Gastrointestinal Flashcards
(130 cards)
1
Q
What are the hallmark signs of GERD
A
Heartburn and regurgitation.
2
Q
What is the most important assessment
A
Patient history and symptom evaluation.
3
Q
What is the gold standard lab
GERD
A
Esophageal pH monitoring.
4
Q
What is the resting pressure of the LES
A
Typically between 10-45 mmHg.
5
Q
Diet of a patient with GERD
A
Avoid spicy foods, caffeine, and fatty foods.
6
Q
After eating, the patient should remain upright for how many minutes
A
At least 30 minutes.
7
Q
What is the DOC
A
Proton pump inhibitors (PPIs).
8
Q
What drugs are taken after meals (2)
A
Antacids and prokinetics.
9
Q
What drugs are taken before meals (3/4)
A
Proton pump inhibitors, H2 blockers, and sucralfate.
10
Q
Give an example of an antacid
A
- Tums (Calcium carbonate)
- Milk of Magnesia
11
Q
What is the side effect of prokinetics
A
Diarrhea.
12
Q
What drug classification causes hypomagnesemia
A
Proton pump inhibitors.
13
Q
What are the side effects of antacids
A
Constipation or diarrhea, depending on the type.
14
Q
What is the side effect of sucralfate
A
Constipation.
15
Q
Surgical intervention that widens the esophagus
A
Esophageal dilation.
16
Q
What is your nursing responsibility after esophageal dilation
A
Monitor for signs of perforation and bleeding.
17
Q
Medication for esophagitis (3)
A
- Proton pump inhibitors
- H2 blockers
- Sucralfate.
18
Q
What specific medications cause GERD (2)
A
NSAIDs and certain antihypertensives.
19
Q
What is the difference between primary and secondary GERD
A
- Primary GERD is idiopathic
- secondary GERD is due to other conditions.
20
Q
What cranial nerve is involved in GERD because it stimulates LES relaxation
A
Vagus nerve (Cranial Nerve X).
21
Q
What viral infections are causes of achalasia?
A
Viral infections such as herpes simplex virus and cytomegalovirus can cause achalasia.
22
Q
What is the term for unintentional weight loss due to difficulty eating and inadequate nutrition caused by swallowing difficulties?
A
The term is ‘cachexia’.
23
Q
First complication of achalasia?
A
The first complication of achalasia is esophageal dilation.
24
Q
Gold standard lab for achalasia?
A
The gold standard lab test for achalasia is esophageal manometry.
25
What is the DOC for achalasia, give example?
The drug of choice (DOC) for achalasia is a calcium channel blocker, such as nifedipine.
26
Give example of nitrate.
An example of a nitrate is nitroglycerin.
27
Example of Phosphodiesterase inhibitor?
An example of a phosphodiesterase inhibitor is sildenafil.
28
What surgery is most common for achalasia?
The most common surgery for achalasia is laparoscopic Heller myotomy.
29
Diet?
A soft diet is recommended for patients with achalasia.
30
What is done during POEM?
| Peroral endoscopic myotomy,
During POEM (Peroral Endoscopic Myotomy), the muscle fibers of the lower esophageal sphincter are cut.
31
What compress should be applied for chest pain?
| Achalasia
A warm compress should be applied for chest pain.
32
What assessment finding indicates possible incarceration/obstruction?
Signs of pain, tenderness, or a palpable mass.
33
This is a type of inguinal hernia that is acquired and pushes through a weak spot in the abdominal wall.
Indirect inguinal hernia.
34
This is a type of inguinal hernia that is congenital, following the pathway of the testes.
Direct inguinal hernia.
35
This is a bulge/protrusion in the tissue in the linea alba, containing fat rather than bowel.
Epigastric hernia.
36
Enumerate 5 types of hernia.
1. Inguinal hernia 2. Femoral hernia 3. Umbilical hernia 4. Incisional hernia 5. Hiatal hernia.
37
What hernia is most common?
Inguinal hernia.
38
What hernia is common in males?
Inguinal hernia.
39
Hernia common in women?
Femoral hernia.
40
What hernia is at risk of strangulation and surgery is the primary approach?
Inguinal hernia.
41
Pain of femoral and incisional hernia?
Localized pain in the groin or surgical site.
42
Pain of hiatal hernia?
Chest pain or heartburn.
43
Pain of inguinal hernia?
Groin pain, especially with activity.
44
Pain of umbilical hernia?
Pain around the belly button.
45
What laboratory is the gold standard for hernia?
Ultrasound.
46
What is your education for a patient using trusses/binders?
Educate on proper use and limitations.
47
Trusses and binders are not suitable for which type of hernia?
Strangulated hernia.
48
Diet?
High-fiber diet to prevent constipation.
49
Amount of fluid intake of patient with hernia?
Adequate hydration to prevent constipation.
50
What should be the position of the patient to reduce hernia protrusion?
Supine position.
51
In inguinal hernias, what position will help the patient to reduce discomfort?
Lying down with legs elevated.
52
If swelling/inflammation is present, what compress should be applied?
Cold compress.
53
The line in the abdomen where the muscle layer is weaker?
Linea alba.
54
Medication for mild pain?
Acetaminophen or NSAIDs.
55
What is the most important thing to do after administering analgesics?
Monitor the patient's pain level.
56
What surgery is for inguinal hernias?
Herniorrhaphy.
57
Antibiotic for hernia surgery?
Prophylactic antibiotics may be used.
58
In strangulated hernia surgery, what needs to be done if necrosis is present?
Resection of necrotic tissue.
59
What surgery is commonly used for inguinal hernia?
Laparoscopic hernia repair.
60
What cells secrete HCl in gastritis?
Parietal cells secrete HCl.
61
Which cells release pepsinogen in gastritis?
Chief cells release pepsinogen.
62
What cells release intrinsic factor (IF) in gastritis?
Parietal cells release intrinsic factor (IF).
63
Enumerate the 6 types of gastritis.
1. Acute gastritis
2. Chronic gastritis
3. Erosive gastritis
4. Non-erosive gastritis
5. Atrophic gastritis
6. Autoimmune gastritis.
64
What is the most common type of gastritis?
Chronic gastritis is the most common type.
65
What 2 types of gastritis are caused by H. pylori?
1. Chronic gastritis
2. Erosive gastritis.
66
What are the vital signs of someone with gastritis?
Vital signs may include tachycardia, hypotension, and fever.
67
What is the gold standard lab for gastritis?
Endoscopy with biopsy is the gold standard lab for gastritis.
68
What test detects microscopic GI bleeding in gastritis?
Fecal occult blood test detects microscopic GI bleeding.
69
What test confirms H. pylori infection in gastritis?
Urea breath test confirms H. pylori infection.
70
What is the recommended diet for gastritis?
A bland diet is recommended for gastritis.
71
What type of exercise is recommended for gastritis?
Low-impact exercise is recommended.
72
What is the frequency of meals for someone with gastritis?
Meals should be small and frequent.
73
What position should the patient be in for gastritis?
The patient should be in a sitting or upright position.
74
What is the drug of choice (DOC) for gastritis?
Proton pump inhibitors (PPIs) are the DOC for gastritis.
75
What antibiotics are given for gastritis? (3)
1. Amoxicillin
2. Clarithromycin
3. Metronidazole.
76
What are the classifications of gastritis?
Gastritis is classified into acute and chronic types.
77
What are the types of acute gastritis?
1. Erosive
2. Non-erosive.
78
Enumerate 5 signs of acute gastritis.
1. Abdominal pain
2. Nausea
3. Vomiting
4. Anorexia
5. Hematemesis.
79
What is the diet in acute gastritis?
A bland diet with avoidance of irritants is recommended.
80
What is the IV treatment in acute gastritis?
IV fluids may be administered for hydration.
81
What vital signs indicate that there is bleeding in gastritis?
Signs include tachycardia and hypotension.
82
What is the DOC for acute gastritis?
Proton pump inhibitors (PPIs) are the DOC for acute gastritis.
83
What are the types of chronic gastritis?
1. Atrophic gastritis
2. Autoimmune gastritis.
84
What are the manifestations of chronic gastritis? (BESPLIS)
Bloating, Epigastric pain, Sensitivity, Loss of appetite, Indigestion, and Stomach upset.
85
What is the frequency and how long should vitamin B12 be administered?
Vitamin B12 should be administered monthly for life in pernicious anemia.
86
What are the signs of pernicious anemia?
Signs include fatigue, weakness, and pallor.
87
What medication is used for bile reflux?
Ursodeoxycholic acid is used for bile reflux.
88
What is the onset of pain after meals in gastric ulcer?
Pain typically occurs shortly after eating.
89
What is the onset of pain after meals in duodenal ulcer?
Pain usually occurs 2-3 hours after eating.
90
What are other manifestations of duodenal ulcer?
Other manifestations may include nausea and vomiting.
91
What are other manifestations of gastric ulcer?
Other manifestations may include weight loss and anorexia.
92
What nutrient deficiencies cause Peptic Ulcer Disease (PUD)?
Deficiencies in vitamin B12 and iron can cause PUD.
93
What are the findings of abdominal palpation in PUD?
Palpation may reveal tenderness in the epigastric region.
94
What is the gold standard for diagnosing PUD?
Endoscopy is considered the gold standard for PUD diagnosis.
95
What is the recommended diet when asymptomatic in PUD?
A regular diet is usually recommended when asymptomatic.
96
What is the recommended diet during exacerbation of PUD?
A bland diet is often recommended during exacerbation.
97
What is an example of an antacid for PUD?
Examples include magnesium hydroxide and aluminum hydroxide.
98
When should PUD medications be taken?
Medications should be taken before meals.
99
When should cytoprotective agents be taken, and give an example?
Cytoprotective agents should be taken before meals. An example is sucralfate.
100
What are the medications used in triple therapy for PUD?
Triple therapy typically includes a proton pump inhibitor, amoxicillin, and clarithromycin.
101
What does quadruple therapy for PUD consist of?
Quadruple therapy consists of bismuth, metronidazole, tetracycline, and a proton pump inhibitor.
102
Should patients with PUD avoid milk?
Yes, patients are often advised to avoid milk as it can stimulate acid production.
103
How many weeks should an ulcer be non-healing before considering surgery?
An ulcer should be non-healing for at least 12 weeks before considering surgery.
104
What is the surgery that creates a direct connection between the stomach and the duodenum?
The surgery is called a gastroduodenostomy.
105
What surgery creates a direct connection between the stomach and jejunum?
The surgery is called a gastrojejunostomy.
106
What is the syndrome when food moves too quickly from the stomach to the small intestine?
This syndrome is known as dumping syndrome.
107
When is the highest time for bleeding post-operation in PUD?
Bleeding is highest within the first 24 hours post-operation.
108
What is the progression of blood color post-operation?
Blood is initially reddish, then becomes dark red after some time.
109
What are the components of cholelithiasis?
There are three components: cholesterol, bilirubin, and bile salts.
110
What is the condition wherein the stones from the gallbladder migrate into the bile ducts?
This condition is known as choledocholithiasis.
111
When there is an obstruction, inflammation results; what is this condition?
This condition is called cholecystitis.
112
What are the 2 types of stones in cholelithiasis?
The two types of stones are cholesterol stones and pigment stones.
113
What are the 2 types of pigment stones?
The two types of pigment stones are black stones and brown stones.
114
Where do types of stones form in the sterile gallbladder?
Stones form in the gallbladder due to supersaturation of bile.
115
Give at least 4-5 manifestations of cholelithiasis.
Manifestations include biliary colic, jaundice, nausea, vomiting, and abdominal pain.
116
How long does biliary colic last?
Biliary colic typically lasts from 30 minutes to several hours.
117
Where does pain radiate due to shared innervation via the phrenic nerve C3-C5?
Pain radiates to the right shoulder or back.
118
What is the hallmark sign of cholelithiasis?
The hallmark sign is the presence of gallstones on imaging.
119
What is the 1st line and gold standard lab for cholelithiasis?
The gold standard lab test is an abdominal ultrasound.
120
What should be done post-op to expand the lungs fully and prevent atelectasis?
Incentive spirometry should be used post-op.
121
What should be the diet for cholelithiasis?
A low-fat diet is recommended.
122
If there's sepsis, what broad-spectrum antibiotics are administered?
Broad-spectrum antibiotics such as piperacillin-tazobactam are administered.
123
What is the drug of choice (DOC) for acute cholecystitis?
The DOC is ceftriaxone.
124
When is fat restriction usually lifted after cholelithiasis treatment?
Fat restriction is usually lifted after 4-6 weeks post-op.
125
What medication is for mild to moderate pain in cholelithiasis?
Acetaminophen is used for mild to moderate pain.
126
What medication is for severe pain in cholelithiasis?
Opioids such as morphine are used for severe pain.
127
What are the symptoms of post cholecystectomy syndrome?
Symptoms include abdominal pain, diarrhea, and dyspepsia.
128
What non-surgical oral medication is used to dissolve small, radiolucent cholesterol gallstones?
Ursodeoxycholic acid is used to dissolve small cholesterol gallstones.
129
What is the range of time for taking oral dissolution therapy?
The range is typically 6 months to 2 years.
130
What happens to blood color during the progression of cholelithiasis?
Blood is reddish, then becomes dark red after.
