NUR 201 GI幻灯片.pptVIP

Management of Clients with Digestive and Gastrointestinal Disorders Overview of the Gastrointestinal Tract Structure Function Nerve supply Blood supply Oral cavity Esophagus Stomach Pancreas Liver and gallbladder Intestines Assessment Techniques History Demographic data Family history and genetic risk Personal history Diet history Anorexia Dyspepsia Current Health Problems Pattern of bowel movements Color and consistency of the feces Occurrence of diarrhea or constipation Effective action taken to relieve diarrhea or constipation Presence of frank blood or tarry stools Presence of abdominal distention or gas Skin Changes Related to Gastrointestinal Disorders Skin discolorations or rashes Itching Jaundice Increased susceptibility to bruising Increased tendency to bleed Physical Assessment Mouth and pharynx Abdomen and extremities Inspection (Cullen’s sign) Auscultation, look for borborygmus Percussion Palpation Laboratory Tests Complete blood count Clotting factors Electrolytes Assays of liver enzymes—aspartate and alanine aminotransferase Serum amylase and lipase Bilirubin: the primary pigment in bile Evaluation of oncofetal antigens CA 19-9 and CEA Urine tests—amylase, urine urobilinogen Stool tests—fecal occult blood test, ova parasites, Clostridium difficile infection Radiographic examinations Diagnostic Evaluation CBC, CEA, LFT, serum cholesterol, and triglycerides Stool tests Breath tests- Hydrogen and Urea breath tests Abdominal Ultrasonography DNA testing Imaging Studies Gastric Analysis, Gastric Acid Stimulation Test, and pH Monitoring Laparoscopy Upper Gastrointestinal Series and Small Bowel Series Before test: Maintain NPO for 8 hr. Withhold analgesics and anticholinergics for 24 hr. Client drinks 16 ounces of barium. After the test: Give plenty of fluids. Administer mild laxative or stool softener; stools may be chalky white for 24 to 72 hr. Barium Enema Barium enema enhances radiographic visualization of the large intestine. Only clear liquids are