Chronic GI disorders

Chronic GI disorders

1. Crohns

2. Colorectal Ca

   • Cancer of the Colon
     • Stage 0-4

3. GORD

   • Gastro-oesophageal reflux disease

4. Ulcerative Colitis

5. Hemorrhoids

6. Coealiac

7. Polyposis

   • polyps
     • skin tag inside of bowel
       • increased risk of colon Ca

8. Nursing Interventions

   • Bowel Assessment stool assessment
     • Stool sample
       • Blood
       • Consistency
       • Frequency + amount
       • Smell
   • Food chart
     • NBM + Bowel rest
   • Fluid Balance Chart
     • Monitor and administer IVF
   • Monitor electrolytes
     • Blood tests
     • ECG
   • Assess urine
     • Bladder scan
       • Urinalysis
   • Manage Nausea + vomiting
     • emesis bags + IV meds
     • NGT therapy if required
     • Sit patient up
   • Pain management
     • Monitor for constipation
     • Provide preventative antiemetics
     • monitor use of NSAIDs
   • Pre procedure prep
     • CT contrast
     • liquid prep to clear the bowel
     • IVC maintain patency

9. Nursing Management

   • Education
     • Lifestyle
       • Diet
       • Exercise
       • Smoking cessation
       • alcohol intake
       • Stress
     • Effect on co-morbidities
       • Compliance
     • Mgmt comlpications
       • medication action plan
         • what to take + when
         • when to seek medical advice
     • Family
       • support
       • Understanding
       • screening
       • medication adherance
       • ADLs
     • disease
   • Creating and maintaing rapport
   • Wound and stoma management @ home
     • Hygiene
     • HITH care
   • Psychological + adjustment support
     • Family + Patient
   • Process of the disease

10. Referrals

    • gastroenterologist
    • pschologist
    • dietician
    • Procedure referrals
    • Social work
    • Wound CNC
    • Stomal Therapist
    • Community support
      • suuport groups
      • online groups coealiac australia
      • Blue care
    • physio

11. Diagnostic

    • Xray
    • Colonoscopy
      • NBM + Prep
      • education re: procedure
      • Document + Consent
      • Post operative care
        • ASsess vitals, GCS/ sedation score, maintain airway
    • gastroscopy
    • pH test + stomach content
    • saliva
    • feacal assessment
    • CT + MRI
    • PET scan
    • sigmoidoscopy

12. Clinical manifestations

    • nausea + vomitting
    • diarrheoa or constipation or malena
    • abdo pain + distention
    • dysphagia
    • weight fluctuations
    • anorexia
    • fever
    • electrolyte imbalance
      • aggitated
      • muscle spasms
      • termour
      • neuro changes
      • cardiac changes
    • bloating + belching
    • faitgue
    • sweaty
    • absent bowel sounds
    • Assessment Quadrants
      • palpate
        • pain
        • tightness/ hardness
        • Guarding
      • auscultate
        • bowel sounds
      • visual
        • distension
        • bruising
        • protusions
      • percussion
    • reflux
    • chest pain
      • ALWAYS RULE OUT CARDIAC

13. Goals of care

    • Decrease number and severity of exacerbations Maintain fluid and electrolyte balance Relieve pain and discomfort Comply with medical regime Maintain nutritional balance Have improved quality of life