GI conditions affect just about everyone at one time or another. These conditions, so intimately tied to psychological health and stability, range from simple changes in bowel habits to life-threatening disorders requiring major surgery and radical lifestyle changes. GI conditions may be acute or chronic. Patient care for GI conditions also varies widely. For example, the patient with simple constipation may need only brief teaching about diet and exercise. However, the patient with colorectal cancer may need ongoing nursing care — from encouragement and support during the diagnostic workup to meticulous colostomy care during recovery.

Therapeutic GI procedures reflect the wide spectrum of systemic abnormalities. They may involve feeding a patient through a tube, teaching him how to use a gastrostomy feeding button, or minimizing his anxiety before abdominal surgery or his discomfort after it.

To carry out responsibilities like these successfully, you need to address the patient’s emotional and physical needs. Where to place the incision or what colostomy to use has important emotional implications for him. Your knowledge of anatomy and physiology as well as your familiarity with surgical procedures will influence your care plan and, ultimately, how your patient responds. The best practices recommended by organizations, such as the Wound Ostomy and Continence Nurses Society WOCN, the American Society for Gastrointestinal Endoscopy ASGE, the American Academy of Clinical Toxicology AACT, American College of Gastroenterology ACG, and the American Gastroenterological Association AGA, will significantly enhance your ability to care for your patient. In addition to evidence-based EB practices and those stemming from standard principles of science SCIENCE, many of the best practices in this chapter also reflect mandates of the Centers for Disease Control and Prevention CDC, the U.S. Food and Drug Administration FDA, the American Cancer Society ACS, the American Dental Association ADA, the American Hospital Association’s Patient Care Partnership PCP, the American Society for Parenteral and Enteral Nutrition ASPEN, and the Joint Commission on Accreditation of Healthcare Organizations JCAHO. For points related to equipment, manufacturers MFR may recommend specific guidelines.

Patients undergoing certain GI procedures, especially those that are uncomfortable or embarrassing, require considerable emotional support. Helping such patients maintain their sense of dignity, while at the same time eliciting their cooperation, requires a skillful blend of compassion and judgment.

For many GI procedures, you’ll need to work cooperatively with other staff members, including the pharmacist, physicians, laboratory personnel, diagnostic technicians, dietitians, and the case manager.