This document provides information on gastrointestinal disorders, specifically chronic inflammatory bowel disease. It discusses two main conditions: Crohn's disease and ulcerative colitis. Crohn's disease causes inflammation of the digestive tract that can affect any area from the mouth to the anus, and symptoms may include abdominal pain, diarrhea, and weight loss. Ulcerative colitis only affects the large intestine and rectum, causing ulcers and inflammation of the lining. It can cause diarrhea with blood or pus, abdominal pain, and weight loss. Both conditions involve periods of flare-ups and remission and are treated with medications, nutrition therapy, or surgery in some cases.
This document provides an overview of the anatomy and physiology of the gastrointestinal system and its components. It discusses the mouth, esophagus, stomach, small intestine, large intestine, liver, gallbladder and pancreas. It also reviews common laboratory procedures related to the GI system like fecalysis, upper and lower GI studies, and endoscopy. Common GI symptoms like constipation, diarrhea and dumping syndrome are discussed along with nursing interventions.
This document discusses gastroesophageal reflux disease (GERD). It begins with the anatomy and physiology of the esophagus and definitions of GERD. It then explains that GERD occurs when the lower esophageal sphincter is deficient, allowing gastric contents to back up into the esophagus. Symptoms include pyrosis, dyspepsia, regurgitation, and pain on swallowing. Diagnostic tests include endoscopy, barium swallow, and pH monitoring. Management involves lifestyle changes like diet modification and elevation of the head of the bed, medications like antacids, H2 blockers, and PPIs, and potentially surgery. Nurses play a role in educating patients, monitoring
This document discusses duodenal ulcers. It states that duodenal ulcers occur in the upper small intestine called the duodenum. Common causes include Helicobacter pylori infection, use of anti-inflammatory drugs, smoking, stress, and heavy alcohol use. Symptoms include abdominal pain or nausea, loss of appetite, weight loss, and hematemesis. Diagnosis involves endoscopy to visually confirm the ulcer. Treatment consists of acid-suppressing medications, antibiotics if H. pylori is present, and possibly surgery for complications. Nursing assessments focus on pain management, risk factors, and educating the patient.
The document provides information on the gastrointestinal system and gastrointestinal disorders. It describes the structures and functions of the upper and lower gastrointestinal tract, including the mouth, esophagus, stomach, small intestine, and large intestine. It discusses digestion, absorption of nutrients, and the role of the gastrointestinal tract in fluid and electrolyte balance. Common gastrointestinal disorders mentioned include dysphagia, esophageal disorders, and various conditions affecting the stomach and intestines.
This document discusses gastritis, an inflammation of the stomach lining. It defines gastritis and lists common signs and symptoms such as nausea, vomiting, and abdominal pain. The major causes are identified as Helicobacter pylori bacteria and nonsteroidal anti-inflammatory drugs. Treatment involves antibiotics to kill H. pylori, medications to reduce acid production, antacids, and lifestyle changes like avoiding smoking and NSAIDs. Nursing care includes giving antiemetics if vomiting, administering IV fluids, providing a bland diet, and educating patients about the disorder. The document also notes that the elderly are more susceptible due to thinning stomach lining with age.
Medical-surgical nursing (MSN) is a specialized branch of nursing that provides care to adult patients being treated medically, surgically, or pharmacologically. MSN nurses play a vital role at various stages of a patient's treatment before, during, and after surgical intervention. Their responsibilities include collecting patient information, developing care plans, ordering tests and procedures, and more. MSN is considered a foundation of nursing because it has led to several advanced specializations in areas like cardiology and oncology. To work in MSN, nurses must have strong clinical skills and knowledge to care for patients and advocate on their behalf as members of the healthcare team.
Cholecystitis refers to inflammation of the gallbladder. It is most commonly caused by gallstones which can block the cystic duct and cause bile to build up. There are two main types - acute cholecystitis which occurs suddenly and causes severe pain, and chronic cholecystitis which is a long-term lower intensity inflammation. Diagnosis involves blood tests, imaging like ultrasound or CT scans. Treatment options include pain medication, antibiotics if infected, and surgical removal of the gallbladder (cholecystectomy) for severe or long-term cases.
This document provides an overview of the anatomy and physiology of the gastrointestinal system and its components. It discusses the mouth, esophagus, stomach, small intestine, large intestine, liver, gallbladder and pancreas. It also reviews common laboratory procedures related to the GI system like fecalysis, upper and lower GI studies, and endoscopy. Common GI symptoms like constipation, diarrhea and dumping syndrome are discussed along with nursing interventions.
This document discusses gastroesophageal reflux disease (GERD). It begins with the anatomy and physiology of the esophagus and definitions of GERD. It then explains that GERD occurs when the lower esophageal sphincter is deficient, allowing gastric contents to back up into the esophagus. Symptoms include pyrosis, dyspepsia, regurgitation, and pain on swallowing. Diagnostic tests include endoscopy, barium swallow, and pH monitoring. Management involves lifestyle changes like diet modification and elevation of the head of the bed, medications like antacids, H2 blockers, and PPIs, and potentially surgery. Nurses play a role in educating patients, monitoring
This document discusses duodenal ulcers. It states that duodenal ulcers occur in the upper small intestine called the duodenum. Common causes include Helicobacter pylori infection, use of anti-inflammatory drugs, smoking, stress, and heavy alcohol use. Symptoms include abdominal pain or nausea, loss of appetite, weight loss, and hematemesis. Diagnosis involves endoscopy to visually confirm the ulcer. Treatment consists of acid-suppressing medications, antibiotics if H. pylori is present, and possibly surgery for complications. Nursing assessments focus on pain management, risk factors, and educating the patient.
The document provides information on the gastrointestinal system and gastrointestinal disorders. It describes the structures and functions of the upper and lower gastrointestinal tract, including the mouth, esophagus, stomach, small intestine, and large intestine. It discusses digestion, absorption of nutrients, and the role of the gastrointestinal tract in fluid and electrolyte balance. Common gastrointestinal disorders mentioned include dysphagia, esophageal disorders, and various conditions affecting the stomach and intestines.
This document discusses gastritis, an inflammation of the stomach lining. It defines gastritis and lists common signs and symptoms such as nausea, vomiting, and abdominal pain. The major causes are identified as Helicobacter pylori bacteria and nonsteroidal anti-inflammatory drugs. Treatment involves antibiotics to kill H. pylori, medications to reduce acid production, antacids, and lifestyle changes like avoiding smoking and NSAIDs. Nursing care includes giving antiemetics if vomiting, administering IV fluids, providing a bland diet, and educating patients about the disorder. The document also notes that the elderly are more susceptible due to thinning stomach lining with age.
Medical-surgical nursing (MSN) is a specialized branch of nursing that provides care to adult patients being treated medically, surgically, or pharmacologically. MSN nurses play a vital role at various stages of a patient's treatment before, during, and after surgical intervention. Their responsibilities include collecting patient information, developing care plans, ordering tests and procedures, and more. MSN is considered a foundation of nursing because it has led to several advanced specializations in areas like cardiology and oncology. To work in MSN, nurses must have strong clinical skills and knowledge to care for patients and advocate on their behalf as members of the healthcare team.
Cholecystitis refers to inflammation of the gallbladder. It is most commonly caused by gallstones which can block the cystic duct and cause bile to build up. There are two main types - acute cholecystitis which occurs suddenly and causes severe pain, and chronic cholecystitis which is a long-term lower intensity inflammation. Diagnosis involves blood tests, imaging like ultrasound or CT scans. Treatment options include pain medication, antibiotics if infected, and surgical removal of the gallbladder (cholecystectomy) for severe or long-term cases.
This document discusses gastritis, which is inflammation of the stomach lining. It defines acute and chronic gastritis and lists risk factors like smoking, drinking, and medications. Symptoms are discussed as well as diagnostic tests. Treatment focuses on antacids, bland diets, and treating any underlying causes. Chronic gastritis can lead to pernicious anemia or gastric cancer if not properly managed.
This document discusses peptic ulcers, including their definition, causes, symptoms, diagnosis, and treatment. Peptic ulcers form in the stomach or duodenum when the protective mucus layer is damaged, allowing acid and pepsin to erode the lining. The primary cause is infection by H. pylori bacteria, though smoking, caffeine, alcohol, stress, and NSAIDs can also contribute. Common symptoms include belching, nausea, vomiting, and abdominal pain. Diagnosis involves endoscopy or blood tests. Treatment includes medications to reduce acid production, antibiotics to treat H. pylori, and sometimes surgery. Nursing care focuses on medication administration, diet, rest, monitoring for complications, education, and stress
This document discusses intestinal obstruction, including its causes, signs and symptoms, assessments, nursing diagnoses, and treatment. Intestinal obstruction can be mechanical or functional and causes a blockage in the small or large intestine. Common signs are abdominal pain, nausea, vomiting, and constipation. Assessments include physical exams, imaging, and labs. Nursing focuses on relieving pain, maintaining fluid and electrolytes, and preparing for possible surgery. Treatment involves correcting the underlying cause through medical or surgical management.
The document discusses constipation and diarrhea. It defines constipation as difficult or incomplete emptying of the bowels accompanied by hard or dry stool. Common causes are low-fiber diet, dehydration, and medications. Signs include abdominal pain and straining. Complications are rectal bleeding and hemorrhoids. Diagnosis is based on history and exams. Treatment involves laxatives, fiber, fluids and exercise. The document also defines diarrhea as 3 or more loose stools per day. Causes can be infections, lactose intolerance, or medications. Symptoms are urgent watery stools with cramps. Complications include dehydration. Treatment focuses on fluid replacement and anti-diarrheal medications.
Achalasia is a motility disorder of the esophagus characterized by lack of peristalsis and failure of the lower esophageal sphincter to relax. This causes food to become obstructed at the esophagogastric junction. The cause is unknown but may involve the degeneration of inhibitory neurons in the esophageal wall. Symptoms include dysphagia, regurgitation, chest pain, weight loss and coughing when lying down. Diagnosis involves barium swallow, endoscopy and manometry. Treatment aims to reduce lower esophageal sphincter pressure and may include botulinum toxin injections, medications, surgery or dilation. Complications can include weight loss, pneumonia, esophagitis and
The document provides an overview of Celiac Disease presented by Bhavya Sharma. It discusses the anatomy and histology of the small intestine, causes and risk factors of Celiac Disease including genetics and prolamin proteins. The pathophysiology involves an immune response triggered by ingesting gluten that damages villi in the small intestine and interferes with nutrient absorption. Signs and symptoms along with diagnostic tests are described, including blood tests, endoscopy and biopsy of the small intestine. Treatment involves maintaining a strict lifelong gluten-free diet.
Gastritis is an inflammation of the stomach lining that can be acute or chronic. Acute gastritis develops suddenly while chronic gastritis persists over a long period of time. Common causes include bacterial infections, NSAIDs, autoimmune disorders, and bile reflux. Symptoms may include abdominal pain, bloating, weight loss, and nausea or vomiting. Diagnosis involves medical history, physical exam, and tests like blood tests, stool tests, or endoscopy. Treatment focuses on antacids, H2 blockers, PPIs, antibiotics, and managing pain or nutrition imbalances. Prevention emphasizes diet, avoiding alcohol/smoking, exercise, and stress management.
Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.
This document provides guidelines for assessing the gastrointestinal system. It describes how to take a patient history and examine the mouth, pharynx, abdomen, rectum, and anus. The abdominal examination involves inspecting, auscultating, percussing, and palpating the abdomen in its four quadrants and nine regions to evaluate for abnormalities. Assessment techniques are described for examining specific organs like the liver and spleen.
Introduction of medical surgical nursingSanjaiKokila
The document outlines an introduction to medical surgical nursing presented by Mr. A. Sanjaikumar. It discusses key concepts such as the definition and scope of medical surgical nursing, health and illness, and the nursing process. The nursing process is described as having five components: assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting both subjective and objective data from patients to identify health issues.
This document discusses intestinal obstruction and intussusception. Intestinal obstruction is defined as a mechanical or functional blockage of the intestines. Common causes of small bowel obstruction include adhesions, Crohn's disease, and volvulus. Large bowel obstruction may be caused by inflammatory bowel disease, constipation, or colon atresia. Intussusception is the telescoping of one segment of intestine into another, and accounts for 1-4 cases per 1000 live births. Clinical features of intestinal obstruction and intussusception include abdominal pain, vomiting, distention, and constipation. Diagnostic tests include blood tests, imaging like CT scans and ultrasound. Surgical management is often needed to correct the obstruction
Intestinal obstruction occurs when the intestine is blocked, preventing normal movement of its contents. It can be caused by mechanical blockages such as tumors or hernias, or functional issues like neuromuscular problems. Symptoms include abdominal pain, vomiting, distension and constipation. Treatment involves fluid resuscitation, antibiotics, pain management, and sometimes surgery to remove the obstruction. Proper diagnosis and timely treatment are important to prevent complications like perforation and sepsis.
Diverticulitis is an inflammation and infection of small pouches called diverticula that form in the lining of the intestines, usually in the colon. It is commonly caused by trapped fecal material and bacteria. Symptoms include crampy lower abdominal pain, fever, and changes in bowel habits. Treatment involves rest, clear liquids, antibiotics, and analgesics. A high fiber diet and fluid intake are recommended for prevention and management of diverticulitis. Nursing care focuses on monitoring for complications, managing pain and nutrition, and health education.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
A hiatal hernia occurs when part of the stomach pushes through an opening in the diaphragm and into the chest cavity. There are two main types - a sliding hernia, where the stomach slides up during increased abdominal pressure and back down when pressure is relieved, and a paraesophageal hernia where part of the stomach remains stuck in the chest. Tests like chest x-rays, barium swallows, and endoscopy can diagnose hiatal hernias. Treatment may involve antacids, proton pump inhibitors, or surgery to repair the diaphragm if symptoms are severe.
This document provides information about peptic ulcers, including their causes, symptoms, diagnosis, and treatment. Peptic ulcers occur when the lining of the stomach, duodenum, or esophagus is corroded by acidic digestive juices. Common causes are infection with H. pylori bacteria and long-term use of NSAIDs. Symptoms vary depending on the location of the ulcer but can include abdominal pain, nausea, vomiting, weight loss, and fatigue. Diagnosis involves blood, breath, stool, or biopsy tests to detect H. pylori. Treatment aims to relieve symptoms, promote healing, and prevent complications and recurrence. It involves use of medications to reduce acid secretion such as PPIs, H
IRRITABLE BOWEL SYNDROME(IBS) WITH NURSING MANAGEMENTSwatilekha Das
This document discusses irritable bowel syndrome (IBS). IBS is a common disorder affecting the large intestine that causes abdominal pain, bloating, constipation, and diarrhea. While the exact causes are unknown, factors like psychological issues, altered gut motility, abnormal pain perception, and past gastrointestinal infections may play a role. IBS symptoms can range from mild to severe and most commonly begin in late teens or early adulthood. Diagnosis involves ruling out other conditions through tests and meeting symptom-based diagnostic criteria. Treatment focuses on relieving symptoms through diet, medication, psychological support, and in some cases antibiotics or probiotics.
Peptic ulcers form when the lining of the stomach or duodenum is corroded by acidic digestive juices. Common symptoms include abdominal pain relieved by food or antacids. While acid contributes to ulcer formation, infection with H. pylori bacteria is now believed to be the leading cause. Other risk factors include NSAID use, smoking, alcohol, and stress. Complications can include bleeding, perforation, and narrowing or obstruction of the stomach outlet. Endoscopy allows visualization and biopsy of ulcers, while treatment aims to eliminate H. pylori infection and reduce acid secretion.
The document discusses a seminar presentation about history collection and physical assessment. It covers key terminology, the importance and components of collecting a patient history, and the definition, principles, preparation, techniques, and components involved in performing a physical assessment. The presentation provides an overview of best practices for nurses to obtain comprehensive information about a patient's health status through thorough history collection and physical examination.
Neonatal nursing care for GZIT[Autosaved].pptSikoBikoAreru
The document discusses gastroschisis, omphalocele, and Hirschsprung's disease. It defines gastroschisis as a birth defect where abdominal contents protrude through an abdominal wall defect to the right of the umbilicus without a protective sac. Omphalocele is defined as a birth defect where abdominal contents protrude through a defect at the umbilicus, covered by a sac. The document discusses the epidemiology, pathophysiology, clinical presentation, diagnosis, management, and nursing care of these conditions.
This document discusses complications of bariatric surgery. It begins with an introduction noting the growing rates of morbid obesity and effectiveness of bariatric surgery for long-term weight loss and health improvements. It then provides an index of patient-related and procedure-related complications. Several specific procedures are discussed in detail, including their intraoperative and postoperative complications. Common complications include leakage, bleeding, malnutrition, and marginal ulcers. Prevention, early diagnosis, and management approaches are described for various complications.
This document discusses gastritis, which is inflammation of the stomach lining. It defines acute and chronic gastritis and lists risk factors like smoking, drinking, and medications. Symptoms are discussed as well as diagnostic tests. Treatment focuses on antacids, bland diets, and treating any underlying causes. Chronic gastritis can lead to pernicious anemia or gastric cancer if not properly managed.
This document discusses peptic ulcers, including their definition, causes, symptoms, diagnosis, and treatment. Peptic ulcers form in the stomach or duodenum when the protective mucus layer is damaged, allowing acid and pepsin to erode the lining. The primary cause is infection by H. pylori bacteria, though smoking, caffeine, alcohol, stress, and NSAIDs can also contribute. Common symptoms include belching, nausea, vomiting, and abdominal pain. Diagnosis involves endoscopy or blood tests. Treatment includes medications to reduce acid production, antibiotics to treat H. pylori, and sometimes surgery. Nursing care focuses on medication administration, diet, rest, monitoring for complications, education, and stress
This document discusses intestinal obstruction, including its causes, signs and symptoms, assessments, nursing diagnoses, and treatment. Intestinal obstruction can be mechanical or functional and causes a blockage in the small or large intestine. Common signs are abdominal pain, nausea, vomiting, and constipation. Assessments include physical exams, imaging, and labs. Nursing focuses on relieving pain, maintaining fluid and electrolytes, and preparing for possible surgery. Treatment involves correcting the underlying cause through medical or surgical management.
The document discusses constipation and diarrhea. It defines constipation as difficult or incomplete emptying of the bowels accompanied by hard or dry stool. Common causes are low-fiber diet, dehydration, and medications. Signs include abdominal pain and straining. Complications are rectal bleeding and hemorrhoids. Diagnosis is based on history and exams. Treatment involves laxatives, fiber, fluids and exercise. The document also defines diarrhea as 3 or more loose stools per day. Causes can be infections, lactose intolerance, or medications. Symptoms are urgent watery stools with cramps. Complications include dehydration. Treatment focuses on fluid replacement and anti-diarrheal medications.
Achalasia is a motility disorder of the esophagus characterized by lack of peristalsis and failure of the lower esophageal sphincter to relax. This causes food to become obstructed at the esophagogastric junction. The cause is unknown but may involve the degeneration of inhibitory neurons in the esophageal wall. Symptoms include dysphagia, regurgitation, chest pain, weight loss and coughing when lying down. Diagnosis involves barium swallow, endoscopy and manometry. Treatment aims to reduce lower esophageal sphincter pressure and may include botulinum toxin injections, medications, surgery or dilation. Complications can include weight loss, pneumonia, esophagitis and
The document provides an overview of Celiac Disease presented by Bhavya Sharma. It discusses the anatomy and histology of the small intestine, causes and risk factors of Celiac Disease including genetics and prolamin proteins. The pathophysiology involves an immune response triggered by ingesting gluten that damages villi in the small intestine and interferes with nutrient absorption. Signs and symptoms along with diagnostic tests are described, including blood tests, endoscopy and biopsy of the small intestine. Treatment involves maintaining a strict lifelong gluten-free diet.
Gastritis is an inflammation of the stomach lining that can be acute or chronic. Acute gastritis develops suddenly while chronic gastritis persists over a long period of time. Common causes include bacterial infections, NSAIDs, autoimmune disorders, and bile reflux. Symptoms may include abdominal pain, bloating, weight loss, and nausea or vomiting. Diagnosis involves medical history, physical exam, and tests like blood tests, stool tests, or endoscopy. Treatment focuses on antacids, H2 blockers, PPIs, antibiotics, and managing pain or nutrition imbalances. Prevention emphasizes diet, avoiding alcohol/smoking, exercise, and stress management.
Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.
This document provides guidelines for assessing the gastrointestinal system. It describes how to take a patient history and examine the mouth, pharynx, abdomen, rectum, and anus. The abdominal examination involves inspecting, auscultating, percussing, and palpating the abdomen in its four quadrants and nine regions to evaluate for abnormalities. Assessment techniques are described for examining specific organs like the liver and spleen.
Introduction of medical surgical nursingSanjaiKokila
The document outlines an introduction to medical surgical nursing presented by Mr. A. Sanjaikumar. It discusses key concepts such as the definition and scope of medical surgical nursing, health and illness, and the nursing process. The nursing process is described as having five components: assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting both subjective and objective data from patients to identify health issues.
This document discusses intestinal obstruction and intussusception. Intestinal obstruction is defined as a mechanical or functional blockage of the intestines. Common causes of small bowel obstruction include adhesions, Crohn's disease, and volvulus. Large bowel obstruction may be caused by inflammatory bowel disease, constipation, or colon atresia. Intussusception is the telescoping of one segment of intestine into another, and accounts for 1-4 cases per 1000 live births. Clinical features of intestinal obstruction and intussusception include abdominal pain, vomiting, distention, and constipation. Diagnostic tests include blood tests, imaging like CT scans and ultrasound. Surgical management is often needed to correct the obstruction
Intestinal obstruction occurs when the intestine is blocked, preventing normal movement of its contents. It can be caused by mechanical blockages such as tumors or hernias, or functional issues like neuromuscular problems. Symptoms include abdominal pain, vomiting, distension and constipation. Treatment involves fluid resuscitation, antibiotics, pain management, and sometimes surgery to remove the obstruction. Proper diagnosis and timely treatment are important to prevent complications like perforation and sepsis.
Diverticulitis is an inflammation and infection of small pouches called diverticula that form in the lining of the intestines, usually in the colon. It is commonly caused by trapped fecal material and bacteria. Symptoms include crampy lower abdominal pain, fever, and changes in bowel habits. Treatment involves rest, clear liquids, antibiotics, and analgesics. A high fiber diet and fluid intake are recommended for prevention and management of diverticulitis. Nursing care focuses on monitoring for complications, managing pain and nutrition, and health education.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
A hiatal hernia occurs when part of the stomach pushes through an opening in the diaphragm and into the chest cavity. There are two main types - a sliding hernia, where the stomach slides up during increased abdominal pressure and back down when pressure is relieved, and a paraesophageal hernia where part of the stomach remains stuck in the chest. Tests like chest x-rays, barium swallows, and endoscopy can diagnose hiatal hernias. Treatment may involve antacids, proton pump inhibitors, or surgery to repair the diaphragm if symptoms are severe.
This document provides information about peptic ulcers, including their causes, symptoms, diagnosis, and treatment. Peptic ulcers occur when the lining of the stomach, duodenum, or esophagus is corroded by acidic digestive juices. Common causes are infection with H. pylori bacteria and long-term use of NSAIDs. Symptoms vary depending on the location of the ulcer but can include abdominal pain, nausea, vomiting, weight loss, and fatigue. Diagnosis involves blood, breath, stool, or biopsy tests to detect H. pylori. Treatment aims to relieve symptoms, promote healing, and prevent complications and recurrence. It involves use of medications to reduce acid secretion such as PPIs, H
IRRITABLE BOWEL SYNDROME(IBS) WITH NURSING MANAGEMENTSwatilekha Das
This document discusses irritable bowel syndrome (IBS). IBS is a common disorder affecting the large intestine that causes abdominal pain, bloating, constipation, and diarrhea. While the exact causes are unknown, factors like psychological issues, altered gut motility, abnormal pain perception, and past gastrointestinal infections may play a role. IBS symptoms can range from mild to severe and most commonly begin in late teens or early adulthood. Diagnosis involves ruling out other conditions through tests and meeting symptom-based diagnostic criteria. Treatment focuses on relieving symptoms through diet, medication, psychological support, and in some cases antibiotics or probiotics.
Peptic ulcers form when the lining of the stomach or duodenum is corroded by acidic digestive juices. Common symptoms include abdominal pain relieved by food or antacids. While acid contributes to ulcer formation, infection with H. pylori bacteria is now believed to be the leading cause. Other risk factors include NSAID use, smoking, alcohol, and stress. Complications can include bleeding, perforation, and narrowing or obstruction of the stomach outlet. Endoscopy allows visualization and biopsy of ulcers, while treatment aims to eliminate H. pylori infection and reduce acid secretion.
The document discusses a seminar presentation about history collection and physical assessment. It covers key terminology, the importance and components of collecting a patient history, and the definition, principles, preparation, techniques, and components involved in performing a physical assessment. The presentation provides an overview of best practices for nurses to obtain comprehensive information about a patient's health status through thorough history collection and physical examination.
Neonatal nursing care for GZIT[Autosaved].pptSikoBikoAreru
The document discusses gastroschisis, omphalocele, and Hirschsprung's disease. It defines gastroschisis as a birth defect where abdominal contents protrude through an abdominal wall defect to the right of the umbilicus without a protective sac. Omphalocele is defined as a birth defect where abdominal contents protrude through a defect at the umbilicus, covered by a sac. The document discusses the epidemiology, pathophysiology, clinical presentation, diagnosis, management, and nursing care of these conditions.
This document discusses complications of bariatric surgery. It begins with an introduction noting the growing rates of morbid obesity and effectiveness of bariatric surgery for long-term weight loss and health improvements. It then provides an index of patient-related and procedure-related complications. Several specific procedures are discussed in detail, including their intraoperative and postoperative complications. Common complications include leakage, bleeding, malnutrition, and marginal ulcers. Prevention, early diagnosis, and management approaches are described for various complications.
The document provides an overview of approaches to examining the gastrointestinal system (GIS) and genitourinary system. It discusses various symptoms associated with gastrointestinal diseases like dysphagia, nausea, abdominal pain, and changes in bowel habits. It also describes how to perform a physical examination of the GIS, including inspection, palpation, percussion, and auscultation of the abdomen. Examination techniques for specific organs like the liver, spleen, kidneys, and bladder are outlined.
The document provides information on inflammatory bowel disease (IBD), including its classification into ulcerative colitis and Crohn's disease. It discusses the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, treatment goals, and pharmacological and non-pharmacological treatment approaches for IBD. The major drug therapy types used for IBD include aminosalicylates, corticosteroids, immunosuppressants, TNF inhibitors, and antimicrobials. Surgery may be required for severe cases or complications that do not respond to medical management.
The document provides information on inflammatory bowel disease (IBD), including its classification into ulcerative colitis and Crohn's disease. It discusses the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, treatment goals, and pharmacological and non-pharmacological treatment approaches for IBD. The major drug therapy types used for IBD include aminosalicylates, corticosteroids, immunosuppressants, TNF inhibitors, and antimicrobials. Surgery may be required for severe cases or complications that do not respond to medical management.
This document provides information on gastric outlet obstruction (GOO), including its definition, causes, pathophysiology, clinical presentation, investigations, and management. It presents the case of a 59-year-old male patient who presented with generalized weakness, postprandial vomiting, and weight loss. Endoscopic biopsy revealed gastric carcinoma known as linitis plastica, resulting in a diagnosis of GOO secondary to gastric malignancy. The document discusses benign and malignant causes of GOO, and the metabolic effects, clinical features, and approach to investigating and initially managing a patient with GOO.
Inflammatory bowel disease (IBD) represents a group of chronic disorders that cause prolonged inflammation of the digestive tract. The two main types are ulcerative colitis, which causes inflammation and ulcers in the lining of the large intestine, and Crohn's disease, which is a chronic inflammatory disease that can affect any part of the gastrointestinal tract from mouth to anus. IBD is treated through a combination of medications, dietary changes, and sometimes surgery, with the goals of inducing and maintaining remission of symptoms, preventing complications, and avoiding surgery if possible. Treatments include aminosalicylates, corticosteroids, immunosuppressants, biologics that target tumor necrosis factor, and antimicrobial agents.
Inflammatory bowel disease (IBD) refers to chronic inflammation conditions like Crohn's disease and ulcerative colitis that damage the gastrointestinal tract. Common symptoms include persistent diarrhea, abdominal pain, bloody stools, weight loss and fatigue. The exact causes are unknown but involve a genetic predisposition and exaggerated immune response to environmental triggers. Complications can include colon cancer, malnutrition, and in severe cases perforation or toxic swelling of the colon. Diagnosis involves lab tests, endoscopy, and imaging. Treatment focuses on anti-inflammatory drugs, immune suppressors, antibiotics, nutrition and sometimes surgery to remove diseased sections of bowel.
- Inflammatory bowel disease (IBD) includes Crohn's disease and ulcerative colitis, both characterized by chronic inflammation of the gastrointestinal tract. The causes are not fully understood but involve immune dysfunction and genetic factors.
- Crohn's disease can affect any part of the GI tract and cause transmural inflammation and complications like strictures and fistulas. Ulcerative colitis primarily involves only the inner mucosal layer of the colon and rectum.
- Treatment depends on disease severity and includes medications to induce and maintain remission as well as surgery for complications. The goals are to control symptoms, improve quality of life, and prevent disease progression.
This document discusses inflammatory bowel disease (IBD), specifically focusing on Crohn's disease. It begins with objectives and definitions of IBD and its two main types: Crohn's disease and ulcerative colitis. It then covers the causes, pathophysiology, clinical manifestations, diagnostic tests, complications, and medical and surgical management of Crohn's disease. The goals of treatment are reducing inflammation, suppressing the immune response, providing bowel rest for healing, improving quality of life, and preventing complications. Nutritional therapy, medications like aminosalicylates, corticosteroids, and immunosuppressants may be used. Surgery is indicated for complications like obstruction or severe perianal disease.
cholecystitis and other gall bladder disorders 1.pdfAmanyireDickson1
The document presents a case of a 38-year-old female presenting with abdominal pain and is assessed for acute cholecystitis. It outlines the anatomy, epidemiology, clinical features, diagnosis and treatment of acute cholecystitis. The diagnosis of acute cholecystitis is considered based on the patient's history, physical exam findings, and diagnostic imaging and lab tests showing signs of gallbladder inflammation.
The document provides an outline and overview of a presentation on disorders of the esophagus. It discusses the anatomy and physiology of the esophagus, defines different esophageal disorders including achalasia, hiatal hernia, GERD, esophageal varices, and esophagitis. For each disorder, it describes the etiology, clinical manifestations, diagnosis, and treatment/nursing management. The presentation aims to educate about the types of esophageal disorders and their pathology and management.
The document discusses the anatomy, physiology, and clinical presentation of acute appendicitis. It describes the appendix's embryological development and typical locations. Obstruction of the appendiceal lumen is the main cause of appendicitis. Clinical signs include initially diffuse abdominal pain localized to the right lower quadrant, anorexia, and tenderness near McBurney's point. Escherichia coli is the most common infecting bacterium. Complications arise if the appendix perforates.
The document discusses inflammatory bowel disease (IBD), specifically ulcerative colitis (UC) and Crohn's disease. It describes the main differences between UC and Crohn's, including that UC only affects the colon and rectum while Crohn's can affect any part of the gastrointestinal tract. The document provides details on the symptoms, diagnosis, classification, complications, and treatment of UC. Surgical management is discussed as an option when medical treatment is not effective or complications arise.
This document provides an overview of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease. It discusses the classifications, clinical features, diagnosis, management, and conclusions regarding IBD. Key points include that IBD is characterized by chronic inflammation in the gastrointestinal tract. Ulcerative colitis only affects the colon while Crohn's disease can affect any part of the GI tract. Diagnosis involves ruling out other conditions through history, physical exam, labs, imaging and endoscopy. Management includes medications like 5-aminosalicylates, corticosteroids, immunosuppressants, biologics and surgery for severe cases.
This document discusses a case of intestinal obstruction in a patient with a history of colon cancer. It provides background on the patient's symptoms and signs, including abdominal pain and distention, vomiting, and hemoccult-positive stool. The next steps are described as an abdominal series to determine the level and severity of obstruction. The pathophysiology of mechanical bowel obstruction is traced, involving distention, pain, potential ischemia and necrosis. Nursing management focuses on acute pain, risk for deficient fluid volume, risk for imbalanced nutrition, and ineffective tissue perfusion monitoring.
This document discusses nursing interventions for patients with gastrointestinal disorders, focusing on peptic ulcer disease. It defines PUD and describes its types, causes, pathophysiology, clinical manifestations, complications, diagnosis and management. PUD results from an imbalance between gastric acid and mucosal defenses, and is caused by H. pylori infection, excessive acid secretion, NSAIDs or stress. Symptoms include epigastric pain relieved by food or antacids. Complications are hemorrhage, perforation or gastric outlet obstruction. Treatment involves lifestyle modifications, antacids, H2 blockers, PPIs, antibiotics and sometimes surgery.
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2. Chronic Inflammatory Bowel Disease
(IBD)
It is used to designate two chronic
inflammatory GI disorders:
1) Regional enteritis (Crohn's Disease)
2) Ulcerative Colitis:-It is very serious
and high mortality rate.
12/13/2019 2
3. Regional enteritis (Crohn's Disease)
Epidemiology;
commonly occurs in adolescents or
young adults.
It is more common in older women
population (50 and 80).
Most common affected areas are the
distal ileum and colon.
12/13/2019 3
4. Cont…d
Pathophysiologic feature of the lesion:
Subacute and chronic inflammation that
extends through all layers.
Lesions are not in continuous contact with
one another and are separated by normal
tissue.
In advanced cases, the intestinal mucosa has
a cobblestone appearance.
It is characterized by periods of
remissions and exacerbations.
12/13/2019 4
12. Ulcerative Colitis
It is a recurrent ulcerative & inflammatory disease
of the mucosal layer of the colon &rectum.
It affects superficial mucosa of the colon & is
characterized by multiple ulcerations & diffuse
inflammations which end up with shading of
colonic epithelium.
The lesions are contiguous, occurring one after the
other.
The disease process usually begins in the rectum
and spreads proximally to involve the entire colon.
12/13/2019 12
13. Cont…d
Etiology – unknown (may be
mycobacterium), and an auto
immune response to certain
predisposing factors.
Predisposing factors:-
Anxiety
Tobacco
Radiation
12/13/2019 13
20. Medical Management of Chronic
Inflammatory Bowel Disease
Management depends on the disease
location, severity, and complications.
The goal of the management is: -
1.To reduce the inflammation
2.To suppress in appropriate immune
response
3.To provide rest for the diseased bowel
4.To improve quality of life and
5.To prevent complications
12/13/2019 20
21. Cont…d
Nutritional therapy
Advice to have a low residual, high protein,
high-calorie diet with supplemental vitamin
therapy & iron supplement.
Advice to take oral fluids/ IV fluids as
tolerated.
Advice to avoid any food (milk) which
exacerbate diarrhea.
Advice to avoid smoking and cold foods.
12/13/2019 21
23. Cont…d
Surgical management
The surgical procedure is termed as
proctocolectomy with ileostomy.
Indication includes;
Profuse bleeding
Perforation/Stricture forming ulcers.
Development of cancer
Lake of improvement with medical
managements.
12/13/2019 23
24. Cont…d
Nursing management
Education about diet, medications,
about management of the ostomy and
referral to support groups.
Careful monitoring, parenteral
nutrition, fluid replacement.
Emotional support if surgery is done.
12/13/2019 24
25. Comparison between UC and RE
See Medical-Surgical Nursing, 10th ed -
Brunner & Suddarth, chapter 38, page
1041, table 38-4,
12/13/2019 25
26. Intestinal obstruction
Intestinal obstruction exists when
blockage prevents the normal flow of
intestinal contents through the intestinal
tract.
It can be classified as the following:-
A) Mechanical obstruction Vs Functional
B) Small bowel Obstruction Vs Large
bowel
C) Partial Obstruction Vs Complete12/13/2019 26
27. Cont…d
Causes of Intestinal Obstructions
1) Causes of Small bowel
obstruction
Adhesion (the most common)
Surgery
Intestinal Tuberculosis
Inflammatory Condition of
intestine. 12/13/2019 27
28. Cont…d
Paralytic ileus
Hernia
Gallstones ileus
Tumor
Ascaris bolus
Intusscusption (It is the small bowel
telescopes, as if it were swallowing itself
by invagination. It is the commonest
problem in infants.)
12/13/2019 28
30. Cont…d
C/M of SBO
Sudden Colicky pain intermittent with
10 -20 minute Interval.
Initial Vomiting
Normal Stool may be passed or
bloody.
Restless, dehydration &cry
Distention is late
12/13/2019 30
31. Cont…d
2) Cause of large bowel Obstruction
Colorectal Cancer
Adhesion
Paralytic ileus
Inflammatory bowel disease
Volvulus (It is twisting of a mobile loop
bowel on its mesentery. It occurs mostly
in sigmoid colon but it can affect small
intestine & caecum.)
12/13/2019 31
33. Cont…d
Cardinal S/S of large bowel Obstruction
Colicky lower abdominal pain
Absolute Constipation ( Flatus & Feces
)
Gross abdominal distention
Nausea and Vomiting
Abdominal x-ray reveals grossly
distended 2 limbs of sigmoid colon often
with fluid - air level. 12/13/2019 33
34. Comparison of obstruction
SBO LBO
Abdominal
crampy
Vomiting early
S/S
Constipation late
sign
Abdominal
distention
Abdominal
crampy
Constipation is
early S/S
Grossly distended
abdomen
Fecal vomiting12/13/2019 34
35. Cont..d
SBO… LBO…
Diagnostic method-
Hx & P/E.
Abdominal X-ray
indicates abnormal
quantities of gas &/or
air in the bowel.
Decompression of the
bowel through NG
tube.
Diagnostic method-Hx &
P/E.
Abdominal x-rays reveals
abnormally distended
colon.
Colonoscopy may be
performed to untwist &
decompress the bowel in
high colon obstruction.
12/13/2019 35
36. Cont…d
SBO… LBO…
IV fluid ( N/S or R/L )
administered to replace
electrolyte and water.
Surgical Intervention is
needed.
More severe because
most of the GI content
are absorbed in this
part.
In lower bowel
obstruction rectal tube
may be used for
decompression.
Surgical Intervention if
it is caused by tumor
Iv fluid administration.
Minor unless necrosis
occurred. 12/13/2019 36
37. Cont…d
Diagnostic evaluation of Intestinal
Obstruction
1) Hx
2) P/E - pt is acutely sick looking
V/S: - B/P - decrease due to fluid loss &
sepsis
PR:- Tachycardia
To :-Increases if there is complication
HEENT :- dry buccal mucosa12/13/2019 37
38. Cont…d
Abdomen
Distended
Mild tenderness on palpation
Visible loop but not always
Tympanic on percussion
Bowel sound may be absent or
increase
Empty rectum or hard stool
12/13/2019 38
40. Cont…d
Medical Management:
A) General Management
Keep the patient NPO
NG tube should be inserted for small bowel
obstruction to aspirate intestinal content.
Secure IV line ( Normal Saline or ringer
Lactate )
Triple antibiotic ( Ampicillin,
Gentamycin,& CAF )
Sedation
12/13/2019 40
41. Cont…d
B) Specific RX
Sigmoid Volvulus :-
Rectal tube is inserted for deflation but
contraindicated if gangrenous.
Laparatomy.
1) If loop is viable= de-rotation
2) If gangrenous= resection &
Colostomy
12/13/2019 41
42. Hernias
Def.:-It is a protrusion of bowel through a
weak point in the musculature of the
anterior abdominal wall or an existing
opening.
Etiology
Powerful muscular effort or strain.
Weakness or defect to the wall of
abdominal cavity.
12/13/2019 42
44. Classifications of hernias
1. Based on Sites of Hernias :
I) Inguinal Hernia
The protrusion of bowel through the
weak point in the inguinal canal which
contains the spermatic cord in the male
& the round ligament in the female.
It occurs more commonly in males than
females.
12/13/2019 44
46. Cont…d
Inguinal Hernia Can be:-
A) Direct inguinal Hernia
Push their way directly forward
through posterior wall of the
inguinal canal, into a defect in the
abdominal wall.
Less common (20%).
Strangulate Rarely.
12/13/2019 46
47. Cont…d
B) Indirect inguinal Hernia
Pass through the internal inguinal
ring & then through the external
ring.
Common (80%)
Can Strangulate
12/13/2019 47
48. Cont…d
Distinguishing direct from indirect
hernias;
The best way is to reduce the hernia
& occlude the internal ring with 2
fingers. Ask the pt. to cough - if the
hernia is restrained it is indirect; if
it pops out it is direct.
12/13/2019 48
49. Cont…d
II) Femoral Hernia
More Common in women than men.
Bowel enters the femoral canal,
presenting as a mass in the upper middle
thigh or above the inguinal ligament
where it points down the leg, unlike an
inguinal hernia which points to the groin.
It is frequently strangulate & irreducible.
12/13/2019 49
50. Cont…d
III) Para-umbilical Hernias:
These occur just above or below the umbilicus.
IV) Epigastric Hernias :
These pass through linea alba above the
umbilicus.
V) Incisional Hernias:
These follow breakdown of muscle closure
after previous Surgery. If obese, repair is not
easy.
12/13/2019 50
51. Cont…d
VI) Umbilical Hernia: -
Results from failure of umbilical orifice
to close.
Occur most often in obese women &
children & in patients with cirrhosis and
ascites.
C/F:-
Only abdominal mass if not
complicated.
Bowel sound on auscultation.
12/13/2019 51
52. Cont…d
2. Based on severity
i) Reducible Hernia :- The protruding
mass can be replaced in abdomen.
ii) Irreducible Hernia :- The protruding
mass cannot be moved back into
abdomen.
iii) Incarcerated: - An irreducible hernia
in which the intestinal flow is completely
obstructed.
12/13/2019 52
53. Cont…d
IV) Strangulated: - an irreducible hernia in
which the blood & intestinal flow is
completely obstructed.
C/F of Strangulation:
Pain, vomiting
Swelling of hernial sac,fever
Lower abdominal sign of peritoneal
irritation
12/13/2019 53
54. Cont…d
Treatment
1) Mechanical ( reducible hernia only)
A truss is an appliance having a pad
that is held snugly in the hernial
orifice.
Does not cure a hernia - it prevents
abdominal contents from entering
hernial sac.
12/13/2019 54
55. Cont…d
2) Surgical
Recommended to correct the hernia before
a strangulation occurs which then becomes
on emergency situation.
I. Hernial Sac, is dissected free
II. Contents of sac, are replaced in abdominal
cavity.
12/13/2019 55
56. Cont…d
III. Neck of sac is legated
IV. Muscle and fascial layers are sawed
together firmely.
V. Strangulated hernia requires resection
of ischemic bowel in addition to
hernia repair.
12/13/2019 56
57. Disorders of the rectum
1) Haemorrhoids
Def: - It is an enlarged & congested patch of
mucosa & sub-mucosa at anorectal junction
or
Are dilated portions of veins in the anal
canal.
Sites: - at 3, 7, 11 O'clock, on lithotomy
position.
Hemorrhoid based on its site:-
1) Internal hemorrhoid (if it is above internal
sphincter.) 12/13/2019 57
58. Cont…d
C/F
Bright red blood occurring at the end of
defecation (Late)
Mass Per-rectum
Peri-anal Discomfort
Pruritus
Mucosal Discharge
12/13/2019 58
59. Cont…d
Pain when complicated
External hemorrhoids are associated
with severe pain due to
inflammation & edema caused by
thrombosis. Clotting of blood
(thrombosis) lead to necrosis &
ischemia.
Internal Haemorrhoids are painless
until they bleed.
12/13/2019 59
60. Classification of heamorhoids based on
its stage(severity)
a) 1st degree:- Bleed but no prolapsed
b) 2nd degree :- Prolapsed but reduce
spontaneously
c) 3rd degree :- but need manual
replacement
d) 4th degree :- not returned.
12/13/2019 60
62. Cont…d
Rx:
Regulating bowel by laxatives
Avoid Constipation
Advice high - residue diet that
contain fruit.
Sitz bath
12/13/2019 62
63. Cont…d
Good personal hygiene & by avoiding
excessive straining during defecation,
haemorrhoid symptoms & discomfort can
be relieved.
Non-operative Treatment:-
1) Infrared Photocoagulation (rays)
2) Bipolar Diathermy (Heat)
3) Laser Therapy
4) Injecting Sclerosing Solution
12/13/2019 63
64. Cont…d
Conservative Surgical Rx of internal
Haemorrhoid;
A) Rubber - band ligation procedure: - The
haemorthoid is visualized through the
anoscape, & its proximal portion above the
muco-cutaneous lines is grasped with an
instrument. A small rubber band is then
slipped over the hemorrhoid. Tissue distal to
the rubber band becomes necrotic after several
days & sloughs off. It may cause infection,
pain & hemorrhage.
12/13/2019 64
65. Cont…d
B) Cryosurgical Hemorrhoidectomy
Involves freezing the tissue of the
hemorrhoid for a sufficient time to cause
necrosis.
Not used widely because the discharge is
very foul-smelling & wound healing is
prolonged.
C) Hemorrhoidectomy, or surgical excision, can
be performed to remove all of the redundant
tissue involved in the process. 12/13/2019 65
66. Ano-rectalAbscess
Def:
It is an infection in the para-rectal
spaces.
Risk Factors:
Regional enteritis
Immuno-defcient States (HIV/AIDS)
Many of these abscesses will result in
fistulas.
12/13/2019 66
67. Cont…d
C/M:
Abscess may occur in a variety of spaces in
& around the rectum.
Pain
Foul - Smelling pus
In Superficial abscess, (Swelling, redness &
tenderness).
Deeper abscess ( Fever, abdominal Pain )
Fistula
12/13/2019 67
69. Anal fistula
Def:- It is a tiny, tubular, fibrous tract that
extends into the anal canal from an opening
located beside the anus.
Cause:
Fistula usually results from an infection.
Trauma
Fissures
Regional Enteritis
12/13/2019 69
70. Cont…d
C/M
Pus or stool may leak constantly from the
cutaneous opening
Passage of flatus or feces from the vaginal or
bladder depending on the fistulas tract.
Fever
Mgx
Surgery is always recommended
Fistulectomy (excision of the fistulous tract)
12/13/2019 70
71. Anal fissure
Def:
It is a longitudinal tear or ulceration in the
lining of the anal canal
Cause:
Trauma of passing a large firm stool
Persistent tightening of the anal canal
secondary to stress or anxiety (leading to
Constipation)
Child birth
Trauma 12/13/2019 71
73. Cont…d
Mgx
Increase water intake
Sitz bath
Emollient Suppositories
Corticosteroid Suppositories (Relieve
Discomfort)
Surgery
*Most of the fissures will heal by conservative
measures.
12/13/2019 73
74. Cancer of the large intestine:
Colon & Rectum
Tumors of the small intestine are rare;
conversely tumors of the colon &
rectum are relatively common.
Cause: - Unknown
12/13/2019 74
76. Cont…d
Risk factors:-
Age: - incidence increases with age (most
patients are over age 55). It is the most
common cancer in old age except for
prostates cancer in men.
Family history of colon cancer
Chronic inflammatory bowel disease
Polyp
A diet high in fat, protein, & beef & low in
fiber
12/13/2019 76
77. Cont…d
C/M
It is determined by the location, stage of
cancer & function of the intestinal
segment.
Unexplained anemia
Anorexia
Weight loss
Fatigue
12/13/2019 77
78. Cont…d
Symptoms most Common in right side
lesions;
Abdominal Pain
Melena
Symptoms most commonly associated with
left side lesions.
Abdominal pain
Crampy
Constipation
Distention
12/13/2019 78
79. Cont…d
Symptoms associated with rectal lesion;
Tenesmus
Rectal Pain
Feeling of incomplete evacuation after
a bowel movement
Alternating Constipation & Diarrhea
Bloody Stool
12/13/2019 79
81. Cont…d
Medical Mgx
The patient with symptoms of
intestinal obstruction is treated with
IV fluids & nasogastric Suction.
Treatment depends on the stage of
the disease & related complications.
12/13/2019 81
82. Cont…d
The most widely used staging method is
duke's classification:-
Class A- tumor limited to mucosa & Sub-
mucosa
Class B- Penetration through bowel wall
Class C- Invasion into regional draining lymph
system.
Class D- Advanced & widespread regional
metastasis
12/13/2019 82
83. Cont…d
Radiation Therapy
Surgical Removal
It is primary treatment
Indicated for most class A- lesions & all class- B
and C.
Segmental Resection with anastomosis
Temporary Colostomy followed by segmental
resection & anastomosis
Permanent Colostomy or ileostomy
12/13/2019 83
85. Nursing Care for Patient with
Colostomy
Colostomy;
Is the surgical creation of an opening
(stoma) into the colon.
It can be temporary or permanent
divertion.
It allows for the drainage or evacuation of
colon contents to the outside of the body.
12/13/2019 85
86. Cont…d
Colostomy Irrigation;
It is washing out of the intestinal content
through the stoma.
Indication
a) It is done to permit escape of feces when
there is an obstruction of the large bowel
or a known lesion, such as cancer, that
will eventually cause an obstruction.
12/13/2019 86
87. Cont…d
b) It also may be done to permit healing of the
bowel distal to it after an infection,
perforation or traumatic injury since it
diverts the fecal stream from the affected
area.
c) It may be done as a palliative measure in the
treatment of an obstruction caused by an
inoperable growth of the colon or if the
rectum must be removed to treat cancer.
d) It may be done to provide a permanent
means of bowel evacuation.
12/13/2019 87
88. Cont…d
Purpose of colostomy irrigation
1. To encourage a bowel motion in a recently
established colostomy and to ensure that the
opening is patent.
2. To relieve constipation in patients who has
difficulty managing their colostomy.
3. To teach the patient how to establish
regularity of evacuation through the
colostomy.
4. To reduce distention before closure of
colostomy 12/13/2019 88
89. Cont…d
Read about/Remind your fundamentals of
nursing course about;
The equipments needed.
The procedure.
The special considerations.
Develop nursing care plan for a patient with
colostomy.
12/13/2019 89