Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 7 Gastrointestinal System^307



  • Epigastric area discomfort

  • Epigastric tenderness on palpation due to gastric irritation

  • Bleeding from irritation of the gastric mucosa

  • Hematemesis—possible coffee ground emesis due to partial digestion of blood

  • Melena—black, tarry stool


INTERPRETING TEST RESULTS



  • Hemoglobin and hematocrit decrease.

  • Anemia (iron deficiency) due to chronic, slow blood loss.

  • Fecal occult blood positive.

  • Helicobacter pylorimay be positive.

  • Upper endoscopy shows inflammation, allows biopsy.


TREATMENT



  • Administer antacids:

    • Maalox, Mylanta, Tums, Gaviscon



  • Administer sucralfate to protect gastric lining.

  • Administer histamine 2 blockers:

    • ranitidine, famotidine, nizatidine, cimetidine



  • Administer proton pump inhibitors:

    • omeprazole, esomeprazole, pantoprazole, rabeprazole, lansoprazole



  • EradicateHelicobacter pyloriinfection if present.

  • Diet modification.

  • Monitor hemoglobin and hematocrit.


NURSING DIAGNOSES



  • Risk for imbalanced nutrition: less than what body requires

  • Risk for imbalanced fluid volume

  • Nausea

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