Assessment of a patient with a GI disorder

ByGabie Gomez

Assessment (subjective)

• Past history: smoking, alcohol use, medication abuse, recent travel, food intake.

• Pain (oral, tongue,throat, abdominal)• Appetite • Pyrosis• Dysphagia• Dyspepsia (nausea, eructation,

distention)• Weakness• Diarrhea or Constipation

Assessment (objective)

• Vitals signs• Feel for hard spots/distention(palpitate 4

quadrants)• Skin color• Edema• Abdomen distention• Wheezing• Weight Loss• Stool color, consistency, presence of

ascites, frequency, blood, and last BM• Hematemesis

Outcomes/Planning

• Relief pain and discomfort• Stabilization of fluid and electrolyte

imbalance• Having no complications• Resume normal activity• If possible return to normal pancreatic

and liver function• Patient will feel rested and assist in

ADL’s.

Implementation• Assessment• Monitor nutritional status• Administer medication• Relieving pain• Managing fluid and electrolyte

imbalance• Prevent wound infections• Eliminate smoking, and excessive

alcohol abuse• Promote normal bowel elimination• Stoma care

Meds

•Antacids ( maalox, mylanta, titrialac)

Action: Neutralizes gastric acid.Side Effects: Constipation, chalky taste,

diarrhea, increased thirst, stomach cramps

Nursing Implication: Monitor electrolyte with long tem use

Intervention: Do not take antacids if you have signs of appendicitis or an inflamed bowel.

Meds

•Antiemtic: (Dramamine, Compazine, Promethazine,Reglan)

Action: Blocks central vomiting center.Side Effects: Drowsiness, dry mouth, constipationNursing Implication: Avoid the use with other

CNS depressants and alcohol.Intervention: They may may produce

hypotension when used with antihypertensives, nitrates, or acute ingestion of alcohol.

Meds

• H2 receptor blockers (Zantac, Pepcid, axid, Tagamet)

Action: decrease acid by blockingthe production of gastric acid, used to heal ulcers and relieve the symptoms of pain

Side Effects: confusion, headache, constipation, diarrhea.

Nursing Implications: Increases serum levels, effects anticoagulants

Interventions: Do not give histamine receptor antagonist within 2 hours of antiacids.

Meds• Antibacterial therapy (Flagyl, tetracycline,

biaxin, prilosec)Action: kills or prevents the growth of certain bacteria

and protozoa (single cell animals).Side Effects:clumsiness, dizziness, or unsteadiness

fever or chills, sore throat, numbness, tingling, pain or weakness in the hands or feet, seizures (convulsions) skin rash, itching

Nursing Implications: Smoking should be eliminatedInterventions:Dietary modifications are necessary,

foods and beverages irritating to the pt. should be avoided .

Meds

• Proton pump inhibitor: ( Zantac, Pepcic, Nexium)

Action: antisecretory agent that inhibits secretion of gastrin by the parietal cell of the stomach.

Side effects: Headache, dizziness, abdominal pain, nausea, vomiting, bone marrow suppression(rare).

Nursing Implications: Inhibits hepatic metabolism of warfarin, phenytonin and other drugs.

Interventions: Do not chew or crush capsule contents

Meds

• Mucosal healing agents (Carafete)Action: Heals ulcers without antisecretory

properties, possibly by adhering to the proteins in the ulcer base.

Side effects: Constipation, hypophosphatemia

Nursing Implication: Take Carafate 2 a other drugs can interfere with absorption.

Intervention:If Carafate is taken with certain other drugs, the effects of either could be increased, decreased, or altered.

Meds• Antisecretory and cytoprotective:

(Cytotec)Action: prostaglandin (hormone-like

substance), reduces the production of stomach acid and protects the stomach lining against NSAID induced ulcers.

Side effects:Constipation, gas, indigestion, headache, heavy menstrual bleeding, cramps, paleness, stomach or intestinal bleeding, vomiting

Nursing Implications: Avoid with the use of alcohol or sedatives

Interventions: To reduce the risk of diarrhea, take Cytotec with food and avoid taking it with a magnesium-containing antacid

THE END

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