NLE Gastrointestinal Nursing — Lower GI & Bowel DisordersConcept Map

Concept

GI Assessment

Sub Concepts

• Inspection technique
• Auscultation (bowel sounds)
• Percussion
• Palpation
• History taking

Relationship To Central

Foundation for diagnosing all upper GI disorders

Concept

Gastroesophageal Reflux Disease (GERD)

Sub Concepts

• Pathophysiology - LES incompetence
• Manifestations - pyrosis, regurgitation
• Barrett's esophagus - premalignant change
• Diagnostic procedures - 24h pH monitoring, EGD
• Management - positioning, diet, lifestyle

Relationship To Central

Most common upper GI disorder with chronic complications

Concept

Hiatal Hernia

Sub Concepts

• Sliding type - common, GERD-like
• Rolling type - surgical emergency risk
• Nissen fundoplication
• Lifestyle modifications

Relationship To Central

Structural disorder related to GERD symptoms

Concept

Peptic Ulcer Disease (PUD)

Sub Concepts

• Gastric ulcer vs duodenal ulcer
• Helicobacter pylori etiology
• NSAID-related ulcers
• Pain characteristics by type
• Complications - hemorrhage, perforation

Relationship To Central

Common cause of upper GI bleeding and complications

Concept

Gastritis

Sub Concepts

• Acute vs chronic gastritis
• H. pylori association
• Autoimmune pernicious anemia
• Intrinsic factor loss
• Vitamin B12 absorption impairment

Relationship To Central

Mucosal inflammation with chronic sequelae

Concept

Upper GI Bleeding

Sub Concepts

• Hematemesis and melena
• Shock management
• IV access and fluid resuscitation
• Emergency endoscopy
• Transfusion protocol

Relationship To Central

Life-threatening complication requiring emergency response

Concept

Pharmacological Management

Sub Concepts

• Proton pump inhibitors
• H2-receptor antagonists
• Antacids
• Mucosal protectants
• H. pylori eradication therapy

Relationship To Central

Evidence-based treatment regimens

Concept

Nasogastric Tube (NGT) Management

Sub Concepts

• Placement verification
• Aspiration and pH testing
• X-ray confirmation
• Residual volume monitoring
• Aspiration prevention

Relationship To Central

Essential nursing skill for GI interventions

Concept

Stress-Related Mucosal Disease

Sub Concepts

• Curling's ulcer - severe burns
• Cushing's ulcer - head injury
• Prophylactic management
• ICU prevention protocols

Relationship To Central

Acute ulceration in critically ill patients

Concept

Patient Education and Prevention

Sub Concepts

• Medication adherence
• Dietary modifications
• Lifestyle changes
• Warning sign recognition
• Smoking and alcohol cessation

Relationship To Central

Long-term management and complication prevention

To

All Upper GI Disorders

From

GI Assessment

Strength

strong

Relationship

Assessment findings guide diagnosis and management of all upper GI conditions

To

Barrett's Esophagus

From

GERD

Strength

strong

Relationship

Chronic GERD leads to metaplastic change and premalignant transformation

To

Esophageal Adenocarcinoma

From

GERD

Strength

strong

Relationship

Barrett's esophagus from untreated GERD increases cancer risk significantly

To

GERD

From

Hiatal Hernia

Strength

moderate

Relationship

Structural herniation contributes to GERD symptoms and pathophysiology

To

Peptic Ulcer Disease

From

H. pylori Infection

Strength

strong

Relationship

H. pylori is leading infectious cause of PUD; damages protective mucosa

To

Gastritis

From

H. pylori Infection

Strength

strong

Relationship

H. pylori causes chronic inflammation of gastric mucosa

To

Peptic Ulcer Disease

From

NSAIDs

Strength

strong

Relationship

NSAID use inhibits protective prostaglandin synthesis, leading to ulcer formation

To

Gastritis

From

NSAIDs

Strength

strong

Relationship

NSAIDs cause acute mucosal inflammation and gastritis

To

Upper GI Bleeding

From

Peptic Ulcer Disease

Strength

strong

Relationship

Ulcer erosion into vessels is most common cause of upper GI hemorrhage

To

Upper GI Bleeding

From

Esophageal Varices

Strength

strong

Relationship

Portal hypertension causes variceal rupture with massive hemorrhage

To

Upper GI Bleeding

From

Mallory-Weiss Tear

Strength

strong

Relationship

Forceful vomiting causes mucosal laceration at GE junction with acute bleeding

To

Upper GI Bleeding

From

Erosive Gastritis

Strength

moderate

Relationship

Severe mucosal erosion can lead to acute hemorrhage

To

Upper GI Bleeding

From

Stress-Related Mucosal Disease

Strength

moderate

Relationship

Critical illness causes acute erosions and potential hemorrhage in ICU patients

To

Pernicious Anemia

From

Gastritis

Strength

strong

Relationship

Autoimmune gastritis destroys intrinsic factor-producing cells, impairing B12 absorption

To

GERD

From

Proton Pump Inhibitors

Strength

strong

Relationship

Mainstay therapy for acid suppression in GERD management

To

Peptic Ulcer Disease

From

Proton Pump Inhibitors

Strength

strong

Relationship

Essential for PUD healing by reducing gastric acid; used in H. pylori eradication

To

Peptic Ulcer Disease

From

H. pylori Eradication Therapy

Strength

strong

Relationship

Triple or quadruple therapy definitively treats H. pylori-induced PUD

To

Gastritis

From

H. pylori Eradication Therapy

Strength

strong

Relationship

Eradication therapy treats H. pylori-associated chronic gastritis

To

Upper GI Bleeding

From

NGT Management

Strength

strong

Relationship

NGT used for decompression and monitoring during acute bleeding episodes

To

Gastric Outlet Obstruction

From

NGT Management

Strength

moderate

Relationship

NGT provides decompression in obstruction from severe ulcer disease or scarring

To

GERD Prevention

From

Patient Education

Strength

strong

Relationship

Lifestyle modifications and trigger avoidance reduce GERD symptoms and complications

To

PUD Prevention

From

Patient Education

Strength

strong

Relationship

NSAID avoidance, smoking cessation, and medication compliance prevent ulcer recurrence

To

Peptic Ulcer Disease Complications

From

Dumping Syndrome

Strength

moderate

Relationship

Post-gastrectomy complication from rapid gastric emptying after ulcer surgery

To

GERD

From

Aspiration Pneumonia

Strength

moderate

Relationship

Nocturnal reflux increases aspiration risk, particularly in elderly or recumbent patients

To

Peptic Ulcer Disease

From

Iron-Deficiency Anemia

Strength

strong

Relationship

Chronic occult bleeding from ulcers causes iron deficiency and anemia

To

Stress-Related Mucosal Disease

From

Curling's Ulcer

Strength

strong

Relationship

Severe burns cause acute gastric ulceration from mucosal ischemia

To

Stress-Related Mucosal Disease

From

Cushing's Ulcer

Strength

strong

Relationship

Head injury and elevated ICP cause acute gastric ulceration

To

Peptic Ulcer Disease Complications

From

Perforation

Strength

strong

Relationship

Full-thickness ulcer erosion creates surgical emergency with peritonitis

To

Peptic Ulcer Disease Complications

From

Hemorrhage

Strength

strong

Relationship

Ulcer erosion into blood vessel causes acute upper GI bleeding

To

Peptic Ulcer Disease Complications

From

Gastric Outlet Obstruction

Strength

moderate

Relationship

Chronic ulcers cause scarring and stenosis of pylorus

To

Nursing Management

From

RA 9173 Professional Practice

Strength

moderate

Relationship

Regulatory framework governing scope of nursing practice in GI care delivery