TOPIC: GI lower
Hepatitis:
Transmission:
A and E: Fecal/oral
B, C, and D: Blood, needles,
intercourse,
Crohns VS Ulcerative Colitis: what is
different?
UC: Blood and mucus present, LLQ
pain, 10-20 bloody liquid stools a day
with mucus calls for concern
regarding fluid and electrolyte
imbalances, teach patient to have
low fiber, high calorie, high protein,
vitamin rich diet,
Tx: they have recessions and
exacerbations but never cured
Diagnosis: barium enema,
colonoscopy
Instruct patient on dietary changes,
increase fluids, antidiarrhea meds,
may need corticosteroids for
inflammation
Small bowel obstruction:
Abdominal distention, upper
epigastric pain, N/V, fluid/electrolyte
imbalance
Large bowel obstruction:
Usually no vomiting, Ribbon like
stool, lower abdominal cramps,
IBS:
Spastic colon (chronic or recurrent)
Stools: Diarrhea or constipation (IBSC)
C/O: Abdominal pain, bloating
Can be related to stress or behavioral
issue
SS: Pain anywhere, belching
Dietary changes: Increase fiber and
fluids, avoid caffeine
Mechanical vs nonmechanical:
Mechanical- intermittent colicy pain
Nonmechanical- Absent bowel
sounds, no peristalsis, paralytic ileus,
hiccups, N/V, abdominal distention,
prolly no pain unless belly is really
big,
Crohn’s: never see mucus but will be
bloody, fever, diarrhea, anorexia,
poor absorption as indicated by
albumin and prealbumin levels being
low, visible peristalsis, diet same
Watch for complications: perforation
Tx: surgical resection
Diagnosis: barium enema,
colonoscopy
Peritonitis:
Inflammation of the peritoneum
Rigid board like abdomen
Sudden severe pain
Hypovolemic
LGI:
Prevent constipation by increasing
fluids
ERCP:
Biliary colic:
Pain from gallstones
Priority: Pain management
Will experience pain in RUQ radiating
to shoulder
Nutrition/diet:
See other boxes
Abdominal distention, diminished
peristalsis
May get comfort in fetal position
Sharp mid epigastric pain
Can be caused by peptic ulcer,
appendicitis
TPN:
Given through central line
Change “bag” q24hr
Monitor glucose q2hr
Monitor albumin
Removal of stones, remove them by
going down throat, will numb throat
prior to procedure
Patient will be NPO until gag reflex
returns
appendicitis:
infection in appendix
RLQ pain, at McBurney’s point
What assessment will you expect to
see done in the patient that may
have appendicitis? Pain is relieved
when flexing the knees
Diverticulosis / itis
Osis: The disease
Itis: Inflammation
SS: Fever, LLQ pain, rebound
tenderness, tachycardia, chills,
abdominal distention, N/V, bloody
stools, can lead to peritonitis
Tx: Broad spectrum antibiotics, NPO
in the hospital with an NG tube, IV
fluids
When they can eat again slowly
increase fiber
Complications: Peritonitis, abscess
due to pockets, bleeding
Acute cholecystitis:
Inflamed gallbladder due to blocked
bile duct
RUQ pain
Requires ERCP if the bile duct is
blocked, and it is.