NCLEX-RN 이것만이라도 보고 가자! : Emergency / Critical Care │ Nurse Haley

날짜:

NCLEX-RN 이것만이라도 보고 가자! : Gastroenterology part │ Nurse Haley

날짜:

🍽️ Gastroenterology by Nurse Haley

GI Disorders · Liver & Pancreas · Bleeding · Nutrition 핵심 요약



안녕하세요! 오늘의 간호사 Haley 입니다 🌿 이번에는 Gastroenterology (소화기계) 파트입니다. 시험 전날 반드시 복습해야 할 소화기 질환 핵심 포인트만 정리했습니다. 시험 하루이틀전에 꼭 보고 가세요!

📖 Table of Contents

⬆️ Upper GI Disorders

Disorder Key Findings Nursing Focus
1️⃣ Peptic Ulcer Disease (PUD) Erosion of gastric/duodenal mucosa from ↑ acid & H. pylori.
Epigastric pain, melena, hematemesis. 		• Avoid NSAIDs, alcohol, caffeine.
• Small, frequent meals; avoid bedtime snacks.
• Meds: PPI (Omeprazole), H2 blocker (Ranitidine), antibiotics.
• Monitor for perforation → sudden sharp pain, rigid abdomen!
2️⃣ GI Bleeding Upper: hematemesis / melena
Lower: hematochezia (bright red blood). 		• NPO, NG tube for lavage.
• Monitor VS, orthostatic changes.
• Avoid anticoagulants & NSAIDs.
• Administer IV fluids, blood products.
• Report HR↑, BP↓ = hypovolemia.

⬇️ Lower GI Disorders

Disorder Key Findings Nursing Focus
1️⃣ Crohn’s Disease / Ulcerative Colitis (IBD) Autoimmune inflammation of GI tract.
Crohn’s = entire GI, “skip lesions”
UC = colon only, continuous. 		• Low-residue, high-calorie, high-protein diet.
• Avoid dairy, caffeine, raw veggies.
• Monitor for dehydration, anemia.
• Meds: Steroids, Mesalamine.
• Post-op stoma care education.
2️⃣ Bowel Obstruction Mechanical or paralytic cause → distention, vomiting, absent flatus. • NPO, NG tube for decompression.
• IV fluids, electrolytes.
• Monitor for perforation (fever, tachycardia).
• No laxatives/enemas.
• Prepare for surgery if unresolved.
3️⃣ Stoma / Colostomy Care Stoma should be pink, moist; mild bleeding early post-op is OK. • Report pale/blue stoma → ischemia.
• Empty bag at 1/3 full.
• Cut wafer ⅛ inch larger than stoma.
• Encourage fluids, avoid gas-forming foods.

🩸 Liver & Pancreas Disorders

Disorder Key Findings Nursing Focus
1️⃣ Hepatitis (A–E) Liver inflammation → jaundice, fatigue, RUQ pain.
A/E = fecal-oral, B/C/D = bloodborne. 		• Rest, avoid alcohol & hepatotoxic meds (acetaminophen).
• Small frequent meals, ↑ carbs.
• Educate hand hygiene, vaccine (A, B).
• Use standard & contact precautions as needed.
2️⃣ Cirrhosis Fibrosis & scarring of liver → portal HTN, ascites, encephalopathy. • Monitor ammonia level, give Lactulose.
• Low sodium diet, fluid restriction.
• Daily weight, abdominal girth.
• Avoid sedatives/narcotics.
• Bleeding precautions (↓ platelets).
3️⃣ Pancreatitis (Acute) Inflammation of pancreas → ↑ amylase/lipase, severe LUQ pain radiating to back. • NPO, IV fluids, NG suction.
• Avoid morphine (causes sphincter spasm) → use hydromorphone.
• Position: knee-chest or fetal.
• Monitor for hypocalcemia (Trousseau sign).
• Avoid alcohol & fatty food.
⚠️ NCLEX 핵심포인트:
- Pancreatitis = NPO + pain mgmt 우선.
- Cirrhosis → ammonia ↑ → Lactulose.
- GI Bleed → airway & fluids first.
- UC/Crohn’s → diet과 dehydration 문제 집중.

🩺 GI Nursing & Nutrition

  • All GI disorders → monitor for fluid & electrolyte imbalance.
  • NPO → initiate parenteral or enteral nutrition as ordered.
  • NG suction → replace fluids (isotonic IV).
  • Teach diet modification (fat, alcohol, caffeine 제한).
  • Always check bowel sounds before feeding post-op.
💡 Exam Tip:
- “Rigid abdomen” = perforation → emergency!
- “Confusion + tremor” in cirrhosis → encephalopathy suspicion.
- “Grey Turner / Cullen sign” → pancreatitis hemorrhage.

정리: 오늘의 간호사 Haley

📌 본문 내용은 오늘의 간호사 Haley의 저작물로 무단 복제·배포를 금합니다.

#NCLEX #Gastroenterology #PUD #Cirrhosis #Pancreatitis #Crohn #UC #GIbleed #RNexam #간호요약