Gastroparesis is a chronic digestive disorder characterized by delayed gastric emptying without mechanical obstruction. This nursing diagnosis focuses on identifying and managing gastroparesis symptoms, preventing complications, and improving the patient’s quality of life.
Causes (Related to)
Gastroparesis can affect patients in various ways, with several factors contributing to its severity and progression:
- Diabetes mellitus (most common cause)
- Post-surgical complications
- Neurological disorders
- Medical conditions such as:
- Multiple sclerosis
- Parkinson’s disease
- Scleroderma
- Thyroid disorders
- Other contributing factors include:
- Certain medications (narcotics, antidepressants)
- Viral infections
- Autoimmune conditions
- Idiopathic causes
Signs and Symptoms (As evidenced by)
Gastroparesis presents with distinctive signs and symptoms that nurses must recognize for proper diagnosis and treatment.
Subjective: (Patient reports)
- Early satiety
- Nausea and vomiting
- Abdominal pain and bloating
- Loss of appetite
- Acid reflux
- Weight loss
- Feeling full after eating small amounts
Objective: (Nurse assesses)
- Documented delayed gastric emptying
- Visible abdominal distention
- Weight loss
- Malnutrition signs
- Dehydration indicators
- Blood sugar fluctuations in diabetic patients
- Abnormal bowel sounds
Expected Outcomes
The following outcomes indicate successful management of gastroparesis:
- Patient will maintain adequate nutrition and hydration
- Patient will report reduced nausea and vomiting
- Patient will demonstrate weight maintenance or gain
- Patient will show improved blood sugar control (if diabetic)
- Patient will report decreased abdominal pain
- Patient will follow prescribed dietary modifications
- Patient will demonstrate understanding of medication regimen
Nursing Assessment
Monitor Nutritional Status
- Assess dietary intake
- Monitor weight trends
- Check for signs of malnutrition
- Document feeding tolerance
- Track caloric intake
Evaluate Gastrointestinal Function
- Assess bowel sounds
- Monitor bowel movements
- Document nausea/vomiting episodes
- Check abdominal distention
- Note presence of pain
Assess Hydration Status
- Monitor fluid intake and output
- Check skin turgor
- Assess mucous membranes
- Track urine output
- Note signs of dehydration
Monitor for Complications
- Check blood sugar levels
- Assess for bezoar formation
- Monitor for electrolyte imbalances
- Watch for signs of malnutrition
- Check for aspiration risks
Review Contributing Factors
- Assess medication history
- Document underlying conditions
- Check diabetes control
- Review surgical history
- Monitor lifestyle factors
Nursing Care Plans
Nursing Care Plan 1: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than body requirements related to impaired gastric emptying as evidenced by weight loss, early satiety, and inadequate food intake.
Related Factors:
- Delayed gastric emptying
- Chronic nausea and vomiting
- Early satiety
- Poor appetite
Nursing Interventions and Rationales:
- Monitor daily weight and intake
Rationale: Tracks nutritional status and effectiveness of interventions - Provide small, frequent meals
Rationale: Reduces gastric overload and improves tolerance - Position patient upright during and after meals
Rationale: Promotes gastric emptying and reduces reflux
Desired Outcomes:
- Patient will maintain stable weight
- Patient will demonstrate improved nutritional intake
- Patient will report decreased early satiety
Nursing Care Plan 2: Risk for Deficient Fluid Volume
Nursing Diagnosis Statement:
Risk for Deficient Fluid Volume related to frequent vomiting and decreased oral intake as evidenced by poor skin turgor and decreased urine output.
Related Factors:
- Frequent vomiting
- Poor oral intake
- Altered absorption
- Chronic nausea
Nursing Interventions and Rationales:
- Monitor intake and output
Rationale: Ensures adequate fluid balance - Administer antiemetics as ordered
Rationale: Reduces fluid loss from vomiting - Encourage appropriate fluid intake
Rationale: Prevents dehydration
Desired Outcomes:
- Patient will maintain adequate hydration
- Patient will demonstrate normal skin turgor
- Patient will produce adequate urine output
Nursing Care Plan 3: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to gastroparesis as evidenced by reported abdominal pain, bloating, and distention.
Related Factors:
- Delayed gastric emptying
- Abdominal distention
- Nerve damage
- Inflammation
Nursing Interventions and Rationales:
- Assess pain characteristics
Rationale: Guides pain management strategies - Administer pain medication as ordered
Rationale: Provides comfort and symptom relief - Teach non-pharmacological pain management
Rationale: Provides additional pain relief options
Desired Outcomes:
- Patient will report decreased pain levels
- Patient will demonstrate improved comfort
- Patient will utilize effective pain management strategies
Nursing Care Plan 4: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to gastroparesis management as evidenced by verbalized questions about diet and medication regimen.
Related Factors:
- Complex treatment regimen
- Lack of exposure to information
- Misinterpretation of information
- Language or cultural barriers
Nursing Interventions and Rationales:
- Provide dietary education
Rationale: Improves dietary compliance - Teach medication management
Rationale: Ensures proper medication administration - Demonstrate proper positioning techniques
Rationale: Enhances gastric emptying
Desired Outcomes:
- Patient will verbalize understanding of gastroparesis management
- Patient will demonstrate proper dietary choices
- Patient will follow prescribed medication regimen
Nursing Care Plan 5: Disturbed Body Image
Nursing Diagnosis Statement:
Disturbed Body Image related to weight loss and dietary restrictions as evidenced by expressed concerns about appearance and social isolation.
Related Factors:
- Unintentional weight loss
- Dietary limitations
- Social restrictions
- Chronic illness adaptation
Nursing Interventions and Rationales:
- Assess psychological impact
Rationale: Identifies need for emotional support - Provide counseling resources
Rationale: Supports emotional adaptation - Encourage support group participation
Rationale: Promotes coping strategies
Desired Outcomes:
- Patient will express improved body image
- Patient will demonstrate positive coping strategies
- Patient will maintain social interactions
References
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