ManagementofthePatientwithDigestiveDisorders.pptVIP

* * * * * * * * * * * 1500ml fluid * * * Bacterial causes E coli Strep Staph Pneumococci Almost anything that causes a leakage or a rupture of an abdominal or pelvic organ and spills contents ? peritonitis Prognosis depends on early diagnosis ? recognize early cm’s * Distributive Shock. Page 814, Black * * * Often take a sample of infected wound and save for C/S order Irrigation with antibiotic solution Packed left open to drain What if you have a drain in and yet there is copious discharge on wound dressings? * * * What is the effect of this disease process on nutrition? Malabsorption. * * * * Amyloidosis – accumulation of insoluble proteins * * * * * * Situation may arise in that the fluid losses from diarrhea plus the decreased intake (anorexia) r/t the fear of cramping can ? a nursing diagnosis of FV? making the patient hemodynamically unstable. Elemental diets – liquid diets that contain all nutrients in digested form so they don’t stress the digestive system * Flagyl for Crohn’s for perianal abscess * Diarrhea r/t inflamed intestinal mucosa Interventions Bowel rest Antidiarrheal meds Skin integrity r/t alkaline diarrhea interacting with skin Encourage protein intake Cleanse well after each BM with warm water Apply protective moisture barrier P * Ineffective Coping, risk for r/t stress of disease and exacerbations aeb maladaptive coping skills, life disrupting challenges Socio-cultural – peers, families Developmental – families, role performance _parenting Psychological – guilt, worry and depression Children – angry, anxious, frustrated r/t having their social activities disrupted * * Kock pouch Maintain ileal drainage * Catheter is implanted. For first several days Hold catheter in upright position to avoid stress on a healing nipple valve Avoid distention in early post-op period to avoid pressure on suture line After first several days, empty pouch q2 x 2 weeks Cather is removed 2 weeks post op then catheter removed and can be used to drain p