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  • September 7, 2023
  • 8
  • 2022/2023
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GI


Peptic ulcers:
Diagnosis:

- Medical management PUD:
1. Sever pain which is acidic which affect the pt with pain r/t gas. Dymtomology
PUD management:
- Conservator management:
o Adequate rest
o Bland diet [six small meal a day]
o Cessation of smoking
o Medication [ joint pain, arthritis, r/t NSAIDS]
o Stress management
- Acute EXACERBATION WITHOUT COMPLICATONS:
o Adequate rest
o Cessation of smoking
o NPO
o Medication
o IV fluid replacement
Pud management –diet:know this slide for diet
- Avoid caffeine and alcohol
- Avoid foods that irritate, spicy, hot, high in sugar
- Favor food that decrease risk of ulcer – high insoluble fibre, milk
- Probiotics/ antioxidants forH. Pylori
- B12 folic acid and iron [absorption and healing process]
PUD- acute management with complication:
- Blood rest
- Blood transfusion
- Iv replacement [lactated Ringers solution]
- NG suction- be careful minimize risk by seeing blood
- NPO
- Stomach lavage [ check potassium coz its need replacement]

Nursing priority
- Hemorrhage- take vitals, input and output,
- Perforation- NG tube, replacement of blood volume [potassium], antibiotics, input and
output
- Obstruction- NG tube for decompression, fluid and electrolytes, pain management
Pancreatitis:
Acute:
- Acute inflammation of pancreas
- Most in middle woman
- Contribution factors:
o Gallstone
o Alcohol use disorder

, GI


o High triglyceride levels
o Trauma
o Infections
o Penetrating duodenal ulcers
o Metabolic disorders
- Chronic:
o Continuous, prolongs inflammatory and fibrosis process
o Pt fails
o 70% r/t alcohol
o not always preceded by acute pancreatitis
o NPO status no NG just IV, pain medication, morphine IV
- Pancreatitis:
o Test amylase blood work
o Trypsin
Clinical manifestations;
Acute:
- n/v
- low grade
- leukocytosis
- abdominal assessment
- hypotension,
- Tachycardia [for significate time]
- jaundice
- decrease BS
- ileus/distention’s
- respiratory complications:
o skin color changes to abdomen
o flank
o periumbilical area
Chronic:
- malabsorption/weight loss
- constipation
- abdominal tenderness
- jaundice with dark urine(orange). {b12, folic acid]
- steatorrhea
- diabetes mellitus
- constipation: pasty clay stool [like cement]
Diagnosis:
- amylase
- glucose
- calcium
- LFTS
- Triglycerides
- Abdominal x-ray, ct scan

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