Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Exocrine: water hydrochloric acid, Condition in which part of the stomach bulges up above the
bicarbonate(pancreas), digestive juices diaphragm into the chest cavity/thoracic. May weaken the LES
Endocrine: stomach and small intestines Hormones of the esophagus which can lead to regurgitation
Medical and Surgical management 1. Dysphagia due to too tight or too long fundoplication
2. Torsion of abdominal esophagus due to poor spatial
1. Proton pump inhibitors (omeprazole, lansoprazole) positioning of fundoplication
before meals stimulate acid production 3. Gastric volvulus
4. Fibrosis (scar tissue formation)
2. laparoscopic fundoplication 5. Wound infection
6. Tension pneumothorax
A new valve is constructed as the upper portion of the stomach
(fundus) is wrapped around the lower end of the esophagus. 1. Pyloric Stenosis
The wrap is intended to support the sphincter muscle so that it
will open only when it is supposed to and not allow stomach acid Also known as infantile hypertrophic pyloric stenosis (IHPS) is
to push its way up into the esophagus. the most common cause of intestinal obstruction in infancy
3. LINX procedure A gastric obstruction brought about by any disease process that
produces mechanical impediment to gastric emptying
A permanent, drug free treatment for GERD that consists of a
small band of magnetized titanium beads wrapped around the 3ps palpable mass projectile vomiting peristalsis visible
Lower esophagus LES located at the base of
Patho
3. endoscopic therapy (to inject botulinum toxin A)
improves esophageal emptying in achalasia Obstruction > vomiting as cardinal symptoms > poor calorie
intake and weight loss > malnutrition > fluid and electrolyte
5. pneumatic dilation dilates narrowed esophageal imbalance >gastric dilatation and decreased contractility >
sphincter in achalasia aspiration pneumonia
Surgical disruption of muscles at LES to decrease resting St segment (t atrial) the time it starts contraction till start of
pressure to release and relax the muscle > opening the LES > relaxation (potassium imbalance)
lowering the pressure of achalasia
Hypocalcemia hyperirritable, tremors, voxtex trousseau
7. use of Ca blocker and nitrates
MEDICAL AND SURGICAL MANAGEMENT
To decrease lower esophageal pressure by relaxing LES
1. Fluid and electrolyte replacement
Cause hiatal hernia also have to manage pylorus via 2. Pyloromyotomy - cutting through the outside later of the
pyloryplasty thickened pylorus muscle (preferred)
3. Atropine treatment (causes contraction of smooth
Nursing Management Esophageal Disorders muscles in small doses and in large relaxation)
4. Endoscopic balloon dilatation (balloon could be
1. Teach the client to avoid factors that increase lower displaced)
esophageal irritation
2. Gastritis
Eat a low fat, high fiber diet
Avoid irritants, such as spicy or acidic foods, alcohol, Causes Helicobacter pylori
caffeine and tobacco because they increase gastric
acid production. MEDICAL AND SURGICAL MANAGEMENT
Avoid food or drink 2 hours before bedtime or lying
1. Medication to eliminate H. Pylori
down after eating
2. Medication to block gastric acid production and
Elevate the head of the bead on 6 to 8 bocks
promote healing of ulcer (proton pump inhibitors H2
Lose weight if necessary
receptor antagonists, antacids)
Administer medications as prescribed and monitor for 3. Medication to protect mucosal lining of stomach and
side adverse effects intestine
Develop post-operative teaching plan (prioritize
respiratory care; due to anesthesia; hypoxemia) 3. Peptic Ulcer disease
2. Ensure nutritional care A break in the lining of the stomach first part of the small
intestine or occasionally the lower esophagus
When to begin oral intake (TPN-hypertonic; cellular
dehydration) An ulcer in the stomach is known as a gastric ulcer while that in
the first art the intestine is known as a duodenal cancer and
Notes stolen from Teanu Tamayo NCM MIDTERMS
sometimes esophagus Nutritional status
Duodenum relieved by eating Tissue perfusion
Gastric leads to cancer more
If there is inflammation > fluid shifting > lowers circulating
Duodenal hyper acid secretion fluid
Gastric hypo/ normal 3. Medication administration and checking for adverse effects
Healthy diet Ulcerative Colitits: affects only the inner lining of the large
Consider food with probiotics intestine and usually the descending, sigmoid colon and rectum.
Control stress
*pathophysio
Smoking cessation (emphasize and find out what
makes them smoke) TREATMENT OF UL CERATIVE COLITIS AND
Avoid alcohol CROHNS
Switch pain killers (dont always change)
Eliminate milk (further stimulates gastric acid C
production) Control diarrhea
Adequate sleep (for recovery of immune system) Control inflammation
R
2. Monitoring and preventing complications relieve pain
Restore fluid
Pain
A
Fluid and electrolyte
Notes stolen from Teanu Tamayo NCM MIDTERMS
Anticholinergics Disorders of the Small intestine
Antibiotics
M 4. Irritable bowel syndrome
Meals correct
A functional disorder causing the nerves and muscles of the
nutritional deficiencies
large intestine to be oversensitive, leading to symptoms such as
P cramps, bloating, flatulence, diarrhea and constipation.
psychological counseling
S Causing/triggers of IBS
support emotionally/coping
1. Food allergens and irritants (caffeine, alcohol, fatty or
diverticulum is a saclike herniation of the lining of the bowel that fried)
extends through a defect in the muscle layer. Diverticula may 2. Psychological stress
occur anywhere in the small intestine or colon but most 3. GIT infection
commonly occur in the sigmoid colon 4. Digestion problems
Soluble gel-like; absorbs water; for diarrhea; bulk forming Hallucination perceive something in the absence of a stimulus
and IBD