Malabsorption Syndrome
Objective
Etiology and pathophysiology
 Possible hereditary factor
 Hereditary malabsorption
(such as hereditary folate
malabsorption is caused by
genetic mutations )
 Genetic mutation
-Can be hereditary.
-May occur randomly
when cells are dividing.
 Non-tropical sprue similar to
celiac disease (a chronic
digestive and immune disorder
that damage the small intestine)
in children and is characterized
by intolerance to gluten.
 Intolerance to gluten results
in blunting of the intestinal
villi.
 Tropical sprue is endemic in
the Indian subcontinent and the
Caribbean and is thought to be
due to infection rather than diet.
 RADIATION THERAPY
 Result in reduction of loss of
digestive enzymes leading of
malabsorption of nutrients
 LACTOSE INTOLERANCE
 Causes osmotic retention of
water and results in
cramping and diarrhea
CLINICAL FINDINGS :
Subjective
 Anorexia
 Fatiguability; weakness
 Abdominal discomfort
 Weight loss
 Anemia (macrocytic)
- A blood disorder that happens
when the red bone marrow
produces abnormally large RBC
 Diarrhea
 Steatorrhea: increase in fat
excretion in the stools

 Visualization of the small bowel
demonstrates fat, blunt vili
 Tetany- involuntary contraction
of muscles that usually result
from low serum calcium levels
 Demineralization of the skeletal
system

THERAPEUTIC INTERVENTIONS
 Tropical sprue may respond to
high protein! Normal fat diet with
supplemental vitamin B12, A, D,
E, K, FOLIC ACID, and Iron; in
addition, antibiotics such as
tetracycline for at least 6
months may be helpful.
 Non tropical sprue may
respond to high-protein, normal
fat, gluten-gliadin, free diet and
vitamin supplements of A,D,K,B,
Complex and folic acid, as well
as iron and calcium.
 Whenever the disease does not
respond to diet, corticosteroids
maybe used.
 Fluid and electrolytes imbalance
must be resolved.
ASSESSMENT
1. History of symptoms and
causative factors
2. History of bowel habits
3. Stool for diarrhea and steatorrhea
4. Presence and extent of bowel
sounds
ANALYSIS/NURSING DIAGNOSIS APPENDICITIS
1. Deficient Nutrition Causes:
2. Fluid Volume Deficit  Obstruction of the lumen of the
3. Acute Pain appendix by hardened feces
4. Fatigue (Fecalith)
5. Activity Intolerance
6. Body Image  Kinking of the appendix
7. Self Care Deficit  Scar tissue in the walls of the
appendix
PLANNING/IMPLEMENTATION

 teach the client and family how to Pathophysiology:

modify the diet comply with
medical management
 Instruct the client that rice, Flour,
corn,and soy flours should be
place of wheat , rye , barley, and
 Advance the client as to the
importance of follow-up care for
disease management
 Provide opportunity for the client
and family to verbalized feelings
about the illness
 Observe the client for signs of
electrolyte imbalance
 Record weight
Causes
Inflammatory response
abdominal pain
Elevation of body temperature and WBC
Increased intraluminal pressure
 Pain typically starts as vague pains at
the middle of the abdomen which may
come and go.
 Then within hours, the pain
progressively becomes severe and
travels to the RLG (McBurney’s point)
Increased intraluminal pressure

EVALUATION/ OUTCOMES a. Decreased mucosal blood flow

 Maintains and regains weight b. Decreased venous drainage
appropriate for height, age, and
c. Thrombosis
frame
d. Bacterial Invasion
 Reports decreased number of
bowel movements
 Maintains fluid and electrolytes
balance
 Client and family verbalize Perforation Bowel
feelings Peritonitis
Reduce bowel sounds
 Follow dietary plan Shock Abdominal distortion;
Death abdomen is ‘board-like’
DIAGNOSIS B. LABORATORY STUDIES
A. physical exam  CBC AND CRP
 The examiner applies slow  ULTRASOUND
pressure over McBurney’s point  CT scan
and the quickly release.
 The presence of pain when the Management:
pressure was released is  Bed rest
indicative of positive test.  NPO
ROVSING’S SIGN  Relieve pain
 Pain elicited in the RLQ with  Avoid factors that increase
palpation pressure in LLQ. peristalsis, thereby preventing
PSOAS SIGN rapture
 Elicited by having the patient lie  IVF therapy to maintain fluid and
on left side while the right thigh is electrolyte balance
flexed backward  Antibiotic therapy
 Surgery: APPENDECTOMY

NURSING CARE:
 Provide emotional support
 Monitor electrolyte and fluid
balance
 Do not apply hot compress in the
OBTURATOR SIGN abdomen
* Pain on passive interval rotation  Encourage ambulation post-op
of the flexed thigh  Assess return of bowel function
 Administer antibiotics as
prescribed

EVALUATION/ OUTCOMES
1. States pain alleviated
2. Maintains adequate fluid balance
3. Verbalizes feelings