Acute medical and surgical gastrointestinal problems

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Acute medical and surgical gastrointestinal problems

Diagram shows process of laparoscopy and laparotomy, specific nursing care of patient with acute GI dysfunction like maintain airway, check skin turgor for signs of dehydration, et cetera. It also shows right hemicolectomy, transverse colectomy, and left hemicolectomy as types of colectomy.


Many disorders affect the organs of the GI tract, both acute and chronic in nature. Nurses need to recognise possible assessment findings for patients with acute GI problems to escalate care in a timely manner, reducing risk of deterioration (Figure 40.1).


Main organs of the gastrointestinal tract: acute disorders


The main organs of the GI tract can be affected by many problems. These may be due to weakened structures, herniation, leakage, obstructions, malignancies or infection. Two specific conditions require immediate attention:haemorrhage and obstruction.


Upper or lower gastrointestinal tract bleeding


Upper GI haemorrhage, carrying a 10% mortality, can originate from the stomach or duodenum and may be due to peptic or duodenal ulceration. Infection with Helicobacter pylori is often found to be the cause. This gram-negative bacterium lives in epithelial walls weakening them and exposing the mucosal layer to gastric secretions which then leads to their erosion. Oesophageal varices occur secondary to liver disease. Bleeding from the lower GI tract (commencing at the jejunum), is often due to inflammatory disease such as ulcerative colitis.


Patients with GI bleeding will present with haematemesis, vomiting bright red blood or dark ‘coffee grounds’ (digested blood), particularly where problems occur higher up the GI tract. The presence of tarry malaena stools, with their characteristic offensive smell, indicates that blood has passed through the GI tract. Whilst for lower lesions, haematochezia or the passing of bright red blood from the rectum occurs. In all cases endoscopic procedures

Apr 8, 2019 | Posted by in NURSING | Comments Off on Acute medical and surgical gastrointestinal problems
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