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Adult health 2 > Exam 3: GI content > Flashcards

Exam 3: GI content Flashcards

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1
Q

What is primary stomatitis

A

inflammation of the oral mucosa

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2
Q

What are the s/s of primary stomatitis and the complications

A

painful ulceration (s) place pt at risk for bleeding and infection

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3
Q

What is the treatment for primary stomatitis

A

topical analgesic application (lidocaine) to opioids or antifungal medications

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4
Q

What is secondary stomatitis

A

Candidiasis –> painful infection caused by the fungus candida albicans

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5
Q

Treatment for secondary stomatits

A

treat with nystatin swish and spit

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6
Q

Oral tumors/oral cancers signs

A

bleeding from mouth, poor appetite, difficult swallowing, weight loss, thick or absent saliva, pain, lump in cheek

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7
Q

What cancer is related to HPV

A

oropharyngeal cancer

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8
Q

What is GERD

A

occurs as a result of regurgitation–backward flow of stomach contents into esophagus

–> obesity and H. pylori may also contribute to reflux

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9
Q

Hiatal hernia will ________ risk for GERD

A

increase

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10
Q

GERD complications

A

ulceration, hemorrhage, adenocarcinoma

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11
Q

S/S GERD

A

heartburn

regurgitation

water brash

frequent belching

nocturnal cough, wheezing, hoarseness

dysphagia or odynophagia (difficulty swallowing)

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12
Q

What are alarm symptoms of GERD

A

dysphagia, odynophagia, anemia, bleeding, weight loss

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13
Q

Diagnostic testing for GERD

A

pH monoitoring–> below 4

Endoscopy

Biopsy to r/o cancer

Manometry: sphincter and muscle function

Barium swallow: hiatal hernia

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14
Q

What surgical procedure do we use for GERD when there is a hiatal hernia

A

laparoscopic Nissen Fundoplication

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15
Q

What is the stretta procedure with GERD

A

The procedure uses radio frequency energy to reshape the lower esophageal sphincter (LES) muscle ring. This strengthens the sphincter, which helps restore the natural barrier that prevents stomach acid from entering the esophagus

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16
Q

What are the different types of hiatal hernias

A

sliding: type l

paraesophageal or rolling: type ll through lV

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17
Q

What is the diagnostic test for a hiatal hernia

A

barium swallow study with fluoroscopy is the most specific –> EGD may be performed for sliding hernias

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18
Q

What are 2 complications of rolling hernias

A

obstruction and/or strangulation

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19
Q

What diet do we want for hiatal hernias

A

high carb, low protein, and increased fluid intake

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20
Q

When we place an NG tube for a hiatal hernia what is the normal coloration

A

drainage bloody then green within 8 hours

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21
Q

What is dyspepsia

A

describe symptoms such as pain, discomfort, fullness, nausea, burning, belching

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22
Q

Gastritis is commonly caused by

A

H. pylori

NSAID use

Local irritation from radiation

autoimmune causes

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23
Q

How do we treat acute gastritis

A

remove causative agent, NPO –advance diet, antacids, H2 receptor antagonists, PPI, monitor for bleeding

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24
Q

How do we treat chronic gastritis

A

treat H. pylori, diet, meds, possibly B-12 injections to treat anemia due to lack of intrinsic factors produced by the stomach lining

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25
What conditions favor gastric ulcer
normal gastric acid secretion and delayed stomach emptying with increased diffusion of gastric acid back into stomach tissues
26
What conditions favor duodenal ulcers
normal diffusion of acid back into stomach tissue with increased secretion of gastric acid and increased stomach emptying
27
What is the triple H pylori treatment modality
clarithromycin, amoxicillin, and a PPI all given twice daily for 14 days (metronidazole can be used instead of amoxicillin)
28
What is the bismuth quadtruple therapy for H pylori
bismuth subsalicylate, metronidazole, tetracycline, and PPI give for 14 days
29
PUD complications
hemorrhage, perforation, intractable pain and obstruction
30
How do we diagnose a GI bleed
nuclear medicine --> bleeding scan
31
What is a perforation
erosion of ulcer through wall of stomach or duodenum --> gastric secretions spill into the abd cavity resulting in peritonitis
32
S/S of a perforation
abdominal pain, rebound tenderness, rigid abdomen (board-like), decreased BS and VS changes
33
What are the classifications of irritable bowel syndrome
D: diarrhea C: constipation A: alternating M: mix
34
What do labs look like with irritable bowel syndrome
usually normal, increased exhaled hydrogen
35
Health teaching with irritable bowel
30 to 40 grams of fiber daily promote normal bowel function
36
Drug therapy for irritable bowel C: D:
C: lubiprostone, linaclotide D: olosetron (serotonin antagonist)
37
What do we monitor for with irritable bowel
obstruction or ischemic colitis
38
Diverticulitis is
perforation and peritonitis
39
S/S of diverticulitis
LLQ pain, low grade fever, N/V common cause of lower GI bleeding (bright blood)
40
Chrons disease vs UC
chrons: skip lesions, abd pain in RLQ and diarrhea --> steatorrhea UC: abd pain and bloody diarrhea --> electrolyte imbalance
41
Extraintestinal symptoms of IBD
arthritis, skin rashes
42
Chrons is most often in
terminal ileus
43
What color stoma is a medical emergency
dark red, dusky colored stoma
44
With stoma care we must monitor for
s/s of ischemia, unusual bleeding, seperation, retraction, prolapse, skin rash
45
What do we clean the stoma with
tap water
46
What are hemorrhoids
masses of dilated blood vessels
47
What is the difference between internal and external hemorrhoids
There are two types of hemorrhoids: Internal hemorrhoids, which are located inside the rectum and often less painful than external hemorrhoids. External hemorrhoids, which are found under the skin around the anus and are generally more painful
48
With an anorectal surgery what is our main priority to monitor for
hypotension and dizziness
49
Cholelithioasis
stone formation
50
Cholecystitis
acute or chronic inflammation
51
Risk factors for gallbladder issues
female, fluffy, fertile, fatty meals
52
S/S of acute gallbladder issues
RUQ abd pain, positive murphys signs, jaundice, fever
53
Charcot's triad for gallbladder
acute obstructive cholangitis fever w/ chills, abd pain, jaundice
54
What diets do we want with gallbladder issues
high fiber, low fat diet
55
Acute pancreatitis
severe condition rapid onset (hours/days) can become necrotic
56
Chronic pancreatitis
ongoing and fibrotic progressive and permanent gallstones or excessive alc association
57
What are the main findings in terms of labs for pancreatitis
increased amylase, lipase, and bili amylase in urine
58
s/s of pancreatitis
tachy, fever, stabbing pain that worsens with eating and radiates to the back, hypotension, jaundice, decreased BS, grey turners and cullens signs
59
What type of aggressive fluid do we give to pancreatitis patients
LR
60
Hep vaccines are for
HAV and HBV
61
HAV specific recommendations
proper handwashing avoid contaminated food or water
62
HCV specific recommendations
avoid IV drug use or sharing needles
63
Viral hepatitis stages
pre-icteric: profound anorexia, malaise, nausea and vomiting, a newly developed distaste for cigarettes (in smokers), and often fever or right upper quadrant abdominal pain icteric: Jaundice (yellowing of the skin and whites of the eyes) develops. Other symptoms may subside. Anorexia, nausea and vomiting may worsen post-icteric: subsiding symptoms, energy levels increase
64
Normal ALT
4 to 36
65
Normal AST
8 to 33
66
Normal ALK phosphate
4.5 to 13
67
Normal bili
less than 1.0 elevated is greater than 2.5
68
HCV curative therapy
ledipasvir (harvoni) sofosbuvir (epclusa)
69
INterferon vs ribavirin side effects for HCV
interferon: flu like, depression, hair thin, diarrhea, insomnia ribavirin: anemia, anorexia, cough, rash, pruritis, dyspnea
70
Chronic HBV primary treatment
peginterferon alpha 2a (pagasys) subcut for 48 weeks--minimum interferon alfa-2b (intron A) subcut injection
71
A patient has been diagnosed with hepatitis A . Which of the following assessment findings would the nurse anticipate? A) dark stools B) weight gain C) malaise D) LUQ pain
C: malaise
72
Which finding confirms that the patient is in the icteric phase of hepatitis
C: jaundice
73
mechanical obstruction
blocked by problems outside the intestine (adhesion, fibrous band, chrons, tumors)
74
Non-mechanical obstruction
paralytic ileus or adynamic ileus
75
What is a strangulation obstruction a result of
tumor, hernias, fecal impactions, strictures, intussusception (bowel telescoping on itself), volvulus (twisting), fibrosis, vascular disorder, and adhesion
76
With mechanical obstruction _______ peristalsis and secretions
increased
77
Causes of paralytic ileus
intestinal handling electrolyte imbalances (hypokalemia) peritonitis vascular insufficiency (ischemia)
78
S/s of non mechanical obstruction
singultus (hiccups) constant, diffuse discomfort abdominal distention decreased to absent bowel sounds (borboygmi-peristalsis waves visible) vomiting
79
Small bowel obstruction
pain accompanied by visible peristalsis waves in upper and middle abdomen upper or epigastric abdominal distention N/V ostipation severe fluid and electrolyte imbalance (low sodium, cl, K)
80
Small bowel obstruction is associated with metabolic
alkalosis (if high)
81
Large bowel obstruction is associated with metabolic
acidosis
82
Large bowel obstruction
lower abdominal cramping and distention no or minimal vomiting obstipation no major electrolyte imbalance
83
What medication do we give for a paralytic ileus
alvimopan

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