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NURS 347 EXAM 5 UROLOGY > Upper Gastrointestinal Problemz > Flashcards

Upper Gastrointestinal Problemz Flashcards

1
Q

What are the two indicators that something is going wrong In the GI tract?

A

Nausea and vomiting ( Emesis )

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2
Q

Medications for nausea/vomitting (2)

A

Antihistamines
- dimendydrainate
- promethazine
- meclizine
- hydroxyzine

Phenothiazines
- prochlorperazine
- chlorpromazine

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3
Q

Whenever giving nausea medications, the answer to all test questions is that there is a what type or risk?

A

Fall risk

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4
Q

Common side effects of Nausea medications are (5)

A

Dry mouth
Hypotension
Sedative effects
Rashes
Gi disturbances

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5
Q

Promethazine isn’t good for Iv, it’s better for which type of injection and causes what?

A

IM injection
Severe tissue damage

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6
Q

Antihistamines and anticloinergies should never been given to patients who are? (5)

A

Glaucoma
Prostatic hyperplasia
Pyloric
Bladder neck obstruction
Biliary obstruction

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7
Q

Zofran can cause what?

A

Constipations

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8
Q

Nursing assessment
What will we want to see and indicates what?
Partially disgested
Fecal odor and bile
Bile
Bright red blood
Coffee ground

A

Gastric outlet obstruction & delayed gastric emptying

Obstruction below pylorus

Obstruction below ampulla or vater

Active bleeding ( Mallory Wei’s, varies, ulcer, cancer )

Gastric bleeding

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9
Q

What causes aMallory weiss tear?

A

Violent coughing or vomiting

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10
Q

Esophageal varies is what?
And when they burst what happens
Is it life threatening?

Who do we see this in more often? What type of patients?

A

Varicose veins in the esophagus
Bleeding

Yes because loss of blood loss

Alcohol patients

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11
Q

Nursing implentstuon
Acute care (5)

A

NPO, IV fluids
NGT
monitor input and output
( dehydration )

Psychosocial and environmental
Aspiration precautions

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12
Q

Nursing implemention
Ambulatory care (4)

A

Manage nausea / vomiting
Avoid sudden position change
Notify provider if symptoms persist
New med awareness

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13
Q

When a patient was NPO, we want them to start on what? Every how many minutes?

A

Clear liquids
15-20mins

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14
Q

We want to what type clear liquids

A

Carbonated
Room temp
Warm tea

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15
Q

After clear liquid, you want to progress to what?

A

High carb low fat ; bland foods

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16
Q

Gerontologic considerations
You want to be careful with them why?(3)

A

Monitor with fluid loss and rehydration
( cardiac & renal issues )

Aspiration precautions

Antiemetic drugs ; CNS effects ( confusion and falls )

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17
Q

Esophageal problems

A
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18
Q

What is gastriesophageal reflux disease ( GERD )

A

Gastric contents reflux into esophagus causing irrational and inflammation

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19
Q

What is the primary factor of GERD?

A

Incompetent LES

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20
Q

How does LES normally act in the body?

A

Acts an anti reflux barrier

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21
Q

An incompetent LES allows gastric contents to move from the stomach to the esophagus when the patient is ?

A

Supine or has an increase in intrabadominal pressure

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22
Q

What are some factors that affect LES pressure? (4)

A

Food and drugs
Obesity
Smoking
Hiatal hernia

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23
Q

What are the clinical manifestations of GERD? (4)

A

Heart burn ( pyrosis)
Dyspepsia ( pain discomfort in upper abdomen )
Regurgitation ( hot bitter sour liquid in throat ) ( Verp)
Respiratory- wheezing

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24
Q

What is pyrosis ?
It mimics what and relived with?

A

Heart burn
Burning tight sensation under lower sternum spread into throat or jaw

Mimics angina but relived with antacids

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25
Q

Patients who have GERD may have globus sensation, which is?

A

Sense of a lump in the throat

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26
Q

What are complications of GERD? (4)
Explain first two

A

Esophagitis
( ulceration, scar tissues, stricture; dysphagia )

Barrerts esophagus
- metaplasia of cells ; increase risk of cancer

Respiratory

Dental Erosion

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27
Q

People who smoke are at higher risk of getting what?

A

Barretts esophagus

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28
Q

Diagnostic study of GERD is? (2)

A

Endoscopy
Barium swallow ; radiography X ray
(1,2,5mins )

29
Q

The most important answer choice to choose when it comes to GI and things making it worse
What 3 things we need to avoid?

A

Alcohol
Caffeine
Smoking

30
Q

Nursing managements for GERD
(6)

A

Low fat diet
Upright position 2-3 hours after meals
Avoid eating 3 hours before bend
HOB increased 4-6
Weight reduction
Drug therapy

31
Q

Drug therapy for GERD (4)

A

PPI
H2 receptor blockers
Prokinetics
Antacids

32
Q

PPIs helps GERD patients how?
Is it the most effective for healing esophagitis?

What are the complications of this? (4)

A

Decrease HCI secretions and irritation
( also most effective for healing esophagitis )

Decreased bone density
Kidney disease
Deficient of vitamin b12
Dementia

33
Q

H2 receptors help GERD patients how?
They have an onset of how long?
Available in what forms?

A

Decrease HCI secretion and Irritation
1 hours to 12 hours
Oral, IV, combined with antacid

34
Q

How does Prokinetics help GERD?
Side effects? (2)

A

Increase gastric emptying and motility

Hallucinations, extrapyradmidal effects ( tremor and dyskinesia )

35
Q

How does antacids help GERD?
You want to take every ?
Becareful with elderly because
Can cause ?

A

Neutralize acid
Provides quick relief for mild
Intermittent symptoms ( short duration )

1-3 hours after meals and bedtime
Increase sodium

Renal failure - no magnesium preparations

36
Q

Antacids they are putting calcium and magnesium, so patients with renal failure, you don’t want that?
True or false

A

True

37
Q

Antacids are quick relief for mild symptoms? True or false

A

True

38
Q

Nutritional therapy for GERD (4)

A

No specific diet
Avoid milk and eating before bedtime
Encourage small meals and fluids between meals
Weight reduction

39
Q

Surgical therapy we can do for GERD is? (3)

A

Anti reflux surgery
Nissan and Toupet fundoplications
Linx Reflux management

40
Q

Antireflux surgery helps?

A

Reduce reflux and enhances LES function

41
Q

Linx Reflux mangament system help GERD how?

A

Ring of titanium beads with magenta implanted into LES to prevent reflux by keeping it closed when not eating or drinking

42
Q

Nissan Fundoplication how does it work?

A

Tighten the fundus and wrap it around to reduce reflux

43
Q

What is Hiatal Hernia?

A

Herniation is part of the stomach into the esophagus through and opening in the diaphragm

44
Q

Hiatal hernia is also called?

A

Diaphragmic or Esophageal hernia

45
Q

There are two types of hiatal hernia?

A

Sliding and paraesophgeal

46
Q

Sliding is the most common hiatal hernia and it’s?

A

The junction of the stomach and esophagus is above the diaphragm

Part of the stomach slides through the hiatal opening in the diaphragm
And occurs when the patient is supine

47
Q

What is paraesophageal or rolling Hiatal hernia?

This is also a medical emergency!?

A

Fundus and greater curvature of the stomach roll up through the diaphragm forming a pocket alongside the esophagus

48
Q

What is eosinophilic esophagitis?

A

Swelling of esophagus due to infiltration of eosinophils

49
Q

Eosinophilic Esophagitis can be ? (2)

A

Personal or family history of allergies

50
Q

Eosinophilic esophagitis can be from food triggers and environmental factors like?

A

Milk, eggs, wheat, rye and beef

Pollen, molds, animals

51
Q

Clinical manifestations of eosinophilic esophagitis are? (6)

A

Heart burn
Dysphagia
Food impaction esophagus
Nausea
Vomiting
Weight loss

52
Q

Diagnostic studies of EOE? (2)

A

Endoscopy with biopsy
Allergy testing

53
Q

Treatment of EOE? (3)

A

Avoid allergies
Ppi and corticosteroids
( monitor for candidiasis )

54
Q

Who is esophageal diverticula?

A

Saclike outpouching of 1 or more layers

55
Q

Symptoms of esophageal diverticula? (5)

A

Dysphagic
Regurgitation
Chronic cough
Aspiration
Weight loss

56
Q

When food gets trapped in the pouches you could have?

A

Sour taste or smell

57
Q

What are complications of esophageal diverticula ? (3)

A

Malnutrition
Aspiration
Perforation

58
Q

Esophageal diverticula treatment? (3)

A

Dietary modifications
Surgery
Endoscopic procedures

59
Q

What is esophageal strictures?
Most often from?

A

Narrowing of esophagus
GERD

60
Q

Other factors that effect esophageal strictures are?

A

Chemical ingestions
Radiation
Surgery
Trauma

61
Q

Manifestations of esophageal structures are? (3)

A

Dysphagia
Regurgitation
Weight loss

62
Q

Treatment of esophageal strictures ? (2)

A

Dilation with bougies or balloons using endoscopy or fluoroscopy
Surgical excision

63
Q

What is achalasia?

A

Absent peristalsis in lower 2/3 esophagus

( food is getting stuck, not loving along where, be careful with eating )

64
Q

What is the pathophysiology of achalasia?

A

Increase LES pressure with incomplete relaxing may cause obstruction near diaphragm ( tapered ) ; fluid and foods accumulation

Upper esophagus dilates

65
Q

What is manifestations of achalsia? (7)

A

Dysphagia
Globus sensation ( chest pain )
Night time regurgitation
Halitosis ( foul breath )
Inability to erucatate
Symptoms of GERD
Weight loss

66
Q

What is globus sensation?

A

Lump in throat but painless

67
Q

What is diagnostic study of achalsia? (3)

A

Barium swallow
Manometry
Endoscopy

68
Q

Treatment goals for achalsia are? (3)

A

Relieve Dysphagia & regurgitation
Improve esophageal emptying by disrupting LES
Precent development of mega esophagus

69
Q

You could do surgiesis for achalsia which are (2)?

A

Endoscopic dilation
Heller myotomy ( cuts LES muscle )

NURS 347 EXAM 5 UROLOGY (16 decks)

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