![]() ![]() For younger patients with no alarm symptoms, a test-and-treat strategy based on the results of H. Patients taking nonsteroidal anti-inflammatory drugs should discontinue their use. Older patients and patients with alarm symptoms indicating a complication or malignancy should have prompt endoscopy. Symptoms of peptic ulcer disease include epigastric discomfort (specifically, pain relieved by food intake or antacids and pain that causes awakening at night or that occurs between meals), loss of appetite, and weight loss. The predominant causes in the United States are infection with Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs. Alteration in dietary intake secondary to slowed GI function post opĭata sources: Assessment Skill Checklist, 2014 Jarvis, Browne, MacDonald-Jenkins, & Luctkar-Flude, 2014 Potter et al.Peptic ulcer disease usually occurs in the stomach and proximal duodenum.Potential for delayed wound healing due to altered nutrition status (10 kg unexplained weight loss in 1 month).Alteration in bowel function (constipation or diarrhea) related to ….Need for information in relation to low fat foods.In the surgical context, significant weight loss can result in delayed wound healing and risk of wound dehiscence.įocused GI assessment may also include ostomy assessment. Unexplained weight loss or weight gain may indicate a larger issue and may need investigation. Ask about recent weight gain or weight loss.What kinds of foods does the patient normally eat? Has this changed? Any of these may be symptoms of a GI issue. Ask about flatus, nausea, vomiting, and pain.Knowing what is normal will help the nurse differentiate if there is a new or emergent concern requiring attention. Normal bowel patterns vary across individuals. Changes to bowel patterns may indicate a larger GI issue. Ask about last bowel movements and normal bowel patterns.Resource: Bladder and Bowel Foundation (nd). Characteristics of bowel movements can assist with diagnosis and to help determine effectiveness of treatment for bowel related conditions. Sometimes observing stool is an important part of the assessment process. Observe stool to identify important characteristics. Palpate Lightly in All Four Quadrants for Distension, Firmness, Masses, Painįirmness may indicate excess gas, ascites, peritonitis. Always ask the patient “is this normal for you?” Hypoactive or absent bowel sounds may be present after GI surgery or when peritonitis or paralytic ileus are present. Hyperactive bowel sounds may indicate bowel obstruction, gastroenteritis, or subsiding paralytic ileus. Auscultate in each quadrant for evidence of gurgling, which suggests peristalsis. Unusual findings may indicate compromised GI function.Īuscultate for bowel sounds Figure 2.21 Abdominal quadrantsĭivide the abdomen into quarters. ![]() It is important for the nurse to ask “is this normal for your abdomen” to help differentiate patient “norm” to signs and symptoms that may indicate an acute issue. Figure 2.20 Ileostomy bag Figure 2.19 Abdominal distensionĪbdominal distension may indicate ascites associated with conditions such as heart failure, cirrhosis, cancer, and pancreatitis.Īn abdomen that appears thin with little adipose tissue might suggest nutrition issues. Overall Appearance: Observe for abdominal distension, stretch marks, contour, symmetry, presence and type of ostomy, overweight or underweight. Objective Data Consider the following observations: ![]()
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