Gall bladder

The gall bladder chapter describes conditions and diseases of the small organ of the gall bladder. The common diseases of the gall bladder are described with the more frequently presenting symptoms listed for the nurse. The occurrence rates of these pancreatic conditions are defined and any potential causes described. The investigations that are used to diagnose the condition are explored. Treatment options or preventative measures are also explored with a description of any potential complications. There are a number of conditions and diseases related to the gall bladder that include primary sclerosing cholangitis and gallstone. Inflammation of the gallbladder, cholecystitis may be acute or chronic. Succinct details related to people with diseases and conditions of the gall bladder are easy to use by the nurse within clinical practice.

Nursing assessment

The nursing assessment chapter explores the essential processes required to enable nurses to effectively assess patients and subsequently plan care. Undertaking a general patient history is important to determine a general health assessment. Additionally, there are a number of additional assessments that can be undertaken to gain greater understanding of specific gastrointestinal systems, such as a gastrointestinal assessment, a liver assessment, or a nutritional assessment. After performing an assessment through the use of questions, to gain more details about the patient and any condition they might be presenting with, a physical examination is necessary of the abdomen and rectum; a digital rectal examination may be undertaken. Succinct explorations on the various assessment methods that nurses use to evaluate the needs of patients can be reviewed when necessary within clinical practice by the nurse.

Stoma care

The stoma care chapter explores the formation of a temporary or permanent stoma and the main types of stoma. The two main types of faecal output stoma are the colostomy and ileostomy. The urostomy or ileal conduit is a urinary output stoma. The care required for people undergoing or living with a stoma is explored and includes preoperative and postoperative care. Stoma appliances and products are described. There is information provided on dietary and discharge home from the hospital and the nursing advice needed in these situations. There are descriptions of the common complications associated with stomas and how these can be addressed as well as longer-term issues, such as living with a stoma. Reversal of a stoma is included to describe considerations related to having the stoma surgically closed. Succinct descriptions related to stomas are detailed within this chapter for use in clinical practice by the nurse.

Other issues in gastrointestinal care

The final chapter is about other issues in gastrointestinal (GI) care and incorporates other important issues related to GI care that do not easily fall into other categories. This will ensure that as many GI-related topics as possible are covered to provide the nurse with a fuller understanding of GI nursing. This chapter incorporates issues related to scars, such as changes in body image and how this can cause psychological issues. Finally, issues related to sexuality, such as sexual dysfunction and erectile dysfunction, will be explored. Concise explanations of the issues within this chapter can aid the nurse, although it is often difficult for nurses to discuss these topics in a busy clinical environment.

Investigating the gut

The investigating the gut chapter examines investigations used to diagnosis diseases of the gastrointestinal tract. The investigations need to be used in the appropriate settings as there are risks associated with some, such as the radiation used in scans. Investigating the gut includes the defaecating proctogram to explore the rectum as well as ultrasounds of the abdomen or endoanal. There are also investigations such as computer tomography, virtual colonoscopy, and magnetic resonance imaging. Simple X-rays can be used to examine the abdomen or monitor gut transit, and barium studies can be taken orally or via the anus. These investigations can be used to diagnose changes within the gastrointestinal tract, such as a colorectal cancer or a stricture. Succinct explorations on the different investigations used to examine the gastrointestinal tract, detailed within this chapter can be reviewed when necessary within clinical practice by the nurse.

Anatomy and physiology of the gastrointestinal tract

The anatomy and physiology of the gastrointestinal (GI) tract chapter provides information on the parts, structure, and function of the gut. The hollow tube of the gastrointestinal tract begins at the mouth and ends at the anus. The GI tract in part lies within the abdominal cavity and the pelvic cavity. There are also the accessory organs of the liver, pancreas, and gall bladder. The nerves, hormones, secretions, and blood supply to the gut are also explored. The role of the GI tract is to ingest food and fluids. These are digested through mechanical and chemical means such as chewing. The nutrients are then absorbed, predominantly in the ileum. Waste products are finally eliminated via the anus.

Pancreas

The pancreas chapter explores the conditions and diseases of the pancreas. The common diseases of the pancreas are described with the identification of the more frequently presenting symptoms. The occurrence rates of these liver conditions are defined and any potential causes documented. The investigations that are used to diagnose the condition are described. Treatment options or preventative measures are also explored with a description of any potential complications. Conditions of the pancreas include pancreatitis which can be either acute or chronic. There is a more in-depth focus on pancreatic cancer. Concise explanations related to people with diseases and conditions of the pancreas will increase knowledge for the nurse that can be used in clinical practice.

Nutrition

The nutrition chapter explains how nutrition is an essential aspect of gastrointestinal nursing care, exploring what foods are needed for health. It is important that the nurse understands the constituents of food, such as carbohydrates, vitamins, and minerals. It is also necessary for the nurse to have an overview of common food intolerances and allergies. There is a brief discussion on some of the dietary conditions that can occur such as undernutrition, obesity, anorexia, or bulimia. The influence of the diet on health is also explored as this is an area in which the nurse can provide advice and support to patients. There is also discussion on functional foods, such as probiotics and prebiotics. Succinct exploration related to nutrition can be reviewed by the nurse as necessary within clinical practice.

Drugs in gastrointestinal care

The chapter entitled drugs in gastrointestinal care explores the many drugs that are either used in the care of people with disorders and diseases of the gastrointestinal tract or affect the gut. Medications are often necessary to treat gastrointestinal issues but there may be side effects that should be managed by nurses, Pain might be treated by drugs, such as different types of analgesia; infections are treated by antibiotics, and nausea by antiemetics. Additionally treatment of constipation with the use of laxatives is explored as there are a variety of medications that have dissimilar methods of working. Upper gastrointestinal diseases may be treated by medications, such as proton pump inhibitors. Alternatively, there may be side effects of other drugs that affect the gastrointestinal tract that require nursing care. This chapter is tabulated for ease of use by the nurse in clinical practice, to include the indication for when to use the drug and any side effects.

Colorectal cancer

The colorectal cancer chapter explores one of the top four cancers being diagnosed in the UK. Within this chapter are explanations of the staging of colorectal cancer. There are also descriptions of the symptoms and causes associated with cancer within the colon or rectum. The incidence and necessary investigations are detailed. Treatment for colorectal cancer is explored in relation to surgery, chemotherapy, radiotherapy, and biological therapy. Ways the nurse can advise prevention of colorectal cancer are identified and bowel screening is examined. Additionally, prognosis for people with colorectal cancer is described. The important nursing issue of long-term care, termed survivorship is reported upon. Succinct details on the issues related to colorectal cancer can be used by the nurse within clinical practice.