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Nursing Care of Patients WithUpper GI Disturbances Nursing Management II.

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Presentation on theme: "Nursing Care of Patients WithUpper GI Disturbances Nursing Management II."— Presentation transcript:

1 Nursing Care of Patients WithUpper GI Disturbances Nursing Management II

2 Knowing Gastroesophageal Reflux  Backward flow of the gastric contents into the esophagus  Heartburn is hallmark symptom  Pressure differences between stomach and lower esophagus  Contributing factors Increased gastric volume Positioning (bending over, lying down) Obesity Tight clothing Hiatal hernia

3 Manifestations of GERD

4 Complications with the Esophagus  Esophageal strictures  Barrett’s esophagus

5 Knowing Achalasia

6 Knowing Hiatal Hernias

7 Knowing Gastritis: Acute and Chronic  Manifestations of Acute: Anorexia Pain, nausea, vomiting Melena or hematemesis Belching Manifestations of Chronic: Asymptomatic or vague symptoms Once atrophied, then digestive and gastric emptying problems Fatigue Anemia B12 deficiency may exist H. pylori

8 Medications  Proton pump inhibitors  H 2 receptor blockers  Anti-ulcer  Promotility agents  Antacids  Clients testing + for H. pylori will be placed on combination antibiotic and PPI therapies

9 Upper Endoscopy

10 Commonly Used Diagnostic Test  Allows direct visualization of the esophagus  Can also biopsy  Uses conscious sedation  Culture for H. pylori (bacteria linked to chronic gastritis & peptic ulcer disease)

11 Common Nursing Diagnosis  Imbalanced Nutrition Less than Body Requirements  Pain  Ineffective Health Maintenance

12 Knowing Peptic Ulcer Disease  Peptic Ulcers may occur in the esophagus, stomach or duodenum  Duodenal most common.  Gastric more often affect older adults  Risk Factors  H Pylori Infection  Use of NSAIDS  Cigarette Smoking  Family History

13 Peptic Ulcers Gastric Ulcer Duodenal Ulcer

14 Manifestations and Complications  Pain is classic symptom  Complications  Hemorrhage  Gastric Outlet obstruction  Perforation

15 Collaborative Care Diagnostics  Upper GI  Gastroscopy  H. Pylori Testing  Biopsy Urease test  Urea breath test

16 Collaborative Care  Treatments Dietary management Surgery Management of complications  Medications  Eradicate H. Pylori  Decrease gastric acid content  Agents that protect the mucosa

17 Knowing Stomach Cancer Risk Factors  H. Pylori Infections  Genetic Predisposition  Chronic Gastritis  Pernicious anemia  Gastric polyps  Carcinogenic factors in the diet such as smoked food and nitrates

18 Collaborative Care  Diagnostics  Surgery Partial gastrectomy Billroth I (duodenum) Billroth II (jejunum) Total gastrectomy Postoperative Nursing Care

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