Nursing interventions for clients with lower gastrointestinal disorders

Select appropriate nursing interventions for clients with lower gastrointestinal disorders.

Scenario

Patient and family education is important in increasing adherence. To provide education to patient and families, you are going to create a poster about a gastrointestinal disorder that will be displayed in a physician’s office.

Instructions

Please be sure to include the following in your poster design.

1. Overview of the disorder
2. Causes of the disorder
3. Diagnostic tests to diagnosis the disorder
4. Assessment findings
5. Multidimensional nursing care interventions for the disorder

Digestive Poster

PEPTIC ULCER DISEASE (PUD)

A peptic ulcer is a stomach or duodenal mucosal lesion. Peptic ulcer disease (PUD) occurs when mucosal defenses fail and the epithelium is no longer protected from the effects of acid and pepsin. PUD affects millions of adults worldwide. The mortality rate for PUD has dropped in recent decades, thanks in part to the use of proton pump inhibitors and earlier H. pylori treatment.

Various types of peptic ulcers
Gastric ulcers are most commonly found in the antrum of the stomach, near the acid-secreting mucosa.
Stress ulcers (less common): are acute gastric mucosal lesions that occur following an acute medical crisis or trauma, such as sepsis or a head injury. Duodenal ulcers: occur in the upper section of the duodenum (Ignatavicius, D. et al., 2021).

PEPTIC ULCER DISEASE CAUSES ( PUD)
Bacterial infection with H. pylori and NSAIDs are the most common causes of peptic ulcer disease.
NSAIDs (e.g., ibuprofen) weaken the mucosal barrier and impair mucosal protection, which is mediated systemically through COX inhibition.
GI problems from NSAID use can emerge at any time, even after lengthy periods of trouble-free use.
Certain chemicals may contribute to gastroduodenal ulceration by changing stomach secretion, causing localized injury to the mucosa and interfering with recovery process. Corticosteroids (e.g., prednisone), theophylline (Theo-Dur), and caffeine, for example, enhance hydrochloric acid production. PUD consequences include bleeding, perforation, pyloric blockage, and intractable disease. The most serious complication is bleeding. It is more common in people with stomach ulcers and in elderly adults. As shown in the image below, gastric and duodenal ulcers can perforate and bleed. Perforation happens when an ulcer grows so deep that it wears away the whole thickness of the stomach or duodenum. The volume and kind of GI contents spilt correspond with the amount and type of pain.

PEPTIC ULCERS DIAGNOSTIC TESTS

H. pylori can be detected in the patient’s blood, breath, or feces using three easy, noninvasive procedures. The most common way for confirming H. pylori infection is

serologic testing for H. pylori antibodies.

The urea breath test consists of eating a capsule, liquid, or pudding containing urea with a certain carbon atom.

The stool antigen test is performed on a stool sample provided by the patient and looks for H. pylori antigens.

The major diagnostic test for PUD is esophagogastroduodenoscopy (EGD), which is the most accurate method of diagnosis. EGD provides direct vision of the ulcer crater, allowing the health care professional to collect specimens for H. pylori tests, as well as biopsy and cytologic examinations to rule out stomach cancer.

• Assessment Findings
  Physical examination findings may demonstrate epigastric soreness, which is usually found between the umbilicus and the xiphoid process.
• Auscultation of the abdomen may indicate hyperactive bowel noises, which may fade as the illness progresses.
  If there is a perforation into the peritoneal cavity, the patient will often have a stiff, board-like abdomen, as well as rebound soreness and pain.
• The most commonly reported symptom of PUD is dyspepsia (indigestion). It is commonly described as being sharp, scorching, or gnawing.
• Some people may experience discomfort as abdominal pressure, fullness, or hunger (Ignatavicius, D. et al., 2021).

• INTERVENTION IN MULTIDIMENSIONAL NURSING CARE FOR PUD

• Unless the patient develops a more severe disease, such as upper GI bleeding, which necessitates hospitalization for management, most PUD patients are cared for in the community.
• While in the hospital, Gather information about the causes and risk factors for peptic ulcer disease (PUD). Inquire with the patient about factors that may contribute to the development of PUD, such as alcohol and tobacco usage.
• PUD creates substantial discomfort and has a negative impact on many parts of everyday life. Drug medication and dietary changes are the mainstays of pain management interventions.
• The major goals of PUD medication therapy are to (1) relieve pain, (2) remove H. pylori infection, (3) heal ulcerations, and (4) avoid recurrence PPI–triple therapy, which comprises a proton pump inhibitor (PPI) such as lansoprazole (Prevacid) with two antibiotics, is a common treatment strategy for H. pylori infection For 10 to 14 days, take metronidazole (Flagyl, Novonidazol) and tetracycline (Ala-Tet, Panmycin, Nu-Tetra) or clarithromycin (Biaxin, Biaxin XL) and amoxicillin (Amoxil, Amoxi).
• Teach the peptic ulcer patient to avoid foods and beverages that enhance stomach acid output. Caffeine-containing beverages are included (coffee, tea, cola). Because coffee contains peptides that increase gastrin secretion, both caffeinated and decaffeinated coffees should be avoided.
• Teach the patient to avoid any foods that make them feel ill. During the acute symptomatic period, a bland, non-irritating diet is advised. Snacks before bedtime are discouraged since they may induce stomach acid release.
• Teach patients about stress-reduction alternative and integrative therapies such as hypnosis and visualization. Yoga and meditation approaches, for example, have been shown to be beneficial in the treatment of anxiety disorders (Ignatavicius, D. et al., 2021)

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