RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
1.
Behavioral Objectives
Apply the terms listed in the content
column appropriate to the patient
situations involving the
gastrointestinal system.
I.
Content Outline
Application of terms
A. Dysphagia
B. Dyspepsia
C. Ascites
D. Ileus
E. Melena
Clinical Objectives
2.
Compare and contrast the normal
anatomy and physiology to the
pathophysiology of selected
gastrointestinal disease processes
in the content column.
II. Anatomy & Physiology of Gastrointestinal
A. System
B. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
C. Pathophysiology of gastrointestinal system
1. Fluid & electrolyte imbalance
3.
Analyze factors included in the
assessment of the patient
experiencing commonly occurring
gastrointestinal problems,
including the developmental and
cultural considerations.
III. Selected commonly occurring problems
A. Interview
1. Chief complaint
2. Precipitating event
3. Medical history
4. Family/ Social/occupational history
5. Medication history
6. (prescription/nonprescription)
7. Knowledge of health maintenance
8. Risk factors
B. Physical exam – gastrointestinal
1. Bowel sounds
2. Size and shape
3. Tenderness
4. Pain
5. Stool
6. Nausea/vomiting
7. Hydration status
8. Skin color
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Learning Opportunities
Readings:
Estes
McKinney
Adams
Berman & Snyder
Lewis
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives
Content Outline
C. Diagnostic tests
D. Laboratory studies
1. Complete blood count (CBC)
2. Electrolytes
3. Stool
4. Urine
a. Specific gravity
4.
Differentiate between the etiology,
pathophysiology, and clinical
manifestations of selected
commonly occurring
gastrointestinal disease processes.
IV. Commonly Occurring Problems
A. Gastroenteritis
B. Obesity
C. Gastroesophageal Reflux Disease (GERD)
5.
Discuss analysis, planning,
implementation, and evaluation for
the nursing management of patients
with commonly occurring
gastrointestinal disease processes.
V. Selected Nursing Diagnoses / Implementation /
Evaluation
A. Fluid / Electrolyte Imbalance
1. Independent interventions
a. See gastrointestinal assessment
b. See endocrine assessment
c. Age related hydration status
d. Monitor pertinent diagnostic tests
e. Maintain skin integrity
f. Intake and output
g. Weight
h. Vital signs
i. Sensorium
j. Adhere to standard precautions
2. Collaborative interventions
a. Administer replacement fluids
(1) Oral replacement solutions
(2) Intravenous fluids
(3) Electrolytes
(4) Enteral feedings
b. Administer medications and monitor
for desired/side/adverse effects.
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives
Content Outline
(1) Antibiotics
(2) Antiemetic
(3) Antidiarrheals
3. Recognition of complications
B. Dehydration / hypovolemic shock
1. Metabolic acidosis / metabolic alkalosis
2. Impaired skin integrity
3. Infection/sepsis
4. Evaluation of Outcomes: The patient
will have improved fluid and electrolyte
balance as evidenced by:
a. Hydration status
b. Improved laboratory studies
c. Intake and output
d. Bowel / urinary elimination
e. Vital signs
C. Imbalanced nutrition: more than body
requirements
1. Independent interventions
a. Monitor intake/output
b. Observe eating styles/behaviors
c. Weight and height
d. Vital signs
e. Obtain adequate equipment
f. Ensure proper cleaning under the
folds of skin
g. Encourage to follow prescribed diet
h. Encourage fruits/vegetables and
limiting high fat foods
i. Medication education
j. Encourage activity
2. Collaborative
a. Refer to dietician
b. Follow prescribed diet
c. Diagnostic test
(1) Thyroid test
(2) Cortisone levels
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Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives
Content Outline
(3) Hormone test
d. Administer medications
(1) Appetite suppressants
(2) Nutrient Absorption-Blockers
D. Altered Discomfort r/t tissue damage
secondary to acid reflux
1. Independent interventions
a. Monitor intake/output
b. Elevate HOB
c. Limit intake prior to bedtime
d. Encourage low fat, low acid meals
e. Teach to avoid aggravating factors
f. Non restricting clothing
g. Discuss weight
2. Collaborative
a. Refer to dietician
b. Diagnostics
(1) Upper GI
(2) Endoscopy
c. Medication
(1) Antacids
(2) Antisecretory Agents
(a) H2-receptor blockers
(b) Proton pump inhibitors
(3) Promotility
3. Selected surgical procedures
a. Nissen fundoplication
N:/ADN/Transition/RNSG1327/Unit V –Part H Gastrointestinal
Clinical Objectives
Learning Opportunities
Revised 03/12
Reviewed 03/13
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