ANOREXIA
LACK OF APPETITE
WHAT ARE SYMPTOMS OF ANOREXIA
NOXIOUS FOOD ODORS,CERTAIN MEDICATIONS,STRESS FEAR PSYCHOLOGICAL PROBLEMS
WHAT HAPPENS WITH PROLONGED ANOREXIA
ELECTROLYTE IMBALANCE,CARDIAC ARRHYTHMIAS
WHAT ARE NURSING PLANS FOR ANOREXIA
ENCOURAGE PREFERRED FOOD,DOCUMENT ACCURATE INTAKE AND OUTPUT, MONITOR VITALS, WEIGHT AND ELECTROLYTES, MONITOR RATE OF IV
WHAT KIND OF TEST YOU CAN GET ON A PATIENT WHO HAS ANOREXIA
ECG
NAUSEA AND VOMITING
SUBJECTIVE, URGE TO VOMIT, EXPELLING STOMACH CONTENTS THROUGH ESOPHAGUS AND MOUTH
CONDITIONS That are either directly related to GI tract or independent can trigger (NV)
viral gi infections, other infections,motion sickness,stress,pregnancy,medications,myocardial infarction,uremia,and other conditions may cause (NV)
what does it means when emesis look like coffee grounds
bleeding in the stomach and requires further investigation
what happens when you loose to much hydrochloric acid from stomach
metabolic alkalosis
what medications treat vomiting
Antiemetics and ginger
what sometimes get order for clients with NV
nasogastric tube, with suction may be ordered to decompress the stomach
anything over 25 to 30 for BMi
Is considered to be obesity
Apthous stomatitis (canker sore)
triggers
dental work
vitamin b12 or b6, zinc,folate, Iron deficiency
irritating food
gastritis therapeutic intervention
antacids
antimetics
avoid alcohol
treat cause
avoid irritating foods
npo
iv fluids
catheter
oxygen
Gastric Cancer
malignant leision
poor prognosis
hereditary
gastric bleeding
from ulcer perforation,tumor gastric surgery
occult is observable
signs and symptoms
mild-slight weaknes diaphoresis
severe hypervolimic shock , weak pulse
chills palpitations
bp goes down with gi bleed
peptic ulcers theraputic interventions
antibiotics
ppi
h2 antagonist
bismuth subsalicylate -Peptobismol
sucrafate
antacids
peptic ulcer disease diagnostics
biopsy urease test ( during endoscopy )
culture
urea breath test most accurate and non invasive
upper gi swallow
barium swallow
egd
stool looks black
signs and symptoms for peptic ulcer
nausea, vomiting,bleeding
complications perforation, obstruction, bleeding
peptic ulcers pin with food
2 to 5 hours after meals / middle of night
peptic signs and symptoms
abdominal burinig pain/ gawning pain
increased 1 to 2 hours after meals or with food
peptic ulcers
erosion of gi lining
h pylori is the main reason why for ulcer disease
its curable
stressed induced gastritis frequent use of n saids- stop them
stress ulcers, ischemia damaging mucous barrier
acid secretions create ulcerations
prophalatic ppi
enviormental gastritis chronic
infection with h pylori
signs/ symptoms-asymptomatic,anorexia,heart burn belching
treatments
antibiotics and a. ppi or h2 antagonist
gastritis -numbness to hands and feet/lack of energy
you can be asymptomatic or
dypepsia-recurrent pain
or pain after meals
leads to pernicious anemia
if you have chronic gastritis
you will need life long vitamin b12 injection
gastritis signs and symptoms
abodominal pain
nausea vomiting
ab tenderness
feeling full
belching
reflux
gastritis
protective mucosal barrier breakdown
autodigestion self eats itself
severe-perforation
scarring
esophageal varices -liver cerrosis -high risk for bleeding
dilated blood vessels in esophagus
rupture can be life threatening -They can bleed to death
hemoraging -bleeding to die
what is the right sodium level
135-145 meq
excessive bleeding with mallory weis can lead to
hypovalemic shock , initiate fluids
mallory weis intervention
self heals
ppi omeperazole
antiemetics zofran
endoscopy to control bleeding
how do we know its Mallory weis
egd
hemoglobin and hematocrit
gerd nursing care
lose weight,eat a low fat ,high protein
sleep with bed elevated 4 to 6 inches
avoid eating three hours before bed time
mallory weis tears signs and symptoms
bright red bloody emesis
bloody or tarry stools
risk factors for mallory weiss tears
hiatal hernia , alcohol use - cerosis
mallory weiss tear -can bleed to death - ding ding
longitudinal tear in mucous membrane of esophogus at stomach junction
tears from sudden, powerful, or prolonged force, ex vomiting or coughing or seizure
ppi inhibitors end in
zole
medications for GERD
antacids,(mylanta)
histamines2 (h2) receptors antagonist (pepsin)
proton pump ppi (omeperazole)
what is the treatment of barretts Esophagus
radiofrequency ablation removes barretts tissue
COMPLICATIONS OF GERD
ASTHMA
ASPIRATION PNEUMONia
broncospasm-went into lung causes stridor
barretts esophagus - precancerous
DIAGNOSIS OF GERD
UPPER ENDOSCOPY
ESOPHAGEAL MANOMETRY
PH MONITORING
SIGNS AND SYMPTOMS OF GERD
HEARTBURN
REGURGITATION
HOARSENESS
SORE THROAT
what test you take with esophogeal cancer
egd biopsies
what are signs and symptoms of esophageal
Difficulty Swallowing. DIngDing
weight loss
feeling full
pain in chest
food regurgitation
\
when you have a hiatal hernia what can it lead to
leads to gerd
whats the problem with gerd
it burns tissue , leads to baretts precancer then it leads to esophogeal
Esophageal Cancer when its late diagnosed
Metastasizes,
Risk factors Alcohol, tobacco
being over weight or obese
Human PapillomaVirus
Barretts esophagus DINGDING
what are some nursing care for oral cancer
alcohol and tobacco cessation
pre opp teaching -Tracheostomy
communications
post opp - Airway Nutrition
what are therapeutic interventions
Radiations
Chemotherapy
surgery radical-Taking part of the neck
oral cancer
highest risk from alcohol or tobacco use
curable if detected early
signs and symptoms painless, difficulty chewing,swallowing ,speaking
if you take nsaids alot what could it do
Give gi bleeding
oral health care prevents what
prevents pneumonia
helps prevent pneumonia related death in older patients
antibiotics prophylaxis
with any surgery what should you be mindful with ding ding
PAIN MAke sure clients pain is under control
With gastric bypass surgery what should you avoid while eating
fluids with meals , wait a while before having fluids and you can lie down 30 to 60 mins after eating
post opp care for gastric bypass
only allowed 30 cc or 30ml
post opp
clear liquid diet small amounts
no straw
progress to full liquids, pureed foods
regular foods at 6 weeks
if a client has diaphoresis or is Tachycardia DINGDING
Gallstones
gastric bypass surgery
eat high protein diets
high fiber
complex carbohydrates
always keep clients head up when they have this surgery to prevent pneumonia
gastric bypass surgery
acids that goes to peritoneum what happens
peritonitis
what kind of bmi is someone who is morbidly obeses
100 % over weight
No more simple sugars with what?
Gastric surgeries
Complications of gastric restrictive Surgeries
nausea and vomiting
erosion of gastric juice-not chewing well
break down of staple line
leaking of stomach secretions
infection or death
protein vitamins deficiency
Gastric bypass (rou-en Y)
reduces stomach size done laproxipy connect to small intestin
sleeve gastrectomy
Most common 75 percent of stomach is gone which looks like a sleeve
surgical management
restrictive how much stomach can hold
malabsorption decrease calorie intake /nutrient absorption
combination - restrictive and malabsorption
nursing diagnosis for obesity
IMbalanced Nutrition more than body requirements
theraputic interventions for obesity
weight loss
support groups
behavior modification
bariatric surgery
obesity comorbidities
Artherosclerosis
gallbladder disease
type to diabetes melitus
heart disease
sleep apnea
depression
hypertension
A bmi over 30
is obese
bmi of 25 to 30 is
over weight
morbid obesity
is 100 percent over ideal body weight
20 percent over
is ideal body weight bmi
ekg
can monitor electrolytes
what test can show anemia
low red blood cells
Can anorexia be deadly
Yes because of electrolyte imbalance cardiac arithmia knocks potassium
Signs and symptoms of Amorhea
hypotension,constapation
what can anorexia cause
It can cause severe electrolyte imbalance
Roux-en-Y gastric bypass
reduces stomach size and bypass the small intestines which reduces the absorption of calories causing weight loss
sleeve Gastrectomy
removes 75 percent of stomach leaving a slim narrow tube (Gastric sleeve) reduce stomach volume and food intake, it decreases ghrelin produced by stomach for hunger
ways to decrease dumping syndrome
eating small meals
eating meals that are high in fiber , high protein, complex carbohydrates,
NO SIMPLE SUGARS
Avoid fluids with meals
what can you avoid to not get gerd or hiatal hernia
avoid spicy food,or foods that cause symptoms,like citrus,or tomatoes products, avoid alcohol, chocolate, coffee peppermint avoid within 3 hours of bed time
a patient who has gastric bypass will always need what supplement
b12,thiamin, iron, copper
what are common micronutrient defficiencys in gastric bypass
thiamin, vitamin b12, vitamin d, iron and copper, intake of less then recommended amounts of calcium, magnesium and zinc, folate and phosphorous occur
what kind of food bariatric patients eat
choosing foods that high protein, low fat and sugar,
eating six small meals a day
chew thoroughly and eat slowly
void carbonated drinks
and drinking from a straw to reduce air in gi
taking vitamins and mineral supplements as prescribe
bariatric surgery how many weeks are you on a strict regiment
12 weeks post opp
what are obesity related disease
sleep apnea, or heart disease, increase health risk ,associated with diseaseases called comorbidities atherosclerosis,gallbladder disease,hypertension,osteoarthritis,type 2 diabetics,decreased mobility lack of self esteem and depression
what kind of patients are candidates get bariatric surgery
patients weigh over 100 more pounds over ideal weight,have a bmi above 40,have a bmi above 35 with comorbidities or type two diabetes mellitus, or have ineffectively control type 2 diabetes
bariatrics surgery
weight loss surgery