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RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives Content Outline Clinical Objectives Learning Opportunities
1. Apply the terms listed in the content I. Application of terms Readings:
column appropriate to the patient A. Dysphagia Estes
situations involving the B. Dyspepsia McKinney
gastrointestinal system. C. Ascites Adams
D. Ileus Berman & Snyder
E. Melena Lewis
2. Compare and contrast the normal II. Anatomy & Physiology of Gastrointestinal
anatomy and physiology to the A. System
pathophysiology of selected B. Developmental considerations
gastrointestinal disease processes 1. Infant
in the content column. 2. Child
3. Adolescent
4. Adult
5. Older adult
C. Pathophysiology of gastrointestinal system
1. Fluid & electrolyte imbalance
3. Analyze factors included in the III. Selected commonly occurring problems
assessment of the patient A. Interview
experiencing commonly occurring 1. Chief complaint
gastrointestinal problems, 2. Precipitating event
including the developmental and 3. Medical history
cultural considerations. 4. Family/ Social/occupational history
5. Medication history
6. (prescription/nonprescription)
7. Knowledge of health maintenance
8. Risk factors
B. Physical exam – gastrointestinal
1. Bowel sounds
2. Size and shape
3. Tenderness
4. Pain
5. Stool
6. Nausea/vomiting
7. Hydration status
8. Skin color
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RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives Content Outline Clinical Objectives Learning Opportunities
C. Diagnostic tests
D. Laboratory studies
1. Complete blood count (CBC)
2. Electrolytes
3. Stool
4. Urine
a. Specific gravity
4. Differentiate between the etiology, IV. Commonly Occurring Problems
pathophysiology, and clinical A. Gastroenteritis
manifestations of selected B. Obesity
commonly occurring C. Gastroesophageal Reflux Disease (GERD)
gastrointestinal disease processes.
5. Discuss analysis, planning, V. Selected Nursing Diagnoses / Implementation /
implementation, and evaluation for Evaluation
the nursing management of patients A. Fluid / Electrolyte Imbalance
with commonly occurring 1. Independent interventions
gastrointestinal disease processes. a. See gastrointestinal assessment
b. See endocrine assessment
c. Age related hydration status
d. Monitor pertinent diagnostic tests
e. Maintain skin integrity
f. Intake and output
g. Weight
h. Vital signs
i. Sensorium
j. Adhere to standard precautions
2. Collaborative interventions
a. Administer replacement fluids
(1) Oral replacement solutions
(2) Intravenous fluids
(3) Electrolytes
(4) Enteral feedings
b. Administer medications and monitor
for desired/side/adverse effects.
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RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives Content Outline Clinical Objectives Learning Opportunities
(1) Antibiotics
(2) Antiemetic
(3) Antidiarrheals
3. Recognition of complications
B. Dehydration / hypovolemic shock
1. Metabolic acidosis / metabolic alkalosis
2. Impaired skin integrity
3. Infection/sepsis
4. Evaluation of Outcomes: The patient
will have improved fluid and electrolyte
balance as evidenced by:
a. Hydration status
b. Improved laboratory studies
c. Intake and output
d. Bowel / urinary elimination
e. Vital signs
C. Imbalanced nutrition: more than body
requirements
1. Independent interventions
a. Monitor intake/output
b. Observe eating styles/behaviors
c. Weight and height
d. Vital signs
e. Obtain adequate equipment
f. Ensure proper cleaning under the
folds of skin
g. Encourage to follow prescribed diet
h. Encourage fruits/vegetables and
limiting high fat foods
i. Medication education
j. Encourage activity
2. Collaborative
a. Refer to dietician
b. Follow prescribed diet
c. Diagnostic test
(1) Thyroid test
(2) Cortisone levels
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RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems Care
Part H – Gastrointestinal Problems
Behavioral Objectives Content Outline Clinical Objectives Learning Opportunities
(3) Hormone test
d. Administer medications
(1) Appetite suppressants
(2) Nutrient Absorption-Blockers
D. Altered Discomfort r/t tissue damage
secondary to acid reflux
1. Independent interventions
a. Monitor intake/output
b. Elevate HOB
c. Limit intake prior to bedtime
d. Encourage low fat, low acid meals
e. Teach to avoid aggravating factors
f. Non restricting clothing
g. Discuss weight
2. Collaborative
a. Refer to dietician
b. Diagnostics
(1) Upper GI
(2) Endoscopy
c. Medication
(1) Antacids
(2) Antisecretory Agents
(a) H2-receptor blockers
(b) Proton pump inhibitors
(3) Promotility
3. Selected surgical procedures
a. Nissen fundoplication
N:/ADN/RNSG1327/Unit V –Part H Gastrointestinal Revised 03/12
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