목차
1. 용어 및 약어
1) 용어 및 약어 ····························································································· 1
2. 주요 학습내용
1) 소화기계 병동에서 주로 시행하는 검사 전·후 간호 ··············································· 3
– GFS(위내시경, Gastrofiberscope)
– CFS(대장내시경, Colonofiberscope)
– ERCP(내시경역행췌담관조영술, Endoscopic retrograde cholangio pancreatography)
– TACE(간동맥 화학색전술, Transcatheter arterial chemoembolization)
– EVL(내시경 정맥류 결찰술, Endoscopic variceal ligation)
– 간 생검(Liver biopsy)
– 복수 천자(Paracentesis, Peritoneal tapping)
2) 위 장관 점막 절제술 환자 관리 ······································································· 6
3) 각종 배액관 삽입환자 관리(PTBD, ENBD, ERBD) ················································ 7
4) 간성혼수간호 ······························································································· 7
3. 주요 질환
1) 위염(Gastritis), 궤양(Ulcer), 위암(Stomach cancer) ··········································· 8
2) 염증성 장질환(Intestinal inflammation), 국소장염(Regional enteritis), 대장암(CRC, Colon cancer), 궤양성 대장염(Ulcerative colitis), 과민대장증후군(Irritable bowel syndrome), 장폐색(Intestinal obstruction) ····················································· 11
3) 직장암(Rectal cancer) ················································································· 15
4) 간염(Hepatitis), 간경화증(Liver cirrhosis), 간암(Hepatoma), 정맥류 출혈(Varix bleeding), 간세포암(HCC, Hepatocellular carcinoma) ······································ 16
5) 담석증(Cholelithiasis), 담낭염(Cholecystitis), 담낭암(Gallbladder cancer), 담관암(Cholangiocarcinoma) ··············································································· 19
6) 췌장염(Pancreatitis), 췌장암(Pancreatic cancer) ·············································· 22
3. 주요 수술 및 시술
1) GFS (위내시경) ·························································································· 24
2) EMR (내시경적 점막 절제술) ········································································· 24
3) ESD (내시경적 점막하 절제술) ······································································· 25
4) PTBD (피부간경유쓸개관배액술) ····································································· 26
5) EST (내시경적유두괄약근절개술) ···································································· 26
6) 내시경적역행성췌담관조영술(ERCP) ································································· 27
7) 경피적간담도조영술(PTCA) ············································································ 28
4. 참고문헌
1) 참고문헌 ··········································································································· 28
본문내용
2. 주요 학습내용
1) 소화기계 병동에서 주로 시행하는 특수 검사 전 · 후 간호
1-1) GFS (위내시경, Gastrofiberscope)
√ 간호
– 검사에 대해 설명하고, 서명한 동의서를 확인한다.
– 검사 8~12시간 이전부터 금식한다.
– 검사 후 운전을 할 수 없으므로 동반한 가족이나 지인의 이름을 기록한다.
– ID팔찌를 손목에 부착한다.
– 액세서리, 의치, 안경을 제거한다.
– 검사 전 배뇨했는지 확인한다.
– 활력징후를 측정하고 진정제를 투여한다.
– 구강·인두 분비물 감소를 위해 항콜린제를 투여한다.
– 검사 관련 질문에 대해 대답한다.
– 내시경이 위 내에 삽입되면 압박감이 있을 수 있으며, 시야 확보를 위해 위에 공기를 주입하면 팽창감을 느낄 수 있음을 설명한다.
– 구강 마취제를 5분 정도 머금게 한 후 서서히 삼키도록 하여 삽관 시 불편감과 구개 반사를 방지한다.
– 마취 후에는 침을 삼키지 말고 옆으로 흘러내리게 하라고 설명한다.
– 수면 내시경을 하는 경유 검사 동안 산소포화도와 맥박수 등을 관찰한다.
– 활력징후와 구개 반사를 자주 체크한다.
– 구개 반사가 회복될 때까지 금식하고 고개를 옆으로 돌린다.
– 출혈이나 발열, 호흡곤란, 연하곤란 같은 천공의 징후를 관찰한다. (비빔소리, 목·가슴·어깨 등의 통증, 청색증, 호흡곤란, 심계항진, 경부의 피하기종, 늑막삼출증, 요통 등)
– 검사 후 적어도 12시간 동안 운전하지 말라고 설명한다.
– 검사 후 목의 자극이나 쉰목소리를 예방하기 위해 함당점제나 생리식염수로 함수한다.
1-2) CFS (대장내시경, Colonofiberscope)
√ 간호
– 아스피린, 항응고제와 같이 출혈을 일으키는 약물의 경우 주치의에게 알려 대장 내시경 전 중단하거나 용량을 줄인다. (& 당뇨, 고혈압, 항경련제 복용도 의료진과 상의 후 복용 유무 확인 필요함)
– 복부 수술 경험, 전립선 비대증, 자궁근종, 신장 질환, 과거 약물 알레르기 확인한다.
출처 : 해피캠퍼스
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