Page 1477 - Saunders Comprehensive Review For NCLEX-RN

Introduction

Pyramid to Success

Pyramid Points focus on diagnostic tests and nursing care related to the various
gastric or intestinal tubes, gastric surgery, cirrhosis, hepatitis, pancreatitis, and
colostomy care. Focus on preprocedure and postprocedure care of the client
undergoing a gastrointestinal diagnostic test. Remember that an informed consent is
required for any invasive procedure. Focus on diet restrictions before and after the
diagnostic test and remember that the gag reflex or bowel sounds must return before
allowing a client to consume food or fluids. Pyramid Points also include instructions
to the client and family regarding the prevention of gastrointestinal problems and
the complications associated with the problem. Focus on teaching the client and
family about diet and nutrition specific to the problem, tube and wound care,
preventing the transmission of infection such as with hepatitis, and care of a
colostomy or ileostomy. Remember that body image disturbances can occur in
clients with a gastrointestinal problem. Specific focus relates to the client with a
diversion, such as an ileostomy or colostomy; the social isolation issues that can
occur; and effective coping strategies.

Client Needs: Learning Objectives

Safe and Effective Care Environment

Consulting with the interprofessional team regarding the client’s care and
nutritional status
Ensuring that confidentiality issues related to the gastrointestinal problem are
maintained
Ensuring that informed consent for treatments and surgical procedures has been
obtained
Establishing priorities of care
Handling infectious drainage and secretions safely
Maintaining standard precautions and other precautions as appropriate
Obtaining referrals for home care and community services
Preventing disease transmission

Health Promotion and Maintenance

Performing physical assessment techniques of the gastrointestinal system

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