The knowledge of digestive diseases

Digestive diseases

Nursing of gastritis patients

Nursing of patients with peptic ulcer

1. The most important risk factor of peptic ulcer is helicobacter pylori infection.

2. Peptic ulcer development is predominant (gastric acid role).

3. The most common site of gastric ulcer is pylorus.

4. The most common site of duodenal ulcer is the duodenal bulb.

5. The pain characteristic of gastric ulcer is (postprandial pain), and the rule is (feeding - pain - relief).

6. Duodenal ulcer pain is characterized by (empty abdominal pain or night pain) and the pattern is (pain - feeding - relief).

7. Complications of peptic ulcer include hemorrhage, perforation, pyloric obstruction, canceration.

8. The most common complication of peptic ulcer is gastrointestinal bleeding.

9. Pyloric obstruction is mainly manifested by repeated vomiting and overnight sour-leaved food.

10. The strongest drug that inhibits gastric acid production is omeprazole.

11. Gastroscopy is the preferred test for the diagnosis of peptic ulcer.

12. The main diagnostic basis for peptic ulcer perforation is (free gas below the diaphragm on X-ray).

13. The first measures to be taken for peptic ulcer perforation are fasting and gastrointestinal decompression.

14. Acid-making agent should be taken within (1 hour after meal).

15. Gastric motility drugs should be taken 1 hour before meals.

Nursing of patients with ulcerative colitis

1. The most common site of ulcerative colitis is sigmoid colon.

Attention should be paid to here, do not mix with the good parts of intestinal tuberculosis, intestinal tuberculosis is good parts of the cecum.

2. Sulfasyridine is the preferred drug for ulcerative colitis.

3. The most typical fecal features of ulcerative colitis are mucus, pus, blood and stool.

4. The clinical manifestations of ulcerative colitis are (diarrhea, mucus, pus, blood and stool, tenesmus, relieving after stool, intermittent lower abdominal pain).

5. The manifestations of toxic megacolon are (dilated bowel, disappearance of intestinal sounds, abdominal muscle tension, and increased abdominal pain).

6. Abstain from ulcerative colitis (raw and cold food, food containing much fiber, milk and dairy products).

Nursing of patients with cirrhosis

1. The main cause of cirrhosis in China is (hepatitis B).

2. The main cause of liver cirrhosis abroad is (cirrhosis caused by alcohol poisoning).

Spider moles are caused by increased levels of estrogen in the body.

4. The three major manifestations of portal hypertension are splenomegalysis, ascites, and establishment and opening of collateral circulation.

5. The most prominent clinical manifestation of cirrhosis is ascites.

6. The most common complication of cirrhosis is upper gastrointestinal bleeding.

7. The most severe cirrhosis and the most common cause of death is hepatic encephalopathy.

8. The nature of ascites in spontaneous peritonitis as a complication of cirrhosis is exudate.

9. The main causes of cirrhotic ascites are portal hypertension and decreased plasma albumin.

10. The daily sodium chloride intake of cirrhotic ascites patients should be controlled at (1.2-2.0g).

11. Patients with cirrhosis who present with persistent pain and progressive enlargement of the liver with bloody ascites are most likely to develop liver cancer.

12. The main manifestations of hypersplenism are red blood cells, white blood cells and thrombocytopenia.

13. Diuretic therapy for cirrhosis should be less than 0.5kg per day.

14. The principle of diuretic administration for cirrhosis is (intermittent, alternate, combined administration).

15. The condition that ascites cannot be returned is (infective ascites, cancerous ascites).

Nursing of patients with hepatic encephalopathy

1. The most common cause of hepatic encephalopathy is viral posthepatitis cirrhosis.

2. The main manifestations of hepatic encephalopathy in four stages.

Phase I (prodromal phase) : mild personality changes and behavior disorders, moody, disordered clothing, flapping wing like tremor, eeg is more normal.

Phase II (early coma) : confusion of consciousness, sleep disorders, behavioral disorders, unable to complete simple calculations, sleep during the day and wake up at night, flapping wing like tremor, increased muscle tension, eeg characteristic abnormalities, positive babinski sign.

Phase 3 (lethargy period) : lethargy and mental disorder is given priority to, often delirium and hallucination, abnormal eeg.

Stage 4 (coma) : complete loss of consciousness, can not wake up, flapping wing like tremor has been unable to elicit, electroencephalogram obvious abnormalities.

3. The earliest manifestation of hepatic encephalopathy (changes in personality and behavior).

4. Patients with hepatic encephalopathy are forbidden (soapy water, as long as it is alkaline solution enema is not good), so as not to (increase the absorption of ammonia, aggravate the condition), can be used (physiological saline or weak acid solution) enema.

5. The purpose of oral lactulose in patients with hepatic encephalopathy is (to acidify the intestine and reduce ammonia absorption).

6. Patients with hepatic encephalopathy are forbidden vitamin (vitamin B6), the reason is (can make dopamine in the peripheral nerve place into dopamine, affect dopamine into brain tissue, reduce the central nervous normal transmitter).

7. The diet of patients with hepatic encephalopathy should limit the intake of protein, provide enough calories and vitamins, and take sugar as the main food.

8. Liver sex encephalopathy coma patient diet (protein), can nasally feed or venous supplement (glucose) in order to supplement quantity of heat, wake up can (gradually increase protein) diet, had better give (plant protein).

9. The drugs contraindicated for patients with hepatic encephalopathy are (sedatives) and (sleeping pills), and (valium) should be used as much as possible.

10. Ammonia lowering drugs mainly include (monosodium glutamate, valley)

Nursing of patients with acute pancreatitis

1. The main cause of acute pancreatitis is (biliary tract disease, cholelithiasis is the most common).

2. The most common cause of acute pancreatitis is (overeating, if caused by alcohol).

3. The main clinical manifestations of acute pancreatitis are abdominal pain.

The first symptom of acute pancreatitis is abdominal pain.

5. The prognosis of acute pancreatitis is poor (hand and foot spasm due to hypocalcemia).

6. The most significant laboratory test for acute pancreatitis is serum amylase.

7. The painful nature of acute pancreatitis is (persistent pain in the middle and upper abdomen, with a band radiating to the lower back).

8. In patients with acute pancreatitis, the pain may be relieved by the smell of lying on the side with knees bent.

9. The contraindicated drug for acute pancreatitis is morphine, which can cause spasm of oddi sphincter and aggravate the pain.

10. The first treatment for acute pancreatitis should be fasting and gastrointestinal decompression.

11. The first treatment principle for acute pancreatitis is (inhibition of pancreatic fluid secretion).

Nursing of patients with massive hemorrhage of upper digestive tract

Clinical manifestations

1. Hematemesis and melena;

2. Hemorrhagic peripheral circulatory failure;

3. Anemia and hemogram changes;

4. Azotemia;

5. A fever.

nursing measures

1. Potential complications: insufficient blood volume

(1) Posture and keep respiratory tract unobstructed.

(2) Treatment and nursing: establish venous access.

(3) Diet nursing: acute hemorrhage accompanied by nausea, vomiting should be fasting.

(4) Psychological care.

(5) Disease monitoring

① Test indicators: vital signs, mental and conscious state, etc.

② Observation of peripheral circulation.

③ Estimation of the amount of blood loss: detailed inquiry of the occurrence of hematemesis and melena time, times, amount and traits, in order to estimate the amount of blood loss and speed.

④ Continue or repeat the judgment of bleeding: repeated hematemesis, and even vomit from brown to bright red; The number of black stools increases and the fecal substance is thin, the color turns dark red, accompanied by hyperactive bowel sounds.

⑤ Observation of patients with primary disease.

Activity intolerance: Associated with hemorrhagic peripheral circulatory failure.

(1) Rest and activity: mental quiet and reduced physical activity are conducive to the cessation of bleeding.

(2) Safe nursing.

(3) Life care.

Handling methods

1. Rest: when bleeding, you should rest in bed and avoid strenuous activities.

2. Keep airway unobstructed: tilt the head to one side to avoid hematemesis into the trachea.

3. Blood volume expansion: Establish two venous channels quickly and replenish blood volume as soon as possible.

4. Hemostatic treatment: (1) Drugs: hemostatic drug therapy should be given as instructed by the doctor; (2) Three cavities and two vesicles: it is suitable for bleeding from esophagogastric variceal rupture.