Chapter 55

Question 1

Clarithromycin nursing implications

Answer 1

Give with caution to patients with renal impairment

monitor renal function lab values

Can increased BUN level

Question 2

Amoxicillin nursing implications

Answer 2

Take with food or immediately after

side effects G.I. disturbance disturbance;
nausea vomiting diarrhea

Question 3

Tetracycline nursing implications

Answer 3

Take at least one hour before meals or two hours after meals;Dairy products in other foods may interfere with absorption

avoid direct sunlight and wear sunscreen photosensitivity can occur

Question 4

Metronidazole nursing implications

Answer 4

Take with food avoid alcohol doing therapy and at least three days

side effects G.I. disturbance; nausea vomiting diarrhea

drug alcohol reaction; severe nausea vomiting and headache

Question 5

Type A gastritis

Answer 5

Nonerosive

chronic gastritis = inflammation of the glands, fundus body of stomach

has a genetic link

Question 6

Type B chronic gastritis

Answer 6

Affects the glands of antrum

Does not effect the entire stomach

most common form of gastritis

Caused by H pie Laurie infection

Question 7

Key features of acute gastritis

Answer 7

Rapid onset of epic gastric pain or discomfort

hematemesis

Gastric hemorrhage

dyspepsia

anorexia
nausea and vomiting

Question 8

Key features of chronic gastritis

Answer 8

Vague report of epigastric pain that is relieved by food

intolerance of fatty and spicy foods

precocious anemia

anorexia

nausea or vomiting

Question 9

Interventions for acute gastritis

Answer 9

Collaborate to relieve the symptoms remove or reduce discomfort

blood transfusion may be necessary

fluid/electrolyte replacement with severe loss

Surgery with a major bleeding or aspiration

administer prescribed drugs that block and buffer secretions and relieve pain

Question 10

intervention for chronic gastritis

Answer 10

elimination of the causative agent
treatment of any underlying disease such as Uremia Crohn’s disease avoid toxic substances such as alcohol tobacco
health Teaching
drugs and nutritional therapy are also used
Vitamin B12 for prevention or treatment of pernicious anemia

Question 11

Patient teaching for gastritis

Answer 11

Avoid drugs/irritants such as cortisteroid, erythromycin,aspirin ASA,naproxen, ibuprofen (Motrin Advil) OTC should not be used
teach patients to read all labels for aspirin or other NSAIDs
limit intake caffeine or high acid tomato product or citric juices
heavily season stronger/hot spicy foods, bell peppers, onions
choose bland none spicy
small frequent meals
alcohol and tobacco should be avoided

Question 12

Hematemesis

Answer 12

Massive bleeding patient VOMIT bright red or coffee ground blood usually indicates bleeding at or above the duodenojejunal or upper G.I. bleeding

Granular dark vomitus=coffee ground appearance

Question 13

Melena

Answer 13

Minimum bleeding is a occult blood in STOOL; dark tarry stool

Digestion of blood within the duodenum and small intestines

most common Duodenal ulcers

Question 14

Upper G.I. bleeding

Answer 14

Bright red or coffee ground vomitus
Melena
decrease blood pressure 
increased heart rate 
Weak peripheral pulses 
acute confusion;older adults 
vertigo 
dizziness or lightheadedness 
Syncope 
decreased hemoglobin or Hematocrit

Question 15

Red blood cell normal range

Answer 15

4.2 to 6.1

Decreased levels indicate anemia or hemorrhage increase levels indicate possible panic hypoxia or polycythemia

Question 16

Hemoglobin

Answer 16

Females 12 to 16

males 14-18

decreased levels indicate possible anemia or hemorrhage

Question 17

Hematocrit levels

Answer 17

Females 37 to 47%

male 42 to 52%

decrease levels indicate anemia or hemorrhage

Question 18

Peritonitis

Answer 18

Sudden sharp pain beginning in the mid epigastric region and spread over the entire abdomen.
Tender rigid and broad like pain
patient often in fetal position
Severely ill within hours
bacterial septicemia and hypervolemic shock follow
Peristalsis diminishes
paralytic ileus develops
THIS is a life threatening ER- prepare pt for surgery

Question 19

Symptoms of obstruction

Answer 19

Bloating
nausea vomiting
may have hypochloremic (metabolic alkalosis)
hypokalemia

Question 20

MISOPROSTOL

Answer 20

A prostaglandin analog

action =Stimulate Mucosal protection & decrease gastric acid secretion

avoid magnesium contain and assess such as myLanta can cause diarrhea

do not administer to pregnant women

Question 21

Risk factor for peptic ulcer disease

Answer 21

H pylori

NSAIDS

Question 22

Substancesthat contribute to gastroduodenal author

Answer 22

Corticosteroids

Theophylline

Caffeine

patients receiving radiation therapy

They stimulate hydrochloric acid production

Question 23

Dyspepsia

Answer 23

Indigestion is the most commonly reported symptoms associated with PD

described as a sharp Burning or gnawing in pain

Question 24

Where is the gastric pain located

Answer 24

Occurs in the upper epigastric region localized to the left of the midline and it’s aggravated by food

Question 25

Where is Duodenum pain located

Answer 25

To the right or below the epigastrium occurs 90 minutes to 3 hours after eating often awakens the patient at night

Question 26

What foods would you teach a patient with PD not to eat?

Answer 26

``` Tomatoes hot spices fried foods onions alcohol caffeine drinks certain drugs like NSAIDs or Corte steroids ```

Question 27

How do you assess fluid volume deficit from bleeding ulcer?

Answer 27

Take orthostatic blood pressure monitor for signs and symptoms of dehydration Assess for dizziness when upright Older adults experience dizziness when they get out of the bed= risk for falls

Question 28

Features of gastric ulcer

Answer 28

``` No differentiation in blood group may be malnourished normal secretion or hyposecretion Occur 30 to 60 minutes after meal Worse when eating/ingestion of food hematemesis malignant less than 10% atrophic gastritis reoccurring the same location ```

Question 29

Mary features of duodenal ulcer

Answer 29

``` Most often type O blood type usually well nourished hypersecretions occur the 1 1/2-3 hours after a meal occurs at night often to awake patient between 1and 2 AM relieved by ingestion of food Recurring 60% to 90% no gastritis ```