Nursing management of the patient with digestive and gastro intestinal disorder.
key terms
1) Define/explain the chillies.
=> Cheilitis is a medical condition in which infection and inflammation of the lips is seen (infection and inflammation of the lips it’s called chellitis).
2) Define/explain the herpes labialis. (Define herpes labialis.)
=> Herpes labialis is a condition in which the lips, mouth, and gums are infected by the herpes simplex virus and due to this, small painful blisters called cold sores and fever blisters develop.
3) Define/explain the gingivitis. (Define gingivitis.)
=> Infection and inflammation of gums is called gingivitis.
4) Define/explain pyorrhea.
=> Periodontitis (periodontitis) is also called pyorrhea.
=> Periodontitis means infection and inflammation of bones and ligaments supporting teeth is called periodontitis/pyorrhea.
5) Define/explain halitosis. (Define halitosis.)
=> Halitosis is called bed breath.
The unpleasant odor present mainly by exhaling the breath is called halitosis.
6) Define/explain Glossotis. (Define glossitis.)
=> Infection and inflammation of tongue is called glossitis.
=> When glossitis occurs, the tongue becomes swollen and its color changes.
7) Define/explain parotitis. (Define parotitis.
=> Infection and inflammation of salivary gland i.e. parotid gland is called parotitis.
8) Define / explain the sialadenitis. (Define Celadenitis.)
=> Infection and inflamation of salivary gland is called cheladenitis.
9) Define/explain dental plaque and caries. (Define dental plaque and caries.
=> The formation of dental plaque occurs when the mineral in the teeth is lost, the formation of a hollow space in the tooth is called tooth decay.
(tooth decay) is called.
=> And there is the formation of dental plaque and caries in the hollow space.
10) Define/explain stomatitis. (Define stomatitis)
=> Infection and inflammation of the mucous membrane lining of the mouth, lips, pallet, is called stomatitis.
11) Define/explain oesophagitis. (Define esophagitis.
=> Infection and inflammation of esophagus is called oesophagitis.
12) Define/explain esophageal structure. (Define esophageal stricture.
=> Esophagus is narrowing due to the buildup of scar tissue in the esophagus. It is called esophageal stricture. Considered because of it
There is difficulty in swallowing.
13) Define/explain esophageal varices. (Define esophageal varices.#
=> Esophagial varices is a condition in which
The vein in the lower part of the esophagus is enlarged, which is mainly seen in people with severe liver disease.
14) Define/explain Dysplagia. (Define dysphagia.
=> When there is difficulty in swallowing or pain while swallowing, it is called dysphagia.
15) Define/explain tracheoesophageal fistula. (Define tracheoesophageal fistula.
=> Tracheoesophageal fistula is a congenital disorder in which there is an abnormal connection between the trachea and the esophagus.
16) define/explain the gastritis. (Define gastritis.)
=> Infection and inflammation of stomach is called gastritis.
17) Define/explain gastro intestinal bleeding. (Define gastrointestinal bleeding.)
=> Gastrointestinal bleeding is a condition in which bleeding occurs from the mouth to the anus in the digestive track.
18) Define/explain Giardiasis. (Define GRDRCS.
=> GRDRCs is an infection of the small intestine caused by the microscopic parasite Grdaria lambliae.
Caused by (giardia lamblia).
19) Define/explain cryptosporidiosis. (Define cryptosporidiosis.
=> Cryptosporidiosis is an infection of the small interstitium that is mainly caused by the parasite cryptosporidiosis enteritis that conditions and creates diarrhea.
20) Define/explain constipation. (Define constipation.)
=> Constipation is a condition in which there is difficulty in emptying the bowel due to hardening of faeces, it is called constipation.
21) Define/explain Diarrhea.
=> Diarrhea is a condition in which more than three liquid stools are passed per day.
=> The frequency and volume of stool increases in diarrhea.
22) Define/explain Gasteroenteritis. (Define gastroenteritis.)
=> Gastroenteritis is a condition in which infection and inflammation occurs in the stomach and small intestine and due to this the condition of acute diarrhea is seen.
23) Define/explain celiac disease. (Define celiac disease.)
Celiac disease is a disease of the small intestine of the digestive tract in which the small intestine is damaged.
Due to this, proper absorption of nutrients from food is not done.
=> So the person who has the condition of celiac disease (celiac disease) should avoid gluten.
, and proteins in wheat, rye, and barley cannot be tolerated.
24) Define/explain Achalasia. (Define Ekalashia.)
=> Achalasia is a condition in which distal oesophagus peristalsis movement becomes ineffective.
=> Achalasia is a condition in which the oesophageal sphincter cannot relax.
25) Give meaning of xerostomia := Dry mouth.
26) Define/explain Anal fissure. (Define anal fissure.
=> Anal fissure is a condition in which there is a minore laceration on the line of anus and it is very painful and bleeding is seen from it.
27) Artificially created opening between a body cavity its called:=
=> stoma,
28) Chronic loss of appetite its called:= Anorexia
29) Define/explain Appendicitis. (Define appendicitis.)
=> Infection and inflammation of the appendix is called appendicitis.
30) surgically create opening into the colon its called:= colostomy ( colostomy) .
31) Define/explain hemorrhoids. (Define hemorrhoids.)
=> Anal veins
(anal veins) dilated are called hemorrhoids and can be on both the internal and external sides of the anal sphincter.
32) Define/explain hernia. (Define hernia.)
=> Protrusion of any body organ or part of an organ from its cavity is called hernia.
33) A wavelike movement that occurs involuntarily in the alimentary canal its called :=
peristalsis movement.
34) The first part of the small intestine its called:=
(Duodenum),
35) Surgically creating of an opening into the stomach for the purpose of administering foods and fluids its called := Gastrostomy (Gastrostomy).
Explain Nursing Assessment := history and physical assessment of the patient with the Digestive and gastro intestinal disorder.
EXPLAIN HEALTH HISTORY OF THE PATIENT WITH DIGESTIVE AND GASTERO INTESTINAL DISORDER. (Write the health history of a patient with digestive and gastrointestinal disorders)
= Taking a proper health history is very important to know the health status of a person.
=> Health history includes patient information including
The patient’s diet, his life style, his habit, his previous medication if any, any previous medical reports, and if he has any family history, all these information are included in the health history.
1) assess the patient presenting complaint
=> In this history, if the patient is having any one abdominal pain, abdominal bloating, gasteroesophageal reflux, nausea, and changes in bowel habit, the information about it is taken.
2) Symptomatology
=> In this symptomatology
Information from the patient on the onset, duration, frequency, duration of the signs and symptoms, and factors that increase or decrease the signs and symptoms. is obtained.
3) Tacking Dietary history of the patient. (Taking dietary history from the patient.)
=> In this history, get information about the dietary habit of patient A and what type of diet the patient has taken, the dietary pattern of the patient.
4)Assess the Bowel habit of the patient:= Asking information about the bowel habit of the patient.
=> Getting information about the patient’s normal bowel habit and any changes in it.
Obtain information from the patient about stool, its frequency, and its consistency.
5) Explain the medical history of the patient. (Obtaining a complete medical history from the patient.)
=> Obtaining complete information from the patient about past and current (current) medical condition and any medication and any surgery done.
=> Asking the patient whether he/she has any diseases of gastrointerstitial system in the past and taking complete information from the patient about taking medication for any disease or not.
6) Explain about the medication history. (To collect information about patient’s medication history.)
=> In this, if the patient is taking any medication, and if the patient is taking any over the counter (over the counter) medication, if the patient is taking any vitamin supplements, then get complete information about it.
7)obtain the family medical history :=Getting information about family medical history:=
=> Asking the patient’s family members about any gastro intestinal track related diseases in this history.
And to get complete information about whether any person had a disease of gastro intestinal track in the past or not.
=> To get complete information about any person having genetic diseases or not.
8) Assess the social history:= Assess the social history of the patient.
=> To assess the life style factor of the patient. Like getting information about stress levels, physical activity, and sleep patterns.
=> Getting complete information about the patient smoking and alcohol consumption or not because smoking and alcohol consumption affects the digestive system too much.
9) psychosocial factor (getting complete information about patient’s psychosocial factor)
=> Getting complete information about the patient’s stress level, and emotional well being.
10) Assess the allergies and sensitivity of patients. (Getting information about patient’s allergies and sensitivities.)
=> Getting information about whether the patient has allergies or sensitivities to any food or medication.
11) screening of risk factors. (Screening for risk factors:=
=> Obtaining information about the patient’s risk factors including age, sex and any other health history, if any, should be screened.
By getting this comprehensive information about the patient, the patient’s present cmplaun and its problem can be identified and information can be obtained about the type of risk factore and what type of treatment needs to be provided to the patient.
=> When taking his health history from the patient, the patient should provide his complete information due to which complete medical treatment can be provided to the patient for whatever disease condition he has.
Explain the physical examination of the patient with digestive and gastero intestinal disorder.
=> In the physical examination, the patient’s mouth, abdomen and rectum are examined.
=> By doing physical examination, the health status of the patient can be known and information about the type of treatment to be provided to the patient can also be obtained.
=> Assessment of patient’s oral cavity is done by inspection method.
=> Inspection to assess whether there are any conditions like ulcer, nodules, swelling, discoloration and inflammation in the patient’s mouth, tongue, teeth, and gums.
(inspection) is done.
=> Physical examination of gastero intestinal track is done by four methods.
1) INSPECTION (inspection:= by eyes (visual examination)),
2) AUSCULTATION ( by the stethoscope),
3) PALPATION (Palpation:= by the palpate the organ by the finger pad),
4) PERCUSSION ( Percussion := by the percussion with the use of finger tips. )
••••>
1) INSPECTION (inspection:= by eyes (visual examination)),
=> Assessment of the interstitial system starts from the oral cavity.
=> Examination of the lips is done to assess whether there is any lesion, abnormal color, and any abnormality in the lips.
=> Oral cavity is inspected for any inflammation, tenderness, ulceration, swelling, bleeding and discoloration.
=> Assess whether there is any abnormal order in the patient’s breathing.
=> If any foul order from patient’s oral cvt
(foul odor) if coming, it indicates infection and impaired oral care.
=> The tongue is aspirated to assess for any signs of dehydration.
=> Any swelling, redness in patient’s gums is assessed.
=> The patient is placed in supine position and then the abdominal cavity of the patient is inspected to see if there is any redness, irregularities, scar, cracks, or not in his skin.
2) AUSCULTATION ( by the stethoscope),
=> When the patient’s abdomen is auscultated, first the stethoscope is placed in the upper right corner of the patient’s abdomen and then the sound of the patient’s abdomen is listened in a clockwise direction.
=> The stethoscope is placed lightly over the abdomen to listen to the patient’s bowel sounds.
=> Bowel sounds are soft clicks and gurgles that are heard over the abdomen every 5 to 15 seconds.
=> Bowel sound assessment of all four quadrants of the abdomen is done using the diaphragm of the stethoscope.
=> High pitch gurgling sound is most audible when bowel sound is heard through stethoscope.
Bowel sound is mainly heard due to peristalsis movement in the bowel.
=>types of the bowel sound is:=
••> 1) Normal bowel sound (Normal bowel sound),
=> Normal bowel sounds are two sounds every 5 to 20 seconds.
••> 2) Hyperactive bowel sound (hyperactive bowel sound),
Hyperactive bowel sounds are five to six sounds heard in less than 30 seconds.
••> 3) Hypoactive bowel sound (Hypoactive bowel sound)
=> One to two sounds are heard every two minutes.
••> 4) Absent bowel sound (absent bowel sound).
=> No sound is heard every three to five minutes.
•••> Hyperactive bowel sounds :=
Hyperactive bowel sound is mainly rapid, high pitched, bowel sound is mainly heard when there is gastroenteritis.
=>Hypoactive bowel sound
Hypo active bowel sound is mainly heard when there is paralytic ileus and any abdominal surgery is mainly infrequent.
3) PALPATION (Palpation:= by the palpate the organ by the finger pad),
=> By lightly palpating the body through the finger pad, any tenderness and swelling can be assessed on the abdominal area.
4) PERCUSSION ( Percussion := by the percussion with the use of finger tips. )
=> Percussion is performed to identify the density of the organ.
=> Percussion is mainly done to detect any fluid, air, and any masses present.
=> And used to identify the size and location of the organs of the abdominal cavity.
Explain the Diagnostic evaluation of the patient with Digestive and Gastrointestinal Disorder. (Write the diagnostic of a patient with a gastrointestinal disorder.)
1) Endoscopy :=
=> Endoscopy involves direct visual examination of the lumen of the gastro-intestinal tract.
=> An endoscope consists of a flexible tube and a light on its front side through which proper visulalisation of the gastro-intestinal track can be done.
=> Length of endoscope is 140 cm.
=> Examination of upper gastro intestinal is done by endoscope.
2)Gastrocopy:=
=> Gastroscopy or Esophago-Gastro-
Duodenoscopy is a diagnostic test that involves visual examination of the inside of the esophagus, stomach, and duodenum.
=> In gastroscopy, a flexible endoscope less than 10 mm in diameter is passed directly into the upper gastro-intestinal track and the proximal duodenum can be visualized.
=> In this, the entire oesophagus, stomach, and proximal duodenum can be visualized directly.
3) Colonoscopy:=
=> Colonoscopy involves examination of the lower gastrointestinal tract, in which the entire colon and rectum are examined.
=> colonoscope is 1.2 to 1.8 m. There are
4)procto sigmoidoscopy:=
=> In procto-sigmoidoscopy, examination of the rectum and sigmoid colon is done using a proctoscope.
=> Proctoscope has a length of 25 to 30 cm and a diameter of 1.5 cm.
=> Visual examination of the anal canal can be done in proctosignemoidoscopy.
=> In proctosigmoidoscopy melaena, persistent diarrhoea, and passage of mucous bacteriological and histological studies are done.
5)flexible sigmoidoscopy:=
=> In flexible sigmoidoscopy, the rectum, sigmoid and proximal colon can be visualized using a flexible instrument.
=> The length of flexible sigmoidoscope is 65 cm.
=> Flexible sigmoidoscopy has higher tolerance than protosigmoidoscopy.
Explain the Radiological investigation of patient with digestive and gastro intestinal disorder. (Write radiological investigation of a patient with digestive and gastrointestinal disorders):=
=> Radiological investigation includes:=
1) Barium swallow,
2) Barium enema (in barium enema),
3) upper gastero intestinal series. (Upper Gastrointestinal Series).
4) Abdominal ultrasound. (Abdominal Ultra Sound).
5) CT (Computed Tomography) scan
=> All these radiological investigations are mainly used to assess the abnormality of the gastrointestinal tract.
=> Barium studies are better tolerated than endoscopic investigations.
=> Contrast medium is mainly used as barium in radiological studies.
=> Barium is a chalky, non-allergic substance that can be used to examine the esophagus, stomach, lower gastero intestinal track.
=> Barium preparation is mainly administered orally, or rectally but in patients with suspected gastro intestinal obstruction or perforation.
Its use is contraindicated.
=> Patient If the barium does not pass within 48 hours of barium administration, the nurse should provide appropriate anema and laxative to the patient so that the patient’s constipation and obstruction can be removed.
••••••>
1) Barium swallow
=> Radiological examination of esophagus is done in barium swallow
=> This procedure is mainly oesophagus
It is used to diagnose if any stricture is present in the esophagus or if there is any motility disorder or if any ulceration and forien body is present or not.
=> Barium swallow is less sensitive than endoscopy for making any diagnosis.
=> Barium swallow should be avoided in persons who have the condition of dysphagia (difficulty in swallowing).
2) Barium enema (in barium enema),
=> Radiological examination of colon (large intestine) is done in barium enema.
=> Barium enema is primarily for any polyps,
•> Diverticula ( Diverticula),
•>Any structural abnormality of the colon,
•>Colorectal cancer and
If there is inflammatory bowel disease, it is used for its detection.
3) upper gastro intestinal series. (Upper Gastrointestinal Series).
=> In upper gasterointestinal series mainly radiological examination of stomach and small interstyle is done, in which barium solution is mainly injected.
=>This procedure is mainly used for any diverticula, stricture, hiatus hernia,
It is used for examination of obesity disorder, tumor, Crohn’s disease and malabsorption syndrome.
4) Abdominal ultrasound. (Abdominal Ultra Sound).
=> Abdominal ultrasound is primarily a procedure used to indicate the size and shape of body organs.
=> It is mainly used to diagnose the abnormality of any organ of Abdominal cavity.
=> Investigation is done using sound waves.
=> Any gallstone mainly in the abdominal cavity
(gall stone) is present, and if the condition of colycystitis is present, it is used for diagnosis.
5) CT (Computed Tomography) scan
=> CT scan is primarily a non invasive radiological scan.
=> It mainly provides a more accurate image of body tissues than ultrasound and it is mainly used to detect any disease condition of liver, spleen, kidney, pancreas and pelvic cavity.
=> CT scan (ct scan) is mainly for inflammatory conditions of the colon such as,
•> Appendicitis (Appendicitis),
•> Diverticulitis,
•> Regional enteritis (regional enteritis),
Ulcerative Colitis
Even if there is a condition, it is used to do dianoses.
Other investigation includes:=
1) Hematological and biological test: =
=> Mainly in this test
RBC (red blood cell),
Hb, serum iron test,
Iron binding capacity,
Serum B 12,
Mcv (mean corpuscular volume),
Serum albumin,
Serum Electrolyte
Tests like etc. are done.
2) stool examination: =
=> In stool examination consistency of stool, presence of blood in stool or not, any abscess is seen or not and color of stool is assessed.
=> When the stool is examined under a microscope and if pus is found in the stool, any bacillary dysentery or inflammatory bowel disease condition is detected.
3) Gastric Acid secretion
=> Gastric acid secretion is mainly used to assess the formation of any ulcer in the stomach and any malignancy condition or not.