Nursing Tips: Gastrointestinal

Proton Pump Inhibitors

Omeprazole and Pantoprazole are Proton Pump Inhibitors used to treat duodenal and gastric ulcers, GERD, and Zollinger-Ellison syndrome. HINT: I will take Omeprazole and pray my ulcer pain goes away.

Proton Pump Inhibitors: Patient Teaching

Gastrointestinal Pharmacology

Educate patients taking proton pump inhibitors (e.g., omeprazole, pantoprazole) to report watery diarrhea, as these medications can cause C. diff by decreasing stomach acid production.

Failure to Thrive (FTT)

Gastrointestinal Pediatrics

Failure to Thrive (FTT) is indicated by a child's weight being less than the fifth percentile. Assess for both organic causes and parental bonding/care of the child.

A patient with appendicitis is likely to have RLQ pain at McBurney's Point along with rebound tenderness, nausea/vomiting, and fever.

Appendicitis: Nursing Care

Gastrointestinal Med-Surg

A patient with appendicitis is likely to have RLQ pain at McBurney's Point along with rebound tenderness, nausea/vomiting, and fever.

When caring for a child with appendicitis, report to the provider any sudden relief of pain. This may indicate that the appendix has perforated and requires emergency surgery!

Appendicitis: Family Teaching

Gastrointestinal Pediatrics

When caring for a child with appendicitis, report to the provider any sudden relief of pain. This may indicate that the appendix has perforated and requires emergency surgery!

A patient undergoing a paracentesis (drainage of fluid from the peritoneal cavity using a needle) must empty their bladder prior to the procedure.

Paracentesis: Nursing Care

Gastrointestinal Medical Terminology

A patient undergoing a paracentesis (drainage of fluid from the peritoneal cavity using a needle) must empty their bladder prior to the procedure.

Ostomy Patient Teaching

Gastrointestinal Med-Surg

Ostomy patient teaching:

Cut opening in skin barrier ≤ 1/8" bigger than the measured stoma size to prevent skin damage from contact with ostomy output.
Assess stoma regularly - should be pink/moist. Pale/blue stoma indicates ischemia.

Meckel's Diverticulum

Gastrointestinal Pediatrics

A child with Meckel's Diverticulum is likely to exhibit painless rectal bleeding and stool with the consistency and appearance of "currant jelly."

A major complication of peptic ulcer disease is perforation of an ulcer. Assess for symptoms of perforation such as severe pain, fever, or a rigid/boardlike abdomen.

Peptic Ulcer Disease: Signs and Symptoms

Gastrointestinal Med-Surg

A major complication of peptic ulcer disease is perforation of an ulcer. Assess for symptoms of perforation such as severe pain, fever, or a rigid/boardlike abdomen.

Celiac Disease is the inability to digest gluten. Foods containing wheat, rye, and barley should be avoided.

Celiac disease is the inability to digest gluten. Patients with celiac disease CAN eat: dairy, rice, corn, potatoes, eggs, fruits and vegetables. Foods containing wheat, rye, and barley should be avoided.

A child who is crying without producing tears should be evaluated for severe dehydration. In this case a child may also have deeply sunken eyes, little to no urine output, have lost > 10% of their body weight, and could have capillary refill > 4 seconds.

Severe Dehydration in Children

Gastrointestinal Pediatrics

A child who is crying without producing tears should be evaluated for severe dehydration.

Best practices for patients with DYSPHAGIA: Sit patient in upright position (High-fowler's). Lightly stroke chin/throat to promote swallowing. Teach patient to tuck their chin towards their chest when swallowing. Thicken thin liquids.

Dysphagia Best Practices

Gastrointestinal Med-Surg Nutrition

Best practices for patients with DYSPHAGIA

ANTACIDS: Take 1 hr and 3 hr after meals, and at bedtime. Also take 1 hour before or after other medications (not WITH other medications)

When to take Antacids

Gastrointestinal Pharmacology

ANTACIDS: Take 1 hr and 3 hr after meals, and at bedtime. Also take 1 hour before or after other medications (not WITH other medications)

Dysphagia

Gastrointestinal Med-Surg

Patients with dysphagia (difficulty swallowing) need to have a swallow evaluation by a speech language pathologist.

Gastric and Duodenal Ulcers

Gastrointestinal Med-Surg

Key differences in symptoms for Gastric and Duodenal ulcers: Gastric ulcer: Pain 30-60 minutes after meal, worse in DAY, worse with eating. Duodenal ulcer: Pain 1.5-3 hours after meal, worse at NIGHT, better with eating.

Patient Teaching for GERD

Gastrointestinal Med-Surg

Patient teaching for GERD: Avoid fatty, fried, citrus, spicy foods. Eat smaller meals. Remain upright after meals. Avoid tight-fitting clothing. Lose weight (if applicable). Quit smoking. Elevate HOB with blocks.

Dumping Syndrome Nutrition

Gastrointestinal Nutrition

Nutrition recommendations to prevent DUMPING syndrome:

Consume small frequent meals.
Do not drink liquids with meals.
Include protein and fat at each meal.
Avoid dairy products and concentrated sugar.

Diverticulitis Nutrition

Gastrointestinal Nutrition

Patients with Diverticulitis should avoid seeds and husks. Avoid: popcorn, tomatoes, berries.

Cholecystitis Nutrition

Gastrointestinal Nutrition

Patients with cholecystitis should consume a LOW FAT diet.

Sucralfate

Gastrointestinal Pharmacology

Sucralfate is a Mucosal Protectant used to treat duodenal ulcers. It reacts with stomach acid to form a thick paste that adheres to ulcers. HINT: Sucralfate gets sucked down into ulcers.

IBS Medications

Gastrointestinal Pharmacology

Irritable Bowel Syndrome (IBS) Medications: alosetron is used for IBS w/diarrhea.
HINT: You might aloe on your backside from all that diarrhea.

Lubiprostone is used for IBS w/consipation.
HINT: Use lubiprostone to "lube up that stone-like stool".

Ondansetron

Gastrointestinal Pharmacology

Ondansetron is an antiemetic (used to prevent nausea and vomiting). Hint: "I threw up on DAN. Better get me some ondansetron."

Misoprostol and Pregnancy

Gastrointestinal Pharmacology

Misoprostol can be used to prevent gastric ulcers in patients taking NSAIDs. Do NOT administer to a patient who might be pregnant (because it can cause a miscarriage). HINT: "Me so pregnant, so no misoprostol for me" or "Misoprostol can cause a Miscarrage".