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Includes: appendectomy, gastroenteritis, inflammatory bowel disease, live cirrhosis, and more. Numerous antibiotics also have nephrotoxic side effects that may worsen kidney damage and urine production. Here are four (4) nursing care plans (NCP) and nursing diagnoses for Gastroenteritis: Diarrhea is a common symptom of acute gastroenteritis caused by bacterial, viral, or parasitic infections because these microorganisms can damage the lining of the digestive tract and lead to inflammation, which can cause fluid and electrolytes to leak from the body. 1. Hemoglobin is the oxygen-carrying component of blood while hematocrit reflects blood volume. The nurse is conducting a community education program on peptic ulcer disease prevention. Observe and assess the patients level of pain on a scale of 0-10. Get a better understanding of this condition and how to provide the best care for patients. 4. Thanks for the questions I have learned something. This restricts or prevents access to infectious agents and cross-contamination. Peptic ulcer is classified into gastric, duodenal or esophageal ulcer. Signs and symptoms include: After a physical examination, diagnostic procedures like blood tests, x-rays, abdominal CT scans, upper endoscopy, or a colonoscopy may be performed to confirm the condition. Decreased bowel sounds may indicate ileus. Ensure infection control precautions are followed.Interventions that can help reduce infection in patients with bowel perforation include meticulous hand hygiene before and after handling the patient, the surgical site, and IV sites or catheters. 2. Educate the client about perianal care after each bowel movement.The anal area should be gently cleaned properly after a bowel movement to prevent skin irritation and transmission of microorganisms. Encourage increase fluid intake of 1.5 to 2.5 liters/24 hours plus 200 ml for each loose stool in adults unless contraindicated.Increased fluid intake replaces fluid lost in liquid stools. 1. Surgery may be necessary if bleeding is severe and tests cant visualize the source. Provide a sufficient amount of free water with meals and a nutritionally balanced diet or enteral feedings.Avoid using formulas that are too hyperosmolar or heavy in protein. In contrast, no client with a duodenal ulcer has pain during the night often relieved by eating food. Encourage the client to eat foods rich in potassium.When a client experience diarrhea, the stomach contents which are high in potassium get flushed out of the gastrointestinal tract into the stool and out of the body,resulting in hypokalemia. These contents can range from feces from a more distal location of perforation to extremely acidic gastric contents in more proximal bowel perforation. F. actors that may affect the functionality of the gastrointestinal tract include age, anxiety levels, intolerances, nutrition and ingestion, mobility or immobility, malnutrition, medications, and recent or coming surgical procedures. Risk for Imbalanced Nutrition: Less Than Body Requirements, Nursing Diagnosis: Risk for Imbalanced Nutrition: Less Than Body Requirements related to metabolic abnormalities (increased metabolic needs) and intestinal dysfunction secondary to bowel perforation. 3. Administer fluids and electrolytes as ordered. Administer antidiarrheal medications as prescribed.Bismuth salts, kaolin, and pectin which are adsorbent antidiarrheals are commonly used for treating the diarrhea of gastroenteritis. B. Peristalsis may be increased, decreased, or may even be absent. Discover the key nursing diagnoses for managing inflammatory bowel disease. It is vital to determine the source and cause of bleeding and intervene. If the condition does not improve, a surgical intervention called fundoplication may be done. Jones MW, Kashyap S, Zabbo CP. Desired Outcome: The patient will maintain a normal weight and a positive nitrogen balance. She found a passion in the ER and has stayed in this department for 30 years. The patient will verbalize an understanding of the individual risk factor(s). It also allows the development of an appropriate and suitable treatment plan that will improve systemic perfusion and organ function of the client. This is due to a decrease in blood flow and oxygen in the gastrointestinal system. Teach the patient how to change the dressing aseptically and wound care. As a result, organs enclosed within the peritoneal cavity are exposed to digestive fluids, forming a hole through the wall of the organ. This reduces the patients urge to vomit and gastrointestinal stimulation. Gastrointestinal Care Plans Care plans covering the disorders of the gastrointestinal and digestive system. Nursing care planning goals of gastroesophageal reflux disease(GERD)involves teaching the patient to avoid situations that decrease lower esophageal sphincter pressure or cause esophageal irritation. Nursing Diagnosis: Dysfunctional Gastrointestinal Motility related to limited fluid intake and sedentary lifestyle as evidenced by infrequent passage of stool, straining upon defecation, passage of dry, hard stool. The loss of blood can decrease oxygenation and perfusion to the tissues. There are three major causes of peptic ulcer disease: infection with H. pylori, chronic use of NSAIDs, and pathologic hypersecretory disorders (e.g., Zollinger-Ellison syndrome). Proton-pump inhibitors may be prescribed to curb stomach acid production. Awareness and ability to recognize and express feelings. Dietary modifications: nothing by mouth, liquids as tolerated. Evaluate the pattern of defecation.The defecation pattern will promote immediate treatment. To help diagnose the patients condition. Other causes include medications, food poisoning, infection, and metabolic disorders. Assess for abdominal pain, abdominal cramping, hyperactive bowel sounds, frequency, urgency, and loose stools.These assessment findings are commonly connected with diarrhea. When intake is restarted, the risk of stomach irritation is reduced by a careful diet progression. The nursing goals of a client with a peptic ulcer disease include reducing or eliminating contributing factors, promoting comfort measures, promoting optimal nutrition, decreasing anxiety with increased knowledge of disease, management, and prevention of ulcer recurrence and preventing complications. Complications of bowel perforation may include: Diagnostic tests for bowel perforation should usually include: Treatment for bowel perforation should usually include the following: Nursing Diagnosis: Risk for Infection related to inadequate primary defenses invasive procedures, and immunosuppression secondary to bowel perforation. Food-borne gastroenteritis or food poisoning is associated with bacteria strains such as Escherichia coli, Clostridium, Campylobacter, and salmonella. Hinkle, J. L., & Cheever, K. H. (2018). This indicates the capacity to resume oral intake and the resumption of regular bowel function. Educate the patient to avoid triggers. Changes in BP, pulse, and respiratory rate. B. Clostridium difficile Stopping the source of gastrointestinal bleeding will also control the fluid volume deficiency. Provide the patient with frequent skin care and maintain a dry and wrinkle-free bedding. Monitor the patients skin moisture, color, and temperature.Warm, dry, and flushed skin are early signs of sepsis. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. This lowers the danger of contamination and gives the chance to assess the healing process. Patient will verbalize understanding of the condition, its complications, and the treatment regimen. Bowel Perforation Nursing Diagnosis & Care Plan Bowel perforation, a serious medical condition requiring emergency medical care, occurs when a hole develops in the bowel wall. Characterize the pain according to onset, quality (dull, sharp, constant), location, and radiation. Here are 6 nursing care plans for Peritonitis. She has worked in Medical-Surgical, Telemetry, ICU and the ER. Nursing diagnoses handbook: An evidence-based guide to planning care. Likewise, the continuous release of fluids may cause dehydration. In this disorder, the esophagus gradually widens as food regularly accumulates in the esophagus. The nurse is assessing a client with advanced gastric cancer. Hafner J, Tuma F, Hoilat GJ, et al. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Instruct patient about particular foods that will upset thegastric mucosa, such as coffee, tea, colas, and alcohol,which have acid-producing potential. The management of the patient with a peptic ulcer is as follows:. Although not unusual, changes in location or intensity could signal developing complications. consistent with gastric perforation. Patient Assessment Assess tissue perfusion. 2. Available from: Lewiss Medical-Surgical Nursing. Administer fluids and electrolytes as ordered. 2014. However, common signs and symptoms include severe abdominal pain, bloating, nausea and vomiting, fever, chills, and a rapid heartbeat. Elsevier, Inc. Bowel perforation is typically diagnosed through a combination of physical examination, imaging tests, and laboratory tests. Assess nutritional status.The nurse must take into account the current consumption, weight fluctuations, oral intake issues, supplement use, tube feedings, and other variables (e.g., nausea and vomiting) that may have an adverse impact on fluid intake. Here are five (5) nursing care plans (NCP) for peptic ulcer disease: Hospitalization may be needed for clients who experience severe dehydration as a result of the vomiting and diarrhea. 3. Since analgesics can conceal symptoms and indications, they may be withheld throughout the first diagnostic process. The most common signs and symptoms noted are heartburn, and indigestion. Bowel ischemia and gastrointestinal (GI) hypoperfusion can be caused by blood loss, hypovolemic or hypotensive shock, or both. Buy on Amazon, Silvestri, L. A. 3. Evaluate the effectiveness of pharmacologic pain management.Because pain perception and alleviation are subjective, it is best to evaluate pain management within an hour after administration of medication. Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). This exposes the structures within the peritoneal cavity to gastrointestinal contents. There are various etiologies of constipation, including but not limited to certain medications, rectal or anal disorders, obstruction, neuromuscular conditions, irritable bowel syndrome, immobility, and others. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. Advance the diet from clear liquids to soft meals. Nursing interventions for the patient may include: If perforation and penetration are concerns: The patient should be taught self-care before discharge. Reduce interruptions and group tasks to allow for a quiet, restful environment. Recommend resuming regular activities gradually as tolerated, allowing for enough rest. In some cases, there may be a pain-free period followed by worsening pain due to decompression just after perforation. Administer prescribed medications.Give prescribed prophylactic medications, such as antiemetics, anticholinergics, proton pump inhibitors, antihistamines, and antibiotics. Assist the healthcare provider in treating underlying issues.Collaboration with the healthcare provider is necessary to determine the root cause of decreased fluid volume and bleeding. Elsevier/Mosby. When the bowel becomes perforated, stool and other gastric contents may spill into the abdomen and the peritoneum, causing peritonitis and sepsis. C. Perforation. Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Anna Curran. Irregular mealtimes may cause constipation. The nurse can also provide non-pharmacologic pain management interventions such as relaxation techniques, guided imagery, and appropriate diversional activities to promote distraction and decrease pain. C. Severe gnawing pain that increases in severity as the day progresses. Maintenance of nutritional requirements. Assess imaging and laboratory studies.Imaging studies like colonoscopy, CT scan, and x-ray can help confirm the diagnosis, locate the perforated site, and plan appropriate interventions to manage the extent of bowel perforation. C. eating meals when desired. Explain diagnostic tests and administering medications onschedule. 1. What are the common causes of bowel perforation? Prepare and assist in surgery.Surgery is indicated in patients with bowel perforation to help repair the perforated area and prevent complications like peritonitis and sepsis. Patient will be able to verbalize relief or control of pain. Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Pneumatic dilation may be done. How is bowel perforation diagnosed and treated? We may earn a small commission from your purchase. Any bleeding that takes place in the gastrointestinal tract is referred to as gastrointestinal (GI) bleeding. Nursing Care Plans Related to Gastrointestinal Bleed Duodenal ulcers cause bowel perforation at a rate that is 2- to 3-times higher than stomach ulcers do, making ulcerative disease the most common cause of bowel perforation in adults. Even though bowel sounds are typically absent, intestinal inflammation and irritation can also cause diarrhea, decreased water absorption, and intestinal hyperactivity.

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