Book Reading A Flashcards by student nursing

what disease is caused by acid reflux from the stomach (or duodenum) into the esophagus

GERD

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what disease results from the backward flow of gastroduodenal contents (refluxate) into the esophagus

GERD

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what disease occurs when the LES is weak or relaxes inappropriately, causing the pressure gradient between the LES and the stomach to be lost.

GERD

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what is the gold standard for the assessment and measurement of esophageal motor activity.

Esophageal manometry or motility testing

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what disease has these risk factors?

Hiatal hernia
LES hypotension
Loss of esophageal motility
Increased compliance of the hiatal canal
Increased states of gastric secretion
Eating large meals
Delayed emptying of gastric contents
Ascites
Tight belts or girdles
Presence of a nasogastric tube

GERD

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what disease has this medication?

Histamine receptor antagonists
Prokinetic medications
Proton pump inhibitors

GERD

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what medication decrease gastric acid production; short acting?

Histamine receptor antagonists

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what medication increase gastric emptying

Prokinetic medications

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what medication decrease gastric acid production; long acting

Proton pump inhibitors

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what is the gold standard for surgery for GERD surgical managment?

laparoscopic Nissen fundoplication

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what is a complication of GERD?

Barrett’s epithelium

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what disease has these manifestations?

Heartburn (dyspepsia)
Severe atypical chest pain
Odynophagia (painful swallowing)
Hemorrhage
Dental caries
Aspiration pneumonia
Chronic cough
Morning hoarseness
Adult-onset asthma
Laryngitis
Pharyngitis
Bronchitis
Regurgitation

GERD

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what disease has this assessment?

Regurgitation
Severe atypical chest pain
Hemorrhage
CBC
Dyspepsia
Dysphagia and odynophagia
Signs of Barrett’s esophagus
Dental caries
Water brash
Eructation, flatulence, or bloating
Nausea
Globus (sensation that there is a lump in the throat)
pH of gastric aspirate

GERD

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what disease has these actions?

medical management
patient positioning
*on right side
*HOB 6-12 inches
provide 4-6 meals a day

GERD

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what disease has this food managment?

spicy/fatty foods,

caffeine,

chocolate,

carbonated beverages,

acidic foods,

peppermint,

alcohol,

certain medications

GERD

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what medications should me avoided on GERD?

calcium channel blockers,

anticholinergic medications,

smooth muscle relaxers.

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what disease is localized or patchy inflammation of the gastric mucosa resulting from repeated exposures to irritating agents.

gastritis

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what disease has

mucosal inflammatory process that may be accompanied by hemorrhage into the mucosa.

thickened, reddened mucous membrane with extrusive rugae, or longitudinal folds.

mucosal necrosis and inflammatory reaction

sloughing of the surface mucosa may lead to acute GI bleeding.

acute gastritis

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what disease has

prolonged, persistent, or intermittent inflammation

patchy, diffuse inflammation of the mucosal lining of the stomach.

leads to atrophy of the glandular epithelium of the stomach.

chronic gastritis

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the 3 types of chronic gastritis are…

Helicobacter pylori gastritis

Most common
total loss of fundal glands, minimal inflammation, thinning of the gastric mucosa leading to atrophy, and abnormal cellular changes.
transmission is likely person-to-person by vomitus, saliva, feces, or inadequately treated drinking water.
contaminated food

autoimmune gastritis

atrophic gastritis

*seen in older adults

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what disease is caused by gastric mucosa is damaged by agents such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), ethyl alcohol, or bile salts, this barrier is disrupted, and hydrogen ions move into the tissue.

gastritis

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what disease has these diagnostic testing?

upper GI x-ray series or endoscopy

histological examination of a tissue specimen

Stool testing

Urea breath testing

gastritis

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what disease has these as risk factors?

Asprin

NSAID

Ethyl alcohol

Bile salts

Stress

Alchohole

Crohns disease

Tuberculosis

Bile reflux

gastritis

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what disease has these as medications?

proton pump inhibitors (PPIs)

H2-receptor antagonists.

Maintain ph of intragastic

 * Esomeprazole 
  * Lansoprazole  
  * Pantoprazole

Antacids

Sucralfate (Carafate)

B12 Vit.

Antibiotics

gastritis

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what disease has these surgical managments? vagotomy gastrectomy pyloroplasty

gastritis vagotomy -surgery to sever the vagus nerve to reduce secretion of acid within the stomach gastrectomy -removal of the stomach pyloroplasty -enlarging the pylorus opening

what disease has this teaching? Avoid Asprin Spicy foods Bland food Small frequent meals

gastritis

what disease has these complications? peptic ulcers and gastric cancer Ulceration may occur and can lead to hemorrhage.

gastritis

what disease has these manifestations? epigastric pain nausea and vomiting weight loss decreased appetite changes in color of the stool dehydration upper GI bleeding.

gastritis

what disease has these Interventions Assessment Vital signs History of presenting signs and symptoms Laboratory assessment for H pylori Serum electrolytes Intake and output

gastritis

what disease has these Interventions Actions Administer IV fluids as prescribed Administer H2-receptor antagonists as prescribed Administer antacids as prescribed Administer PPIs as prescribed

Administer H2-receptor antagonists as prescribed ----H2-receptor antagonists block gastric secretions. Administer antacids as prescribed ----buffering agents correct PH balance Administer PPIs as prescribed ----suppress gastric acid secretion.

what disease has this Intervention Teaching Immediately report hematemesis (vomiting of blood) Take medications as prescribed Avoid medications and other irritants that are associated with gastric episodes Follow prescribed dietary teaching regarding types of foods and how to introduce back into the diet.

gastritis

what disease is an inflammation of the lining of the stomach and small intestines produces watery diarrhea, abdominal pain or cramping, nausea or vomiting, and sometimes fever. Aka “stomach flu”, traveler’s diarrhea, or food poisoning.

Gastroenteritis

what disease is caused by a virus, bacteria, or parasite.

Gastroenteritis

what disease has this as a diagnostic test? clinical evaluation stool culture

Gastroenteritis

what disease has this as a treatment? Oral rehydration IV rehydration

Gastroenteritis

what disease has this diet teaching? clear liquids Oral glucose-electrolyte solutions, broth, or bouillon easy-to-digest foods

Gastroenteritis

what disease has this manifestations? Manifestation Diarrhea Nausea Vometing Anorexia Abdominal distention Poor skin turgor dehydration, hyperactive bowel sounds, decreased blood pressure dry mucus membranes.

Gastroenteritis

what disease has these Assessment Vital signs, including orthostatic measurements Abdomen for distention Bowel sounds and bowel elimination pattern Serum electrolytes, BUN, and creatinine Intake and output Perineal skin status Skin and mucous membranes for signs of dehydration Pain level and effectiveness of interventions

Gastroenteritis

what disease has theseActions Perform hand hygiene Administer IV fluids if the patient is unable to tolerate clear liquids Administer prescribed medications, such as antidiarrheals Give clear liquids or oral rehydration solutions Allow uninterrupted rest periods Apply venous thromboembolism (VTE) prophylaxis Provide meticulous perineal care, including sitz baths if indicated Provide frequent oral care, including lip emollients

Gastroenteritis

what disease has this Include the patient’s family or caregiver in teaching Dietary modifications Preventive measures, especially when traveling Proper food preparation Preventive measures

Gastroenteritis

what disease has a damaged mucosa cannot secrete enough mucus to act as a barrier against gastric acid.

PUD

what types of ulcers does PUD have?

Duodenal ulcers Gastric ulcers

what disease has these diagnostic test? upper GI endoscopy is the preferred procedure for evaluation of PUD barium upper GI x-rays Endoscopy Esophagogastroduodenoscopy Noninvasive testing

PUD

what disease has this as a risk group? patients with Type O blood chronic obstructive lung disease chronic renal failure

PUD

what disease has this as risk factors? Hpylori infection -Contaminated food and water NSAID exposure to irritants trauma psychogenic factors aging Alcoholic Smoking

PUD

what disease has this as medication? Antacids -neutralize gastric acid H2-receptor antagonists -decreases acid production -----ranitidine, nizatidine, cimetidine, or famotidine block gastric acid secretion stimulated by histamine, gastrin, and acetylcholine. PPIs -Proton pump inhibitors -block the final stage of hydrogen ion secretion by blocking the action of the gastric parietal cell proton pump. -----omeprazole, lansoprazole, or pantoprazole Misoprostol- prostaglandin E analog -prevent gastric mucosal damage Sucralfate (Carafate) -enhance mucosal defenses -----binds to necrotic ulcer tissue and serves as a barrier to acid, pepsin, and bile and can directly absorb bile salts.

PUD

what disease has this as surgical management? bilateral vagotomy Pyloroplasty Gastrectomy parietal cell vagotomy

PUD

what disease has this as diet teaching? six small meals avoid dietary irritants spices, alcohol, caffeine adequate fluids No smoking

PUD

what disease has this as a complication? edema GI hemorrhage ulceration of the stomach’s lining abdominal or intestinal infarction perforation and penetration into attached structures obstruction Peritonitis gastric adenocarcinoma

PUD

what disease has this as manifestations? General appearance and height and weight relationship * Abdominal examination including shape and contour * Bowel sounds and tenderness to palpation * Presence of obvious or occult blood in vomitus and stool Left epigastric pain described as heartburn or indigestion accompanied by feeling of fullness or distention * The pain usually is rhythmic and frequently occurs when the stomach is empty—between meals and at 1 or 2 o’clock in the morning. * Increasingly severe and constant localized abdominal pain that increases with movement and respirations may indicate progressing peritonitis. * Possible referral of pain to the shoulder or thoracic area * Anorexia, nausea, and vomiting * Inability to pass stools and flatus * Hiccups

PUD

what disease has this a Interventions Assessment Gastric pH as ordered, check emesis, and feces for occult blood Use of alcohol or other medications, including aspirin and other NSAIDs Serum electrolytes and blood urea nitrogen (BUN) Pain, including exacerbating and relieving factors. Diet, including pattern of food intake, eating schedule, and foods associated with pain CBC Blood culture and/or peritoneal fluid culture Weight Clinical manifestations of abscess formation, including persistent abdominal tenderness and fever.

PUD

what disease has this as Interventions Actions Maintain IV infusions and administer blood products as prescribed Administer prescribed medication therapy Administer medications to reduce gastric acidity as ordered Assist with gastric lavage, as indicated for GI bleeding; irrigate the nasogastric tube with room temperature saline as ordered Prepare the patient and his family for upper endoscopy or surgery as planned Limit food intake after the evening meal; eliminate bedtime snacks Document and report complaints of anorexia, fullness, nausea, vomiting, or symptoms of dumping syndrome Pain documentation to include location, character, timing and relationship to meals, and measures that relieve or aggravate the pain;

PUD

what disease has this as Intervention Teaching Take medications as prescribed H2-receptor ---antagonists block gastric secretions. Antacids ---buffering agents to correct the pH balance of the acidic gastric environment. Antisecretory agents (PPIs) ---used to suppress gastric acid secretion. ---Avoid eating within two hours of bedtime. Advise patients to avoid risk factors such as overuse of aspirin and NSAIDs, spicy foods, and beverages that contain caffeine

PUD

what disease occurs occurs when a portion of the stomach protrudes upward through the esophageal hiatus (opening in the diaphragm that the esophagus passes through) and into the thoracic cavity

Hiatal hernia

what is this disease called? the lack of dietary fiber and the “unnatural” sitting position (causes straining) used for defecation.

Hiatal hernia

what type of disease is this? (sliding type) is usually acquired through an ongoing process of disruption to the GEJ.

Hiatal hernia | type 1

what type of disease is this? (rolling type), or paraesophageal, hernias are thought to occur because of an anatomical defect that causes improper anchoring of the stomach below the diaphragm.

Hiatal hernia | type 2

in what type of hernia is | Reflux is not usually present!

Hiatal hernia | type 2

why type of hernia has these manifestations? * Feeling full after eating * Feeling breathless after eating * Feeling of suffocation * Chest pain that feels like angina * Increased symptoms when lying flat

Hiatal hernia | type 2

what type of hernia has these manifestations? * Heartburn * Regurgitation * Chest pain * Dysphagia * Belching

Hiatal hernia | type 1

what disease has this • Upper abdominal x-ray * Endoscopy * Barium swallow with fluoroscopy (most specific diagnostic test) * Esophagogastroduodenoscopy, or EGD (views the esophagus and stomach lining) Medications are used for the symptoms of heartburn and acid reflux. Most people who have a hiatal hernia do not experience these symptoms, but if they do, they may require medication management or surgery. * Antacids are used to neutralize stomach acid and are usually obtained over the counter. Common antacids are Mylanta, Maalox, Gelusil, Rolaids, and Tums. Common side effects include diarrhea and constipation. * Proton pump inhibitors and H2-receptor antagonists are prescribed to treat GERD

Hiatal hernia

what disease has this At- Risk Groups 50 or older Barrets esophagitis 2cm or more in size obesity pregnancy smoking

hiatal hernia

what disease type has this surgical managment? Nissen fundoplication -Nissen fundoplication is a surgical procedure whereby the surgeon wraps part of the stomach around the distal esophagus to stabilize it and to reinforce the LES --gold standard for the treatment of a hiatal hernia laparoscopic antireflux surgeries - Gastropexy (attachment of the stomach below the diaphragm to prevent reherniation) is used after reduction if the stomach is unusually movable after reduction is performed. Other surgical procedures for type 2 hernias include: - • Herniotomy (surgical removal of the herniated sac) - • Herniorrhaphy (repair of the hiatal defect) - • Antireflux procedure - • Reduction (attachment of the stomach below the diaphragm to prevent reherniation)

hiatal hernia

what type of hatial hernia has this type of complication? GERD coughing, obesity, ascites, and positional changes such as bending and lying supine.

type 1

what type of hatial hernia has this type of complication? Supradiaphragmatic volvulus - abnormal 180-degree twisting of the stomach above the diaphragm - Obstruction - Iron-deficiency anemia-caused by gastric ulcers and erosions.

type 2

what type of hernia has this manifertation? Heartburn * Regurgitation * Dysphagia * Eructation (belching) * Breathlessness * Feeling of suffocation * Chest pain * GERD * Iron-deficiency anemia (related to volvulus) blood loss

hiatal hernia

what type of disease has this type of Assessment Breathlessness, feelings of suffocation, chest pain, palpitations Dysphagia Clinical manifestations of GERD, heartburn Nausea and vomiting Eructation Iron-deficiency anemia

hiatal hernia

what type of hernia has this Interventions Actions Antacids Histamine receptor agonists Proton pump inhibitors Prokinetic medications Position the patient supine on the right side, and elevate the HOB at least 30 degrees after meals.

hiatal hernia

what type of disease has this Teaching Encourage the patient to eat meals 2 hours before lying supine. Educate the patient to limit the following foods and substances: spicy/fatty foods, caffeine, chocolate, carbonated beverages, acidic foods, peppermint, alcohol, caffeinated beverages, and certain medications (if possible), such as calcium channel blockers, anticholinergic medications, and smooth muscle relaxers. eat meals 2 hours before lying supine. wear nonrestrictive clothing. maintaining a normal weight. proper positioning after eating. Conduct postoperative education for patients after laparoscopic Nissen fundoplication (LNF)

hiatal hernia

Book Reading A Flashcards

(69 cards)