BOOK
Gastrointestinal Issues and Complications, An Issue of Critical Care Nursing Clinics of North America, E-Book
Debra Sullivan | Deborah Weatherspoon
(2018)
Additional Information
Book Details
Abstract
Gastrointestinal dysfunction or injury is common in the critical care patient either as a primary diagnosis or as secondary symptoms. Several studies confirm that up to 62% of critical care patients exhibit at least one GI symptom for at least one day. In addition, recent studies have shown that GI problems are related to negative outcomes in the critical care patient. The articles in this issue are current and relevant to critical care patients today: Autoimmune Disease of the Gut in the Critical Care Patient; Nutrition Options in CCU Patients; Mesenteric Ischemia; Management of C-Diff in Critical Care Setting; Management of Acute GI Bleed; Acute Diverticulitis Management; GI Patient Skills Training in the ICU: SOFA assessment and recognizing GI symptoms; EBP with probiotics in treatment for antibiotic associated diarrhea in the ICU; GI Problems in the ICU with Patients with HIV/AIDs; Complications of GI Motility/GI Failure in the Critically Ill Patient; Untreated Gastroesophageal Reflux Patients in the ICU; Liver Transplant; Ecoli Complications in Critical Care-Pediatrics; and GI Traumatic injuries: GI Perforation. Being knowledgeable and skillful in the recognition and care for these problems is paramount to the critical care nurse.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Gastrointestinal Issuesand Complications | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Gastrointestinal Issues and Complications | vii | ||
| Gastrointestinal Manifestations of Autoimmune Diseases Requiring Critical Care | vii | ||
| Nutrition Options in Critical Care Unit Patients | vii | ||
| Mesenteric Ischemia | vii | ||
| Clostridium difficile: More Challenging than Ever | viii | ||
| Management of Acute Gastrointestinal Bleed | viii | ||
| Acute Diverticulitis Management | viii | ||
| Educating Nurses in the Intensive Care Unit About Gastrointestinal Complications: Using an Algorithm Embedded into Simulation | viii | ||
| Evidence-Based Practice in the Treatment for Antibiotic-Associated Diarrhea in the Intensive Care Unit | ix | ||
| Common Gastrointestinal Complications Associated with Human Immunodeficiency Virus/AIDS: An Overview | ix | ||
| Gastrointestinal Motility Problems in Critically Ill Patients | ix | ||
| Gastroesophageal Reflux in the Intensive Care Unit Patient | ix | ||
| Adults with Liver Failure in the Intensive Care Unit: A Transplant Primer for Nurses | x | ||
| Escherichia coli Complications in Pediatric Critical Care | x | ||
| Gastrointestinal Traumatic Injuries: Gastrointestinal Perforation | x | ||
| Gastroesophageal Reflux: Regurgitation in the Infant Population | x | ||
| CRITICAL CARE NURSING\rCLINICS OF NORTH AMERICA | xii | ||
| FORTHCOMING ISSUES | xii | ||
| June 2018 | xii | ||
| September 2018 | xii | ||
| December 2018 | xii | ||
| RECENT ISSUES | xii | ||
| December 2017 | xii | ||
| September 2017 | xii | ||
| June 2017 | xii | ||
| preface:Gastrointestinal Issues and Complications | xiii | ||
| Gastrointestinal Manifestations of Autoimmune Diseases Requiring Critical Care | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| Gastrointestinal Autoimmune Diseases: Liver, Pancreas, Inflammatory Bowel Disease | 2 | ||
| Liver and normal immune function | 2 | ||
| Liver and autoimmune diseases | 2 | ||
| Autoimmune pancreas | 3 | ||
| Inflammatory bowel diseases: ulcerative colitis and Crohn disease | 5 | ||
| Angioedema of abdominal organs an acute abdomen | 6 | ||
| Systemic Autoimmune Diseases with Gastrointestinal Presentations: Antiphospholipid Syndrome, Systemic Lupus Erythematous, a ... | 6 | ||
| Antiphospholipid syndrome | 6 | ||
| Systemic lupus erythematous | 7 | ||
| Rheumatoid arthritis and gastrointestinal organs | 7 | ||
| Autoimmune Disease Pharmacology: Iatrogenic Damage to the Gastrointestinal Tract | 8 | ||
| Glucocorticoids and NSAID | 8 | ||
| Disease-modifying drugs: think liver | 8 | ||
| Biological compounds | 9 | ||
| Two Case Illustrations | 9 | ||
| Organ-Specific Autoimmune Disease | 9 | ||
| Systemic Autoimmune Disease with Gastrointestinal Manifestations | 10 | ||
| SUMMARY | 10 | ||
| REFERENCES | 11 | ||
| Nutrition Options in Critical Care Unit Patients | 13 | ||
| Key points | 13 | ||
| INTRODUCTION | 13 | ||
| NUTRITIONAL OPTIONS | 14 | ||
| ENTERAL ROUTE | 14 | ||
| Prepyloric Tubes | 16 | ||
| Nasogastric and orogastric tubes | 16 | ||
| Gastrostomy tube and percutaneous esophageal gastrostomy tube | 19 | ||
| Postpyloric Feeding Tubes | 20 | ||
| Duodenal or jejunal small bowel feeding tubes | 20 | ||
| Management of Nasogastric and Orogastric Tubes | 21 | ||
| Verify placement | 21 | ||
| Flush and irrigation | 22 | ||
| Gastric residual volume | 22 | ||
| Minimize interruptions to enteral nutrition | 23 | ||
| PARENTERAL ROUTE | 23 | ||
| Peripheral Administration | 23 | ||
| Central Administration | 23 | ||
| SUMMARY | 26 | ||
| REFERENCES | 26 | ||
| Mesenteric Ischemia | 29 | ||
| Key points | 29 | ||
| INTRODUCTION | 29 | ||
| PATHOPHYSIOLOGY | 30 | ||
| ACUTE MESENTERIC ISCHEMIA | 30 | ||
| Causes | 30 | ||
| Arterial embolism | 31 | ||
| Arterial thrombosis | 31 | ||
| Mesenteric venous thrombosis | 31 | ||
| Nonocclusive mesenteric ischemia | 31 | ||
| Independent Risk Factors for Mortality | 31 | ||
| Clinical Manifestations | 33 | ||
| Diagnosis | 33 | ||
| Laboratory tests | 33 | ||
| Radiologic tests | 33 | ||
| Initial Management | 34 | ||
| Revascularization | 34 | ||
| CHRONIC MESENTERIC ISCHEMIA | 35 | ||
| Causes | 35 | ||
| Clinical Manifestations | 36 | ||
| Diagnosis | 36 | ||
| Revascularization | 36 | ||
| NURSING CONSIDERATIONS | 37 | ||
| SUMMARY | 38 | ||
| REFERENCES | 38 | ||
| Clostridium difficile | 41 | ||
| Key points | 41 | ||
| INTRODUCTION | 41 | ||
| PATHOPHYSIOLOGY | 41 | ||
| DIAGNOSIS | 42 | ||
| CLINICAL MANIFESTATIONS | 42 | ||
| PREVALENCE AND COST BURDEN | 43 | ||
| RISK FACTORS AND PREDICTORS | 43 | ||
| TREATMENT | 47 | ||
| IMPLICATIONS FOR NURSES | 50 | ||
| FUTURE RESEARCH | 50 | ||
| SUMMARY | 51 | ||
| Epidemiology | 51 | ||
| Diagnostics | 51 | ||
| Prevention | 51 | ||
| Nursing Diagnosis and Management | 51 | ||
| REFERENCES | 52 | ||
| Management of Acute Gastrointestinal Bleed | 55 | ||
| Key points | 55 | ||
| INTRODUCTION | 55 | ||
| ACUTE GASTROINTESTINAL BLEEDING | 56 | ||
| Pathogenesis | 56 | ||
| Bleeding Presentation | 56 | ||
| Common Disorders Associated with Acute Gastrointestinal Bleeding | 56 | ||
| Common upper gastrointestinal bleeding disorders | 56 | ||
| Common lower gastrointestinal bleeding disorders | 57 | ||
| ENHANCED FOCUS ON COMMON ACUTE UPPER GASTROINTESTINAL BLEEDING DISORDERS | 57 | ||
| Peptic Ulcer Disorder | 57 | ||
| Major clinical manifestations of peptic ulcer disorder | 58 | ||
| Treatment of bleeding ulcers | 59 | ||
| Resumption of anticoagulants, antiplatelet agents, and nonsteroidal antiinflammatory drugs | 60 | ||
| Case report | 60 | ||
| Acute Variceal Hemorrhage | 61 | ||
| Common clinical manifestations for varices | 61 | ||
| Management of acute variceal hemorrhage | 61 | ||
| Case report | 61 | ||
| General Management of Acute Upper Gastrointestinal Bleeding | 62 | ||
| ENHANCED FOCUS ON COMMON LOWER GASTROINTESTINAL BLEEDING DISORDERS | 62 | ||
| Colonic Diverticular Bleeding | 62 | ||
| Clinical manifestations | 62 | ||
| Diagnostic testing | 63 | ||
| Angiodysplasias | 63 | ||
| Diagnosis and management | 63 | ||
| General Management of Acute Lower Gastrointestinal Bleeding | 63 | ||
| SUMMARY | 64 | ||
| REFERENCES | 64 | ||
| Acute Diverticulitis Management | 67 | ||
| Key points | 67 | ||
| INTRODUCTION | 67 | ||
| Pathophysiology | 69 | ||
| Clinical Manifestations | 69 | ||
| Medical Management | 70 | ||
| Case Presentation | 71 | ||
| Nursing Focus on Older Adults | 71 | ||
| Surgical Management | 72 | ||
| SUMMARY | 72 | ||
| REFERENCES | 73 | ||
| Educating Nurses in the Intensive Care Unit About Gastrointestinal Complications | 75 | ||
| Key points | 75 | ||
| INTRODUCTION | 75 | ||
| Background | 76 | ||
| Theoretic Framework | 77 | ||
| Patients with Gastrointestinal Conditions in the Critical Care Setting | 77 | ||
| Overview of Simulation Education in the Acute Care Setting | 80 | ||
| Applying the Algorithm | 81 | ||
| Embedding an Algorithm into Simulation | 82 | ||
| SUMMARY | 83 | ||
| REFERENCES | 84 | ||
| Evidence-Based Practice in the Treatment for Antibiotic-Associated Diarrhea in the Intensive Care Unit | 87 | ||
| Key points | 87 | ||
| WHO IS PRONE TO ANTIBIOTIC-ASSOCIATED DIARRHEA AND WHY? | 88 | ||
| WHY DO ANTIBIOTICS CAUSE DIARRHEA, AND WHICH ANTIBIOTICS ARE PRONE TO CAUSING DIARRHEA? | 90 | ||
| CLOSTRIDIUM DIFFICILE INFECTIONS | 91 | ||
| ARE PROBIOTICS HELPFUL IN PREVENTING ANTIBIOTIC-ASSOCIATED DIARRHEA? | 93 | ||
| WHAT CAN NURSES DO TO PREVENT CLOSTRIDIUM DIFFICILE INFECTIONS? | 94 | ||
| SUMMARY | 96 | ||
| REFERENCES | 96 | ||
| Common Gastrointestinal Complications Associated with Human Immunodeficiency Virus/AIDS | 101 | ||
| Key points | 101 | ||
| INTRODUCTION | 101 | ||
| Diarrhea | 102 | ||
| Pathophysiology | 102 | ||
| Human immunodeficiency virus enteropathy | 103 | ||
| Highly active antiretroviral therapy–associated diarrhea | 103 | ||
| Other causes of noninfectious diarrhea | 104 | ||
| Nausea and Vomiting | 104 | ||
| Pathophysiology of nausea and vomiting | 104 | ||
| Human immunodeficiency virus medications and nausea and vomiting | 104 | ||
| SUMMARY | 105 | ||
| REFERENCES | 105 | ||
| Gastrointestinal Motility Problems in Critically Ill Patients | 109 | ||
| Key points | 109 | ||
| GASTROPARESIS | 110 | ||
| Clinical Manifestations | 110 | ||
| Diagnosis and Testing | 110 | ||
| Treatment | 111 | ||
| Nursing Care | 111 | ||
| ILEUS | 112 | ||
| Clinical Manifestations | 113 | ||
| Treatment | 113 | ||
| Nursing Care | 114 | ||
| TOXIC MEGACOLON | 115 | ||
| Cause and Incidence | 115 | ||
| Pathophysiology | 116 | ||
| Clinical Manifestations | 116 | ||
| Diagnosis | 117 | ||
| Treatment | 117 | ||
| Nursing Care | 117 | ||
| SUMMARY | 118 | ||
| REFERENCES | 118 | ||
| Gastroesophageal Reflux in the Intensive Care Unit Patient | 123 | ||
| Key points | 123 | ||
| INTRODUCTION | 123 | ||
| PATHOPHYSIOLOGY | 124 | ||
| Signs and Symptoms | 124 | ||
| Risk Factors | 125 | ||
| Treatment of Gastroesophageal Reflux and Gastroesophageal Reflux Disease | 126 | ||
| Proton pump inhibitors: Indications and complications | 127 | ||
| The Patient in the Intensive Care Unit | 128 | ||
| Assessment of reflux | 128 | ||
| Respiratory Manifestations of Reflux | 129 | ||
| Nutritional Support and Reflux | 130 | ||
| Stress Ulcer Prophylaxis | 130 | ||
| Effect of Positioning on Reflux | 131 | ||
| SUMMARY | 132 | ||
| REFERENCES | 132 | ||
| Adults with Liver Failure in the Intensive Care Unit | 137 | ||
| Key points | 137 | ||
| INTRODUCTION | 137 | ||
| OVERVIEW OF LIVER FUNCTION | 138 | ||
| CAUSES OF LIVER FAILURE | 139 | ||
| INDICATIONS FOR LIVER TRANSPLANT | 139 | ||
| Acute Liver Failure | 140 | ||
| CONSIDERATIONS FOR INTENSIVE CARE UNIT NURSES | 140 | ||
| Ascites and Respiratory Distress | 140 | ||
| Coagulopathy and Acute Bleeding | 140 | ||
| Hepatic Encephalopathy/Cerebral Edema | 141 | ||
| Sepsis | 141 | ||
| LIVER TRANSPLANT EVALUATION IN THE INTENSIVE CARE UNIT SETTING | 141 | ||
| CONTRAINDICATIONS FOR LIVER TRANSPLANT | 142 | ||
| ORGAN ALLOCATION AND LISTING FOR TRANSPLANT | 142 | ||
| Model for End-Stage Liver Disease Scoring | 143 | ||
| EARLY POSTTRANSPLANT COMPLICATIONS | 143 | ||
| Primary Graft Nonfunction | 143 | ||
| Early Acute Cellular Rejection | 143 | ||
| Vascular Complications | 144 | ||
| Hepatic artery thrombosis | 144 | ||
| Portal vein thrombosis | 144 | ||
| Biliary Complications | 144 | ||
| Biliary leaks and strictures | 145 | ||
| Bilomas | 145 | ||
| Infection | 145 | ||
| Renal Dysfunction | 145 | ||
| ADDITIONAL COMPLICATIONS | 146 | ||
| IMMUNOSUPPRESSION | 146 | ||
| LONG-TERM FOLLOW-UP | 146 | ||
| SUMMARY | 146 | ||
| REFERENCES | 146 | ||
| Escherichia coli Complications in Pediatric Critical Care | 149 | ||
| Key points | 149 | ||
| INTRODUCTION | 149 | ||
| DISCUSSION | 150 | ||
| Diagnosis | 150 | ||
| HEMOLYTIC UREMIC SYNDROME | 151 | ||
| SUPPORTIVE CARE | 152 | ||
| IMPLICATIONS FOR CRITICAL CARE NURSING | 153 | ||
| PROGNOSIS | 154 | ||
| PREVENTION | 155 | ||
| SUMMARY | 155 | ||
| REFERENCES | 155 | ||
| Gastrointestinal Traumatic Injuries | 157 | ||
| Key points | 157 | ||
| INTRODUCTION | 157 | ||
| Gastrointestinal Organs | 158 | ||
| Trauma | 158 | ||
| Seatbelt syndrome | 159 | ||
| Traumatic abdominal wall hernia | 159 | ||
| Penetrating gastrointestinal injuries | 160 | ||
| Nursing management | 160 | ||
| SUMMARY | 165 | ||
| REFERENCES | 165 | ||
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