JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

(GASTROINTESTINAL SYSTEM)
FXN:
1.
2.
3.
4.

ALIBASHER

IV. DIAGNOSTIC TESTS

1. ENDOSCOPY
PREPARATION
i. CONSENT
ii.
NPO:
iii.
MEDICATIONS:

STRUCTURES:
1.
2.
3.

4.

5.

6.

MOUTH
a.
b.
ESOPHAGUS
STOMACH
a.
b.
c.
SMALL INTESTINES
a.
b.
c.
LARGE INTESTINES
a.
b.
c.
d.
RECTUM AND ANUS

DISORDERS/DISEASE:
A. PEPTIC ULCER DISEASE (PUD)

I. RISK FACTORS
a. GENETICS
b. BLOOD:
c. EMOTIONAL
d. ILLNESS:
e. DRUGS:
f. FOODS:
II. TYPES
a. GASTRIC
b. DUODENAL
c. STRESS
III. CLINICAL MANIFESTATIONS
GASTRIC

DUODENAL

ABDONIMAL PAIN
to 1 to 2
HOURS (WITHIN
MEALS)
FOOD = PAIN
WEIGHT LOSS
HEMATEMESIS

ABDONIMAL PAIN
2 to 3 to 4
HOURS (AFTER
MEALS)
FOOD = RELIEF
NOCTURNAL
PAIN (12MN to
3AM)
WEIGHT GAIN
MELENA

2.

AFTER
a. NPO:
b. COMPLICATION:

BARIUM SWALLOW
PREPARATION
a. NPO:
b. DRINK:
c. FLUOROSCOPY

AFTER
a. FLUID:
b. DIET:
c. STOOL COLOR:

3.

FECAL OCCULT BLOOD TEST

PREPARATION
a. AVOID:
b. COLLECT:
c. SMEAR:
d. RESULT:

4.

GASTRIC ANALYSIS
PREPARATION
a. NGT AND ASPIRATE
b. ANALYZE PH AND COLOR
c. RESULT:

V. COMPLICATIONS
1. HEMORRHAGE
MANIFESTATIONS

MANAGEMENT
NPO
MEDICATION:
LAVAGE
BLOOD TRANSFUSION
2. PERFORATION
MANIFESTATIONS

MANAGEMENT
NPO
TPN

MEDICATION
SURGERY

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JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

3.

4.

PYLORIC OBSTRUCTION
MANIFESTATIONS

MANAGEMENT
NPO
TPN
NASOGASTRIC SUCTIONING
SURGERY

COMPLICATIONS
1. DUMPING SYNDROME

MANIFESTATIONS
HYPOGLYCEMIA
DHN
HYPOVOLEMIA
WEAKNESS

INTRACTABILITY
MANIFESTATIONS
ALL SYMPTOMS OF PUD
PERSISTS
MANAGEMENT
SURGERY

VI. MANAGEMENT
1. NURSING
a. BED REST
b. AVOID:
c. DIET:
2. MEDICAL
a. ANTACIDS
i. MAGNESIUM HYDROXIDE
ii. ALUMINUM HYDROXIDE
iii. MAALOX
b. H2 BLOCKERS
i. FAMOTIDINE
ii. RANITIDINE
iii. CIMETIDINE
c. ANTICHOLINERGICS
i. ATROPINE SULFATE
ii. PROPANTHELINE
BROMIDE
iii. DICYCLOMINE
d. CYTOPROTECTIVE AGENTS
i. SUCRALFATE
e. PROTON PUMP INHIBITOR
i. OMEPRAZOLE
f. PROSTAGLANDINS
i. MISOPROSTOL
g. ANTIBIOTICS
i. TETRACYCLINE
ii. METRONIDAZOLE
iii. AMOXICILLIN
iv. AMPICILLIN
3.

ALIBASHER

2.

STEATORRHEA

MANIFESTATIONS
FOUL, FROTHY
STOOL
MANAGEMENT
REPLACE:
DIET:
MEDICATION:
3.

PERNICIOUS ANEMIA

MANIFESTATIONS
RBC
PALLOR
EASY FATIGABILITY
RED, SMOOTH,
BEEFY TONGUE
TINGLING
SENSATION

DIAGNOSTIC TEST
SCHILLINGS TEST
RADIOACTIVE: B12
RESULT:
RADIOACTIVE: B12
PLUS:
RESULT:

SURGICAL
a. VAGOTOMY

b. GASTRECTOMY
TYPES:
1. BILLROTH I
2.

BILLROTH II

MANAGEMENT
FEEDINGS:
CHEW FOOD
POSITION:
AVOID:
DIET:
MEDICATION:

MANAGEMENT
L
I
M
B

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JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

B. GASTROESOPHAGEAL REFLUX DISEASE

(GERD)

I. RISK FACTORS
a. ALCOHOLISM
b. CAFFEINE
c. ANTICHOLINERGICS
d. FATTY FOODS
e. NSAIDs
II. PATHOPHYSIOLOGY

ALIBASHER

II. TYPES
a. TYPE I
b. TYPE II

III. CLINICAL MANIFESTATIONS

a. HEARTBURN
b. DYSPHAGIA
c. DYSPNEA
d. INDIGESTION
e. HEMATEMESIS
IV. DIAGNOSTIC TESTS
a. BARRIUM SWALLOW
b. ENDOSCOPY
V. MANAGEMENT
a. SURGICAL:

III. CLINICAL MANIFESTATIONS

a. HEARTBURN
b. EPIGASTRIC PAIN RADIATING TO NECK
AND BACK
c. BELCHING
d. DYSPHAGIA
e. ESOPHAGITIS
f. FLATULENCE
g. MELENA
IV. DIAGNOSTIC TESTS
a. UGIS / BARIUM SWALLOW
b. ESOPHAGOSCOPY
V. MANAGEMENT
a. MEDICATION:
ANTACIDS
H2 BLOCKERS
METOCLOPRAMIDE
PROTON PUMP INHIBITOR
CYTOPROTECTIVE AGENTS
b. DIET: FAT CHON SPICY (BLAND)
c. FEEDING: SMALL FREQUENT
d. POSITION: SIT ERECT / UPRIGHT
e. AVOID: CONTRICTIVE CLOTHES
f. REDUCE WIEGHT
g. SURGERY: FUNDOPLICATION

C. HIATAL HERNIA

I. RISK FACTORS
a. FEMALE
b. OBESITY
c. AGING

b. MEDICATION:
i. ANTIBIOTIC
ii.
ANTACIDS
iii.
H2 BLOCKER
c. FEEDING:
d. REDUCE WEIGHT
e. AVOID:
D. LIVER CIRRHOSIS

I. RISK FACTORS
a. ALCOHOLICS
b. INFECTION
c. DRUGS:
II. TYPES
a. POST NECROTIC CIRRHOSIS
b. BILIARY CIRRHOSIS
c. CARDIAC CIRRHOSIS
d. LAENNES CIRRHOSIS
III. CLINICAL MANIFESTATIONS
a. ASCITES
b. STEATORRHEA
c. BLEEDING
d. ANEMIA
e. NAUSEA & VOMITING
f. ANOREXIA
g. ABDOMINAL PAIN
h. JAUNDICE
IV. DIAGNOSTIC TESTS
a. LIVER ENZYMES
i. ALT
ii.
AST
b. BLOOD STUDIES
i. BILIRUBIN

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JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

ii. ALBUMIN
iii. SODIUM
iv. POTASSIUM
v. CALCIUM
c. LIVER SCAN
d. LIVER BIOPSY
PREPARATION
i. AVAILABLE:
ii. POSITION:
BEFORE:
AFTER:
iii. INJECTION:
V. MANAGEMENT
a. MEDICAL
i. PARACENTESIS
ii. ALBUMIN
b. SURGICAL
i. LeVeen & Denver Peritoneal
Venous Shunt
ii. TRANSJUGULAR INTRAHEPATIC
PORTOSYSTEMIC SHUNT
c. MEDICATIONS
i. DIURETIC:
ii. LACTULOSE
iii. PROPANOLOL
d. NURSING
i. BED REST
ii. DIET:
iii. FLUID BALANCE:
VI. COMPLICATIONS
a. HEPATIC COMA
MANIFESTATIONS
LOC
ASTERIXES
FETOR HEAPATICUS
MANAGEMENT
DIET:
MEDICATION:
b. PORTAL HYPERTENSION
MANIFESTATIONS
CAPUT MEDUASEA
SPIDER NEVI
HEMORRHOIDS
MANAGEMENT
AVOID:
NGT (LAVAGE):
c. ESOPHAGEAL VARICES
MANAGEMENT
ICED SALINE LAVAGE
SCLEROTHERAPY
TUBE:
SENGSTAKEN-BLAKEMORE

ALIBASHER

E. HEPATITIS
TYPE
S

A.K.A

ROUTE

INFECTIOUS
HEPATITIS

SERUM
HEPATITIS

ORALFECAL
BLOOD
& BODY
FLUID

NON-A, NON-B/
POST
TRANSFUSION
HEPATITIS

INCUBATION

MARKER

2-6 WKS

ANTI-HAV

1-6 MOS

HBsAg

BLOOD
& BODY
FLUID

5-10 WKS

ANTIHCV

DELTA AGENT
HEPATITIS

BLOOD
& BODY
FLUID

2-10 WKS

ANTIHDV

ENTERICALLY
TRANSMITTED
, EPIDEMIC
NON-A, NON-B
HEPATITIS

ORALFECAL

2-9 WKS

ANTIHEV

I. CLINICAL MANIFESTATIONS
a. PRE-ICTERIC
i. FLU-LIKE
ii.
WEAKNESS
iii.
FEVER
iv. NAUSEA & VOMITING
v. WEIGHT LOSS
vi.
PAIN
b. ICTERIC
i. JAUNDICE
ii.
DARK URINE
iii.
CLAY STOOL
iv. PRURITUS
c. POST-ICTERIC
i. FATIGUE
ii.
LETHARGY
iii.
SLOWLY RECEDE
II. MANAGEMENT
a. BED REST
b. DIET:
c. AVOID:
d. VACCINE:
e. UNIVERSAL PRECAUTION
F. CHOLELITHIASIS and CHOLECYSTISIS

I. RISK FACTORS
a. FEMALE
b. FAT
c. FORTIES
d. FERTILE
e. FAIR
f. PREGNANT
g. ESCHERICHEA COLI INVASION
II. TYPES

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JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

ALIBASHER

a. CHOLESTEROL
b. PIGMENT
III. PATHOPHYSIOLOGY

IV. CLINICAL MANIFESTATIONS

a. TENDERNESS & ABDOMINAL RIGIDITY
b. NAUSEA & VOMITING
c. FEVER
d. CLAY-COLORED STOOL
e. STEATORRHEA
f. CLOUDY DARK-AMBER URINE
V. DIAGNOSTIC TESTS
a. CBC
b. UTZ
c. CHOLECYSTOGRAM
IV CHOLANGIOGRAM

PERCUTANEOUS TRANHEPATIC
CHOLANGIOGRAPHY
d. ERCP
VI. MANAGEMENT
a. DIET: CLEAR LIQUID, FAT
b. FEEDINGS: SMALL FREQUENT
c. MEDICATION:

III. CLINICAL MANIFESTATIONS

a. ABDOMINAL PAIN
b. SHOCK
c. PALE SKIN
d. ABDOMINAL DISTENTION
e. NAUSEA & VOMITING
f. CLAY-COLORED STOOL
g. STEATORRHEA
h. TURNERS SPOT/SIGN
i. CULLENS SIGN
IV. DIAGNOSTIC TESTS
a. UTZ
b. CT SCAN
c. CBC
d. BLOOD STUDIES
i. AMYLASE
ii.
LIPASE
iii.
CALCIUM
iv. GLUCOSE
V. MANAGEMENT
a. SURGERY:
b. BED REST
c. MEDICATIONS:
i. PANCREATIN
ii. SOMATOSTATIN
iii. MEPERIDINE
d. DIET:
e. FEEDINGS:
f. MONITOR:

d. ESWL
e. CHOLECYSTECTOMY

H. INFLAMMATORY BOWEL DISEASE

G. PANCREATITIS

I. RISK FACTORS
a. OBESITY
b. ALCOHOLIC
c. DRUGS:
d. CARCINOMA
II. PATHOPHYSIOLOGY

I. RISK FACTORS
a. GENETICS
b. INFECTION
c. IMMUNE SYSTEM
II. CLINICAL MANIFESTATIONS
CROHNS
DISEASE

ULCERATIVE
COLITIS

LOCATION
DISTRIBUTION
DEPTH OF INVOLVEMENT
STOOL CHAR.
DRAINAGE
PAIN LOCATION

III. DIAGNOSTIC TESTS

ALTERATION IN METABOLISM: GASTROINTESTINAL AND ACCESORY ORGAN

JAMIATU MARAWI AL-ISLAMIA FOUNDATION

DEREPOSUN MACALNAS, RN, MAN

a.
b.
c.
d.

STOOL EXAMINATION
BARIUM ENEMA
ENDOSCOPY
CT SCAN

IV. COMPLICATIONS
a. TOXIC MEGACOLON
b. BOWEL OBSTRUCTION
c. FISTULAS
d. PERFORATION
e. COLORECTAL CANCER

ALIBASHER

I. DIVERTICULOSIS AND DIVERTICULITIS

I. RISK FACTORS
a. DIET:
II. PATHOPHYSIOLOGY

V. MANAGEMENT
a. DIET:
b. BT
c. MEDICATIONS:
i.
ii.
iii.
iv.
d. COLOSTOMY
STOMA CARE
i. STARTS:
ii. EMPTY:
iii. MEASURE:
iv. WASH:
v. INFECTION:
FOODS TO AVOID
i. GAS FORMING
ii. ODOR FORMING
iii. OBSTRUCTIONS

PREVENTS GAS
PREVENTS ODOR
MEDICATIONS
i. SALICYLATE
ii. ANTIDIARRHEAL
iii. CORTICOSTEROIDS
STOMA IRRIGATION
i. NSS
ii. IRRIGATE:
iii. DRAIN
iv. TIME:

III. CLINICAL MANIFESTATIONS

a. ASYMPTOMATIC
b. FEVER
c. ALTERNATE: DIARRHEA/CONSTIPATION
d. ABDOMINAL: DISTENTION,
TENDERNESS AND PAIN (LLQ)
e. RECTAL BLEEDING
f. BLOATING
g. ANOREXIA
h. NAUSEA & VOMITING
i. BOWEL SOUND
IV. DIAGNOSTIC TESTS
a. CBC
b. BARIUM ENEMA
c. COLONOSCOPY
V. MANAGEMENT
a. DIET:

b. MEDICATION:
c. SURGERY:

ALTERATION IN METABOLISM: GASTROINTESTINAL AND ACCESORY ORGAN