Nutritional needs must be addressed to meet a client's gestalt of overall health. Using the nursing process in conjunction with a nursing diagnosis in accordance with the North American Nursing Diagnosis Association, or NANDA, the professional nurse creates an evidenced-based plan of action specific to each individual client or patient. Nursing Care Plan Included in the nursing care plan is an outcome classification as well as an intervention classification. The most effective way to achieve this result is to utilize the nursing process:
Ulcer along the lesser curve of stomach Type Nursing care plan imbalanced nutrition Two ulcers present — one gastric, one duodenal Type III: Prepyloric ulcer Type IV: Proximal gastroesophageal ulcer Type V: Anywhere along gastric body, NSAID induced Assessment Abdominal pain Occurs in the epigastric area radiating to the back; described as dull, aching, and gnawing.
Pain may increase when the stomach is empty, at night, or approximately 1 to 3 hours after eating. Pain is relieved by taking antacids common with duodenal ulcers. Nausea, anorexia, early satiety common with gastric ulcersbelching.
Dizziness, syncope, hematemesis, melena with GI hemorrhage: Positive fecal occult blood Decreased hemoglobin and hematocrit, indicating anemia. Orthostatic blood pressure and pulse changes. Gastric Ulcer Gnawing epigastric pain occurring 30 minutes to 1 hour after meals Gnawing epigastric pain occurring hours after meals Aggravated by eating because acid secretion increase at meal time leads to weight loss Relieved by food because the pyloric sphincter, at the junction of stomach and duodenum, closes upon eating to concentrate food in the stomach causes weight gain Relieved by vomiting because acid is expelled out Not relived No pain at hours of sleep HCl production decreases at hours of sleep Pain at hours of sleep because gastric emptying continuous at hours of sleep More common in persons older than age 50 More common between ages 25 and 50 Diagnostic Evaluation Upper GI series usually outlines ulcer or area of inflammation.
Endoscopy esophagogastroduodenoscopy visualizes duodenal mucosa and helps identify inflammatory changes, lesions, bleeding sites, and malignancy through biopsy and cytology. Gastric secretory studies gastric acid secretion test, serum gastrin level tst are elevated in Zollinger-Ellison syndrome.
Pharmacologic Interventions Histamine2 H2 receptor antagonists such as ranitidine to reduce gastric acid secretions. Antisecretory or proton-pump inhibitor, such as omeprazole, to help ulcer heal quickly in 4 to 8 hours.
Cytoprotective drug sucralfate, which protects ulcer surface against acid, bile, and pepsin. Antacids to reduce acid concentration and help reduce symptoms. Anti-biotic as part of a multi-drug regimen to eliminate H. Surgical Interventions Surgery is indicated for hemorrhage, perforation, obstruction, and when unresponsive to medical therapy.
Gastroduodenostomy Billroth I Partial gastrectomy with removal of antrum and pylorus; gastric stump is anastomosed to duodenum. Gastrojejunostomy Billroth II Partial gastrectomy with removal of antrum and pylorus; gastric stump is anastomosed to jejunum. Antrectomy Antrum lower half of stomachpylorus and small cuff of duodenum are resected; stomach is anastomosed to jejunum and duodenal stump is closed.
Total gastrectomy Removal of stomach with anastomosis of esophagus to jejunum or duodenum.
Pyloroplasty Longitudinal incision is made in the pylorus, and closed transversely to permit the muscle to relax and established an enlarged outlet; often performed with vagotomy. Nursing Interventions Monitor the patient for signs of bleeding through fecal occult blood, vomiting, persistent diarrhea, and change in vital signs.
Monitor intake and output. Maintain nasogastric tube for acute bleeding, perforation, and postoperatively, monitor tube drainage for amount and color.
Perform saline lavage if ordered for acute bleeding. Encourage bed rest to reduce stimulation that may enhance gastric secretion. Provide small, frequent meals to prevent gastric distention if not actively bleeding.
Watch for diarrhea caused by antacids and other medications. Restrict foods and fluids that promote diarrhea and encourage good perineal care.
Advise patient to avoid extremely hot or cold food and fluids, to chew thoroughly, and to eat in a leisurely fashion to reduce pain. Administer medications properly and teach patient dose and duration of each medication.
Advise patient to modify lifestyle to include health practices that will prevent recurrences of ulcer pain and bleeding.
Also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer defined as mucosal erosions equal to Drug Study — Ranitidine by: Potent anti-ulcer drug that competitively and reversibly inhibits histamine action at H2-receptor sites on parietal cells, thus blocking gastric acid secretion.
Indirectly reduces pepsin secretion What is Hiatal Hernia Is a protrusion of part of the stomach through the hiatus of the diaphragm and into the thoracic cavity.
Two types of hiatal hernias: Sliding hernia — the upper stomach and gastroesophageal junction move upwardnursing care plan: 8 pneumonia nursing care plan (ncp) Pneumonia is an inflammation of the lung parenchyma, associated with alveolar edema and congestion that impair gas exchange.
These are the possible Nursing Care Plan (NCP) for patients with pneumonia. Stroke care plan. Objective and subjective data, nursing care and rationales.
Learn how to care for a Stroke patient. Nursing Care Plan for Stroke. Promote adequate nutrition. Once a patient is cleared to eat, do what you can to encourage appropriate . Nursing Care Plan. Included in the nursing care plan is an outcome classification as well as an intervention classification.
The most effective way to achieve this result is to utilize the nursing process: assess, diagnose, plan, implement and evaluate. Inflammatory Bowel Disease: Ulcerative Colitis and Crohn's Disease ncp nursing care plan. Risk for imbalanced fluid and electrolytes. deficient fluid volume, hypokalemia, hypomagnesemia, and .
nursing care plan intestinal obtruction.
Intestinal Obstruction. Intestinal (bowel) obstruction is a condition in which the intestinal contents fail to move through the bowel. Jul 22, · Your composing is purely awe-inspiring that I desired to read such high quality material CNA Practice Test.