A. Review of the anatomy and physiology of the
gastrointestinal tract
B. The client with alterations in nutrition and
elimination. Examples:
1. hypermotility and hypomotility
2. inflammation - infections,
gastritis,
inflammatory bowel disease, diverticulitis
3. multifactoral - peptic
ulcer, hernias, fissures,
hemorrhoids
4. surgical intervention
a. ostomy
b. bowel resection
c. gastrectomy
C. Nursing process related to the client with
alterations in nutrition and
elimination
1. nursing assessment
a. risk factors
b. subjective data
c. objective data
d. diagnostic tests
2. nursing diagnoses (examples)
a. alteration in elimination
b. high risk for fluid & electrolyte imbalance
c. pain
d. knowledge deficit
e. alteration in nutrition
f. body image disturbance
3. planning and interventions
a. nutritional interventions
1) cultural implications
2) developmental stage
b. pharmacological interventions
c. replacement of fluids and electrolytes
d. pre- & post operative care for the client
having surgery of the GI tract
e. ostomy care and client teaching
f. therapeutic communication to support
coping measures
4. evaluation
5. Community Resources
Readings:
Kozier: 1224-1240, 1245-1253
Lewis: 946-967, 1003-1050, 1064-1082, 1087-1097, 1099-1102
Winningham & Preusser
Chapter 5: Case Studies #1,2,5,6,9,11,12
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A. Stool Specimens p. 764 (SDLP)
B. 46-2 Ostomy Care
C. Colostomy Irrigation p. 1250 (SDLP)
D. Tube feedings
1. 45-1 insertion of naso-gastric
tube
2. 45-3 administration
of continuous & bolus
feedings
3. 45-2 Removing NG tube
4. 45-4 Gastrotomy Feeding
E. 35-3 GI Suction
Readings:
Kozier: pp. 764-765, 1231-1232, 1245-1250, 920-924, 1204-1216
Videos:
NUR 104 Skills Video
Ostomy Care parts 1-3
Tubes, Tubes, Tubes: Enteral Feedings,
parts 1 & 2
Managing Your Colostomy
Computer:
Clinical Simulations in Medical Surgical Nursing:
1. A Patient with Abdominal Pain (Peptic Ulcer
Disease)
2. A Surgical Patient with Abdominal Pain (Inguinal
Hernia)
Med-Surg Mania: GI
Web Sites for Further Information:
www.niddk.nih.gov
(National Institute of Diabetes and Digestive and Kidney Diseases)
http://www.asge.org/
(Amercian Society for Gastrointestinal Endoscopy- Click on Patient/Public)
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A. Client care assignment
1. utilizing the nursing
process:
a. provide care for a client with
alterations in nutrition and/or
elimination
b. provide teaching for a client with
an ostomy
c. administer tube feedings
d. calculate fluid and caloric requirements
for your client
e. assess hydration and nutritional
status of your client
f. Interview your client
about cultural
and integrative
therapies used in
relation
to nutriton and elimination
In conference:
1. Discuss normal in the gastrointestinal
tract in the aging client.
2. Discuss interventions to prevent
constipation, diverticulosis,
peptic
ulcers.
3. Review the agency's care plans for a
client with
a. new ostomy. Identify resources
available
for clients
with ostomies.
Student Activities
Attend selected support group/community education program
related to nutrition or gastrointestinal health. (option)
Investigate opportunities for service learning in related
agencies.
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