1 / 94

Nursing Care of Upper GI Disorders and Eating Disorders

Learn about therapeutic interventions, nursing diagnoses, and surgical management for upper GI disorders and eating disorders such as anorexia nervosa and bulimia nervosa. Discover essential nursing care practices and complications of bariatric surgeries. Understand oral health care importance and complications associated with esophageal cancer.

wmarguerite
Download Presentation

Nursing Care of Upper GI Disorders and Eating Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 33 Nursing Care of Patients with Upper Gastrointestinal Disorders

  2. Nausea and Vomiting • Nausea: Urge to Vomit • Vomiting: Expelling Stomach Contents Through Esophagusand Mouth

  3. Therapeutic Interventions • None • Protect Airway • Medications • IV Fluids • NG Tube • Clear Liquids, Dry Toast

  4. Nursing Diagnoses • Nausea • Risk for Aspiration • Deficient Fluid Volume

  5. Anorexia • Lack of Appetite

  6. Eating Disorders • Anorexia Nervosa • Bulimia Nervosa

  7. Anorexia Nervosa • Females • Age 12 to 18 Years • Treatment goal • Restore Nutritional Health • 18% Die

  8. Anorexia Nervosa (cont’d) • Symptoms • Severe Weight Loss • Low Self-esteem • Compulsive Dieting • Disturbed Body Image

  9. Anorexia Nervosa (cont’d) • Nursing Care • Therapeutic Relationship • Vital Signs • Daily Weights • Intake/Output of Food and Fluids

  10. Anorexia Nervosa (cont’d) • Complications • Poor Nutrition, Electrolyte Imbalances • Decreased Vital Signs • Osteoporosis • Muscle Loss • Diabetes

  11. Bulimia Nervosa • Compulsive Eating, Self-induced Vomiting • Laxatives • “Binge–purge” • Young Women • Enamel Erosion of Front Teeth • Metabolic alkalosis

  12. Bulimia Nervosa (cont’d) • Treatment Goal • Restore Nutritional Health • Nursing Care • Therapeutic Relationship • Vital Signs, Daily Weights • Intake/Output of Food and Fluids

  13. Nursing Diagnoses: Eating Disorders • Imbalanced Nutrition: Less Than Body Requirements • Body Image, Disturbed

  14. Obesity • Weight 20% or Greater Than Ideal Body Weight • BMI • Overweight: 25 to 29.9 Kg/m2 • Obese: >30 Kg/m2

  15. Body Mass Index (BMI)

  16. Obesity (cont’d) • Caloric Intake Exceeds Energy Expenditure • Comorbidites: Diseases Associated with Obesity • Morbid Obesity: BMI >40

  17. Therapeutic Interventions • Weight Loss Through Exercise and Calorie Restriction • Support Groups • Behavior Modification

  18. Surgical Management • Types of Bariatric Surgery • Restrictive • Limits How Much Stomach Can Hold • Malabsorption • Decreases Calorie/Nutrient Absorption • Combination • Restrictive and Malabsorption

  19. Surgical Management (cont’d) • Restrictive • Laparoscopic Adjustable Gastric Banding  • Vertical Banded Gastroplasty (VBG) • Combination • Roux-en-Y Gastric Bypass

  20. Roux-en-Y Gastric BypassVertical Banded Gastroplasty

  21. Complications of Gastric Restrictive Surgeries • Vomiting • Erosion of the Gastric Tissue • Breakdown of Staple Line • Leaking of Stomach Secretions • Infection or Death

  22. Postoperative Care • Clear, Liquid Diet • Progresses to Full Liquids, Pureed Foods • Regular Foods at 6 Weeks

  23. Nursing Diagnosis: Obesity • Imbalanced Nutrition: More Than Body Requirements

  24. Oral Health Care • Important to Overall Health • Often Neglected in Daily Care • Oral Hygiene with Chlorhexidine Gluconate • Prevents Pneumonia • Reduces Ventilator-associated Pneumonia

  25. Oral Health Care (cont’d) • Prophylactic Antibiotics • Xerostomia (Dry Mouth) • Artificial Saliva Substitute • Dentures • Gingival Recession • Fluoride Gel or Rinse

  26. Oral Health Care (cont’d) • Gingivitis • Flossing Daily • Candida Albicans (Yeast Infection) • Nystatin • Angular Cheilosis

  27. Stomatitis • Inflammation of Oral Cavity • Causes • Aphthous Stomatitis (Canker Sores) • Herpes Simplex Virus Type I (Cold Sores)

  28. Oral Cancer • Risk: Alcohol or Tobacco Use • Detected Early, Curable • Painless • Difficulty in Chewing, Swallowing, Speaking • Biopsies • Radiation, Chemotherapy, Surgery

  29.  Radical Neck Dissection

  30. Oral Cancer Nursing Care • Referral: Alcohol/Tobacco Cessation • Preoperative Teaching • Postoperative • Airway • Communication • Nutrition

  31. Esophageal Cancer • Risk: Alcohol or Tobacco Use • Detected Late, Metastasizes • Difficulty Swallowing, Feeling Full, Pain in Chest, Foul Breath, Food Regurgitation • EGD, Biopsy

  32. Esophageal Cancer (cont’d) • Radiation • Chemotherapy • Surgery • Esophagogastrostomy • Dacron Esophageal Replacement • Esophagoenterostomy

  33. Esophageal Cancer (cont’d) • Nursing Diagnoses • Pain • Risk for Deficient Fluid Volume • Imbalanced Nutrition: Less Than Body Requirements

  34. Hiatal Hernia Lower Esophagus/Stomach Slides up Through Hiatus of Diaphragm into Thorax

  35. Hiatal Hernia (cont’d) • Occurs In • Women • Those over 60 • Obesity • Pregnancy

  36. Hiatal Hernia (cont’d)

  37. Hiatal Hernia (cont’d) • Signs and Symptoms • None • Pain • Heartburn • Fullness • Reflux

  38. Hiatal Hernia (cont’d) • Diagnosis • X-Ray • Fluoroscopy

  39. Therapeutic Interventions • Antacids • Small Meals • No Reclining 1 Hour After Eating • Raise Head of Bed 6 to 12 Inches • No Bedtime Snacks, Spicy Foods, Alcohol, Caffeine, Smoking

  40. Hiatal Hernia (cont’d) • Surgical Management • Fundoplication

  41.   Fundoplication

  42. Hiatal Hernia (cont’d) • Nursing Care • Teaching • Preoperative Care • Postoperative • Dysphagia with Eating

  43. Gastroesophageal Reflux Disease (GERD) • Pathophysiology • Gastric Secretions Reflux into Esophagus • Esophagus Damaged • Lower Esophageal Sphincter Does Not Close Tightly

  44. Gastroesophageal Reflux Disease (GERD) (cont’d) • Signs and Symptoms • Heartburn • Regurgitation • Dysphagia • Bleeding

  45. Gastroesophageal Reflux Disease (GERD) (cont’d) • Complications • Aspiration • Scar Tissue • Diagnosis • Barium Swallow • Esophagoscopy

  46. Therapeutic Interventions • Lifestyle Changes • Medications • Antacids • H2 Receptor Antagonists • Proton Pump Inhibitors • Prokinetic Agents

  47. Gastroesophageal Reflux Disease (GERD) (cont’d) • Esophy X • Endoscopic Procedures • Fundoplication

  48. GERD Complications • Esophagitis • Barrett's Esophagus (Precancerous) • Esophageal Cancer • Bronchospasm • Larygeospasm • Aspiration Pneumonia

  49. Barrett's Esophagus • Precancerous • Radiofrequency Ablation

  50. Gastroesophageal Reflux Disease (GERD) (cont’d) • Nursing Diagnosis • Acute Pain

More Related