Assessment of a patient with a GI disorder By Gabie Gomez

Assessment ( subjective) Past history: smoking, alcohol use, medication abuse, recent travel, food intake. Pain (oral, tongue,throat, abdominal) Appetite Pyrosis Dysphagia Dyspepsia (nausea, eructation, distention) Weakness Diarrhea or Constipation

Assessment ( objective) Vitals signs Feel for hard spots/distention(palpitate 4 quadrants) Skin color Edema Abdomen distention Wheezing Weight Loss Stool color, consistency, presence of ascites, frequency, blood, and last BM Hematemesis

Outcomes/Planning Relief pain and discomfort Stabilization of fluid and electrolyte imbalance Having no complications Resume normal activity If possible return to normal pancreatic and liver function Patient will feel rested and assist in ADL’s.

Implementation Assessment Monitor nutritional status Administer medication Relieving pain Managing fluid and electrolyte imbalance Prevent wound infections Eliminate smoking, and excessive alcohol abuse Promote normal bowel elimination Stoma care

Meds Antacids ( maalox, mylanta, titrialac) Action: Neutralizes gastric acid. Side Effects: Constipation, chalky taste, diarrhea, increased thirst, stomach cramps Nursing Implication: Monitor electrolyte with long tem use Intervention: Do not take antacids if you have signs of appendicitis or an inflamed bowel.

Meds Antiemtic : (Dramamine, Compazine, Promethazine,Reglan) Action: Blocks central vomiting center. Side Effects: Drowsiness, dry mouth, constipation Nursing Implication: Avoid the use with other CNS depressants and alcohol. Intervention: They may may produce hypotension when used with antihypertensives, nitrates, or acute ingestion of alcohol.

Meds H2 receptor blockers (Zantac, Pepcid, axid, Tagamet) Action: decrease acid by blockingthe production of gastric acid, used to heal ulcers and relieve the symptoms of pain Side Effects: confusion, headache, constipation, diarrhea. Nursing Implications: Increases serum levels, effects anticoagulants Interventions: Do not give histamine receptor antagonist within 2 hours of antiacids.

Meds Antibacterial therapy (Flagyl, tetracycline, biaxin, prilosec) Action: kills or prevents the growth of certain bacteria and protozoa (single cell animals). Side Effects:clumsiness, dizziness, or unsteadiness fever or chills, sore throat, numbness, tingling, pain or weakness in the hands or feet, seizures (convulsions) skin rash, itching Nursing Implications: Smoking should be eliminated Interventions:Dietary modifications are necessary, foods and beverages irritating to the pt. should be avoided.

Meds Proton pump inhibitor : ( Zantac, Pepcic, Nexium) Action: antisecretory agent that inhibits secretion of gastrin by the parietal cell of the stomach. Side effects: Headache, dizziness, abdominal pain, nausea, vomiting, bone marrow suppression(rare). Nursing Implications: Inhibits hepatic metabolism of warfarin, phenytonin and other drugs. Interventions: Do not chew or crush capsule contents

Meds Mucosal healing agents (Carafete) Action: Heals ulcers without antisecretory properties, possibly by adhering to the proteins in the ulcer base. Side effects: Constipation, hypophosphatemia Nursing Implication: Take Carafate 2 a other drugs can interfere with absorption. Intervention:If Carafate is taken with certain other drugs, the effects of either could be increased, decreased, or altered.

Meds Antisecretory and cytoprotective : (Cytotec) Action: prostaglandin (hormone-like substance), reduces the production of stomach acid and protects the stomach lining against NSAID induced ulcers. Side effects:Constipation, gas, indigestion, headache, heavy menstrual bleeding, cramps, paleness, stomach or intestinal bleeding, vomiting Nursing Implications: Avoid with the use of alcohol or sedatives Interventions: To reduce the risk of diarrhea, take Cytotec with food and avoid taking it with a magnesium-containing antacid

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