Diagnosis
Hypersensitivity of the bowel wall that leads to disruption of the normal function of the intestinal muscles.
Abdominal pain or discomfort
Relieved by defecation
Associated with a changes in stool frequency or consistency.
Other S/S
Mucorrhea (mucus in the stool)
Abdominal bloating
Irritable Bowel Syndrome
Broad- spectrum IV antibiotics
IV fluids and electrolytes
Gastric or intestinal decompression
Surgery
Peritonitis Treatment
YAY, you got it !!!!
Nasogastric Tube (NG) tube
Surgery
*HINT*
S/S
Upper intestinal tract: SHARP, brief pains in the upper abdomen, vomiting, dehydration, and slight abdominal distention.
Colon: abdominal distention, VOMITING FECAL ODOR MATERIAL
Intestinal Obstruction
What is the correct process to assess the abdomen?
Inspect, Ausculate, Percuss, and then Palpate
-colonoscopy
-flexible sigmoidoscopy
-mucosal biopsy
-barium enema
-stool analysis
Ulcerative Colitis and Crohn Disease
Performed to drain fecal material from the ileum.
It is indicated when disease, congenital defects, or trauma require bypassing the ENTIRE colon.
The stool from an ( ) is liquid and still contains digestive enzymes that are highly irritating to the skin.
Illeostomy
Keep it up! You have got this! Get it !!!!
1.) Ascending Colostomy is where?
2.) Transverse colostomy is where?
3.) Sigmoid (descending) colostomy is where?
1.) ascending colon
2.) sitauated toward the middle of the abdomen
3.) lower quadrant of the abodmen
Nursing Problem Priorities
The following are the nursing priorities for patients with gastroenteritis:
How is Cancer of the colon diagnosed?
*HINT*
S/S
weight loss may be the FIRST sign
any change in bowel habits, either diarrhea or constipation, could be a sign of colon cancer
-colonoscopy
-transrectal ultrasound
-carcinoembryonic antigen
Nursing Management of Ostomies
How do nurses take care of an ostomy?
-immediate postoperative care
*assess -stoma area should be moist, above skin level, (normal to be a bit swollen right after surgery and will begin to reduce in size over time- usually 6 to 8 weeks after surgery. There should not be any active bleeding.
*stoma should not a have a blue color if it does this is not normal it means circulation is not occurring to this location and needs to be followed up IMMEDIATELY.
Stool will be loose for some time but will become firmer as time passes.
-psychosocial assessment these pts are at risk for experiencing anxiety, depression, and having a impaired quality of life (specifically sexuality and body image, work, and social functioning.
CARE for a STOMA
A noticeable lightening of blanching of stoma
signs of edema and redness (infection)
Fecal output (color, amount, and odor)
Dressing (frequency of change, what is used and what size is used for wafer and pouch and skin barrier)
A nurse caring for a pt who is post op of a paralytic ileus what is a sign the nurse needs to be looking out for on assessment?
Absent bowel sounds with distention.
What does fiber to for your digestive health"
Dietary fiber normalizes bowel movements by bulking up stools and making them easier to pass. This can help relieve and prevent both constipation and diarrhea. Eating plenty of fiber can also reduce your risk for diverticulitis (inflammation of the intestine), hemorrhoids, gallstones, kidney stones, and provide some relief for irritable bowel syndrome (IBS). Some studies have also indicated that a high-fiber diet may help to lower gastric acid and reduce your risk for gastroesophageal reflux disorder (GERD) and ulcers.
measurement of intake and output
evacuation and irrigation
cultural issues for ostomy patients
Periostomal skin care
-cleanliness
-provision of a protective barrier
Changing the collection device
Psychosocial concerns
Care of a Stoma
Awesome job! Keep working hard!!!!
How to place an Nasogastric Tube (NG) ?
*REVIEW the STEPS*
*Provide privacy as needed.
*Introduce yourself to the client.
*Perform hand hygiene.
*Verify client identification.
*Determine whether the client has allergies.
*Provide client education. Develop signals for client to communicate during procedure. Inspect client nares and check for patency
Assist client into high-Fowler’s position or at a 45-degree angle.
Place a towel over the client’s chest. Measure the length of tubing required for the client, then mark it with an indelible marker. If using a stylet, ensure it is secure and inject 10 mL of water into the tube.
Prepare tape or fixation device.
Apply clean gloves. Lubricate the tip of the tube and apply anesthetics if policy indicates.
Give the client a cup of water with straw, and either have the client keep their neck in a neutral position or have them flex their head back on a pillow, depending on policy. Insert tube following nasal passage. Rotate tube to help pass through the nasopharynx.
Provide reassurance to client if gagging occurs when tube reaches pharynx. Ensure the tube is not coiled in the≈pharynx. Have the client flex their chin to their chest and encourage client to sip through a straw while tube advances.
Stop the procedure if the client becomes cyanotic, is unable to speak or hum, or has continuous coughing or gagging, or if unable to advance the tube after rotating it. Continue advancing tubing until measured mark is reached.
Secure tubing temporarily with tape Determine tube placement by checking aspirate pH or bilirubin or use a CO2 detector. Mark the tube at the client’s nostril.
Apply skin barrier to the nose and secure tube in place with tape or a fixation device. Secure tubing to the client’s gown.
If a double-lumen is used, ensure vent is above stomach level.
Remove gloves and perform hand hygiene. Arrange for an x-ray to confirm placement.
Apply clean gloves and provide oral hygiene.
Discard supplies, remove gloves, and perform hand hygiene.
Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.
Following x-ray confirmation, remove stylet.
What are two forms of fiber?
Insoluble fiber does not dissolve in water. It is the bulky fiber that helps to prevent constipation, and is found in whole grains, wheat cereals, and vegetables such as carrots, celery, and tomatoes.
Soluble fiber dissolves in water and helps control blood sugar levels and reduce cholesterol. Good sources include barley, oatmeal, beans, nuts, and fruits such as apples, berries, citrus fruits, and pears.
Low-residue diet as early has 7 to 10 days before surgery. The last 24 to 72 hours before surgery, the diet is changed to liquids ONLY.
Vitamins and minerals may be given to supplement these restricted diets.
Antibiotics may be given as a prophylaxis against infection of the operative site.
Laxatives and enemas to help clean out the pt.
Nasogastric (NG) Tube and a Miller Abbit tube
Preoperative Nursing Care for a pt going for an ostomy.
-An abdominal incision is made, and the colon is brought to the outside to drain fecal material.
-May be permanent or temporary
Types of (XXXXXXXX)
-loop colostomy
-double-barreled colostomy
-single barreled or end colostomy
Colostomy