perforation
SEVERE, sharp abd pain
Abd tenderness
N/V