Exam 3: Gastrointestinal Flashcards Preview

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Flashcards in Exam 3: Gastrointestinal Deck (53):
1

Four mechanisms that cause ulcers

- Increased contact with HCl acid
- Increased contact with pepsin
- Decreased mucosal resistance
- H. pylori

2

Three patient behaviors that can cause ulcers

- Stress
- Smoking
- Meds (ASA, NSAIDs)

3

What does hematemesis look like?

Coffee grounds

4

Prep for an upper GI series (3)

- NPO
- 16 oz barium solution (chalky)
- Milk of magnesia to offset constipation caused by barium

5

Before a gastroscopy... (4)

- Patient is NPO
- Attain consent
- Monitor VS, O2 sat
- Administer IV and IV sedation

6

What do you watch for after a gastroscopy? What could this lead to?

Sudden abdominal pain--> could be perforation

7

Four sxs involved with perforation

- Profuse sweating
- Shallow breathing
- Hard abdomen
- Sudden abdominal pain

8

How long after an upper GI series or gastroscopy should patient be NPO?

Til gag reflex returns

9

What two labs do you check for a patient with an ulcer?

- WBC
- BUN

10

Six med categories for ulcer patient

- Antacids
- Cytroprotective
- Antispasmotic
- Histamine 2 agents
- Proton Pump inhibitors
- H. Pylori agents

11

3 antacids (ulcer)

Milk of magnesia
Mylanta
Maalox

12

Cytroprotective drug (ulcer)

Sucralfate (carafate)

13

Antispasmotic drug (ulcer)

Banthine

14

Histamine 2 Antagonists (ulcer) - 2

Cimetidine (Tagamet)
Zantac

15

Proton pump inhibitors (ulcer) - 4

Omeprazol (Prilosec)
Prevacid
Nexium
Protonix

16

3 H. Pylori agents

Prevacid
Amoxicillin
Bilaxin

17

______ has diarrheal effect and ______ has a constipation effect. Most antacids are both.

MAGNESIUM
ALUMINUM

18

Most antacids have a very high ______ content -- especially ______.

SODIUM
AKLASELTZER

19

Mechanism of sucralfate

CYTROPROTECTIVE

Take it an hour before meals, it mixes with stomach acid and forms a paste that adheres to - and protects - the ulcer

20

Histamine 2 antagonists should not be given with...

antacids (they will slow H2 antagonist absorption)

21

Role of Histamine 2

Stimulates production of HCl acid (GI specific)

22

Function of a proton pump inhibitor

helps block acid production

23

Common H. Pylori treatment

- Proton pump inhibitor
- Two antibiotics

24

Before and after: Gastroduodenostomy (Bilroth 1)

Bottom half of stomach is removed
Top half of stomach is re-connected to duodenum

25

Before and after: Gastrojejunostomy (Bilroth 2)

Bottom half of stomach is removed
Top half of stomach is re-connected to jejunum

26

Before and after: Gastrectomy (total)

Stomach is removed, lower esophagus is attached to duodenum

27

Levine v. Salem Sump:

Levine is only one tube - intermittent suctioning required

Salem is two tubes - second tube must be connected to low pressure suction at all times

28

What vitamin do you give to patients after GI surgery?

Vitamin B12

29

_____ or ______ is associated with dumping syndrome

- Large meals or
- High amount of simple carbs

after a total gastrectomy

30

Prevention of dumping syndrome (2)

- Small frequent meals
- Lie down for a half hour after eating

(after total gastrectomy)

31

How dumping syndrome occurs with a large meal:

Food is hypertonic, so fluid enters the small bowel. There is not enough volume in the intravascular space, so the body sets off a vasomotor response

32

Vasomotor response for dumping syndrome (5)

- Tachycardia
- Palpitations
- Dizziness
- Weakness
- Hypotension

33

Hypoglycemic reaction for dumping syndrome (6)

- Tachycardia
- Palpitations
- Dizziness
- Weakness
- Diaphoresis
- Trembling

34

Early symptoms of colon cancer:

Absent or vague

35

Later symptoms of colon cancer (5)

- Melena
- Pain
- Change in bowel habits
- Anemia
- Anorexia / Weight loss

36

4 risk factors for colon cancer

- Family history
- Age (40+)
- Diet (fat, protein, simple carbs)
- Smoking

37

Five types of tests to detect / diagnose colon cancer

- Rectal exam for stool guiac tests
sigmoidoscopy
colonoscopy
lower GI series
CAT scan, MRI or Ultrasound

38

How often should a patient get a rectal exam for stool guiac tests?

Yearly

39

How often should a patient get a sigmoidoscopy?

every 5 years

40

How often should a patient get a colonoscopy?

every 10 years

41

Bowel prep before test or surgery
(Diet)

Low-residue diet for 1-2 days
Then clear fluids, laxatives, cleansing enema
NPO 8 hours prior to test surgery

42

What is given before bowel surgery to remove some of the bacteria?

Aminoglycosides

43

3 post-op nursing goals: Colostomies

#1: Help the patient cope
#2: Prevent complications
#3: Maintain nutrition

44

Potential complications after a colostomy (7)

- Paralytic ileus
- Bowel obstruction
- Peritonitis
- Wound infectoin
- Atelectasis
- Pneumonia
- Pain

45

What nutrition should be administered after...
- A colostomy?
- An ileostomy?

- Normal diet
- Low residue diet

46

Irrigating ostomies:
- Yes: 2
- No: 2
- NEVER: 1

Yes: Descending and sigmoid colostomy
No: Ascending and transverse colostomy
Never: Ileostomy

47

With a colostomy, the contents become _____ as you _____

more solid
travel closer to the end of the digestive system

48

Consistency of contents: Ileostomy

Liquid

49

What type of ostomies can have constipation

Sigmoid colostomies only

50

With what ostomy is food blockage possible?

ileostomy -- CHEW a lot

51

Which ostomy has a normal diet?

Colostomy

52

Restrictions for ostomies (2)

No contact sports
No heavy lifting

53

Contraindicated to eat/ take with ileostomy (5)

- Laxatives
- Enteric coated pills
- Time release pills
- Fresh fruit
- Raw veggies or nuts