Gastrointestinal Flashcards

Question

``` Antacids: Magnesium carbonate (Gaviscon), Magnesium hydroxide (Milk of Magnesia), Calcium Carbonate (Tums) ```

Answer 1

``` Common Uses: Heartburn Gastritis Peptic Ulcer disease GERD Indigestion Prophylaxis with burns Hypomagnesemia ``` Contraindicated: Renal Failure/ Hypermegnesiemia ``` PO Interactions: Risk of side effects of anticoagulants. Blocks absorption of other medications when given simultaneously ``` MoA: Antacids work by counteracting or neutralizing the acid in the stomach. The neutralization makes the stomach contents less corrosive. Side Effects: Diarrhea Loss of appetite ``` Adverse: Hives Itching Dyspnea Tightness in chest Edema of face, mouth, tongue ``` Interventions: Give either 30 minutes before or 1 hour after other medications to prevent decreased absorption and effectiveness of medications. Education: Take with or without food. Follow with a full glass (240 mL) water or other liquid.

Answer 2

``` Common uses: Bowel cleansing prior to colonoscopy and barium enema X-ray examination. ``` ``` Contraindications: Gastrointestinal obstruction Gastric retention, Bowel perforation, Toxic colitis, Megacolon / ileus. ``` PO/30 - 60 minutes Interactions: Oral medication administered within one hour of the start of administration of GoLYTELY for Oral Solution may be flushed from the gastrointestinal tract and not absorbed MoA: GoLYTELY for Oral Solution induces a diarrhea which rapidly cleanses the bowel, usually within four hours. The osmotic activity of polyethylene glycol 3350 and the electrolyte concentration result in virtually no net absorption or excretion of ions or water. Accordingly, large volumes may be administered without significant changes in fluid or electrolyte balance. Advantages: Cleanses the bowel thoroughly so that diagnostic tests can be performed efficiently ``` Side Effects: Severe bloating, distention or abdominal pain (may have to discontinue if doesn’t resolve) ``` Interventions: Observed closely with clients that have impaired swallowing or GERD during the administration of GoLYTELY for Oral Solution. NO STRAW. Education: Prepare the solution per the instructions on the bottle. It is more palatable if chilled. For best results, no solid food should be consumed during the 3 to 4-hour period before drinking the solution, but in no case should solid foods be eaten within 2 hours of taking GoLYTELY for Oral Solution.

Answer 3

``` Common Uses: Peptic ulcer disease GERD Esophagitis GI Bleeding Prophylaxis with burns ``` contraindications: Severe renal and liver disease ``` PO/IV Interactions: Cimetidine potentiates the effects of warfarin, phenytoin, theophylline, and lidocaine. Smoking decreases the effectiveness of H2 Antagonists. ``` MoA: Blocks the H2 receptors of the parietal cells in the stomach, thus reducing gastric acid secretion and concentration. Advantages: Overall low incidence of adverse effects ``` Side Effects: Headache Confusion Dizziness Vertigo Constipation Diarrhea Pruritis Depression Decreased libido ``` Adverse: Hepatotoxicity Cardiac dysrhythmias Blood dyscrasias Interventions Give at least 1 hour before antacids for optimal effect. Administer IV in 20-100 mL of solution. EDucation: Take at least 1 hour before antacids for optimal effect. Smoking decreases the effectiveness of H2 Antagonists. Avoid foods that cause gastric irritation.

Answer 4

``` Common uses: Bowel prep – diagnostic/surgical procedures. Hepatic encephalopathy ``` ``` Contraindications: Clients on a lowgalactose diet. (Galactose is a component of lactulose) ``` ``` PO/Rectal/24 hours Interactions: Neomycin, antiinfective(oral) and antacids decrease effects of lactulose ``` MoA: Creates a hyperosmotic (acidic) environment that draws water into the colon and produces a laxative effect. It also reduces ammonia levels by converting ammonia to ammonium. Ammonium is a water-soluble cation that is trapped in the intestines and cannot be reabsorbed in to the systemic circulation Ease of use and works within 24 hours Side Effects: Nausea/Vomiting, Diarrhea, Flatulence, Distention/Bloating Adverse : Hypernatremia, Abd bloating and Rectal irritation Interventions: Administer with a full glass of fruit juice, water or milk to increase palatability of oral form. Give on an empty stomach to increase effect. Assess stool for amount, color and consistency. Monitor glucose levels if diabetic. Education: Teach client causes of constipation such as lack of fiber in the diet, fluids or exercise.

Answer 5

``` Obesity Contraindication: Cholestasis Malabsorption syndromes PO ``` Interactions: Increases effects of warfarin Decreases absorption of fat soluble vitamins. MoA: Inhibits gastric and pancreatic lipases reducing fat absorption by 30%. The fats are excreted in feces. Advantages: DOC for weight loss ``` Side effects: Oily spotting Flatulence Fecal incontinence Steatorrhea Headache Insomnia Anxiety Depression Abdominal cramping Nausea/Vomiting ``` ``` Adverse Effects: Hypoglycemia Hepatic failure Hepatitis Pancreatitis ``` Interventions: Assess weight status before therapy. Assess thyroid function, BMI, glucose, weight weekly Education: Lessen dietary fat intake to decrease side effects. Take multivitamin containing fat-soluble vitamins 2 hrs before or after medication. Psyllium taken with each dose or at bedtime may decrease GI symptoms.

Answer 6

``` Common uses: GERD Peptic ulcer Esophagitis. Prophylaxis with burns ``` ``` PO/IV Interactions: May decrease theophylline levels. Food decreases peak levels. Can enhance the action of digoxin, oral anticoagulants, phenytoin. ``` MoA: Suppress gastric acid secretion by inhibiting the hydrogen/potassium adenosine triphosphatase (ATPase) enzyme system located in the gastric parietal cells. They block the final step of acid production. ``` Side Effects: Headache Dizziness Blurred vision Fatigue Thirst Dry mouth Increased appetite Anorexia Diarrhea ``` Adverse Effects: Elevated AST, ALT Pancreatitis Rhabdomyolysis Interventions: Monitor liver function studies. Monitor glucose levels in diabetic clients. Education: Report severe diarrhea; black, tarry stools; abdominal pain. Hyperglycemia may occur in diabetic clients. Continue taking even if feeling better.

Answer 7

Splenic sequestration is a potentially life-threatening condition that’s most commonly seen as a complication of sickle cell disease (SCD). It happens mostly in children. The condition causes your child’s spleen to get bigger and lowers the amount of oxygen-carrying red blood cells in her body. Pain on the left side of your child’s belly is the most common. Others include: An enlarged spleen, which can be felt through her skin Weakness Pale skin Rapid breathing or heartbeat Irritability Unusual drowsiness Splenomegaly can lead to hypovolemic shock

Answer 8

Pyloric stenosis, also called infantile hypertrophic pyloric stenosis, is a condition caused by an enlarged pylorus. The pylorus is a muscle that opens and closes to allow food to pass through the stomach into the intestine. When this muscle becomes enlarged, feedings are blocked from emptying out of the stomach. Pyloric stenosis can lead to forceful vomiting, dehydration and weight loss. Babies with pyloric stenosis may seem to be hungry all the time. Surgery cures pyloric stenosis. Symptoms Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away (projectile vomiting). Vomiting might be mild at first and gradually become more severe as the pylorus opening narrows. The vomit may sometimes contain blood. Persistent hunger. Babies who have pyloric stenosis often want to eat soon after vomiting. Stomach contractions. You may notice wave-like contractions (peristalsis) that ripple across your baby's upper abdomen soon after feeding, but before vomiting. This is caused by stomach muscles trying to force food through the narrowed pylorus. Dehydration. Your baby might cry without tears or become lethargic. You might find yourself changing fewer wet diapers or diapers that aren't as wet as you expect. Changes in bowel movements. Since pyloric stenosis prevents food from reaching the intestines, babies with this condition might be constipated. Weight problems. Pyloric stenosis can keep a baby from gaining weight, and sometimes can cause weight loss.

Answer 9

Most serious form of thiamine deficiency in alcoholics. Symptoms include paralysis of the ocular muscles, diplopia, ataxia, somnolence and stupor. Death will occurred.

Answer 10

Syndrome of confusion and loss of recent memory. Often seen when the client is coming of out Wernickes.

Answer 11

Individuals are considered to have a substance use disorder when the use of the substance interferes with the ability to fulfill obligations such as work school or home Alcohol is a depressant ``` Treatment: Keep on the light Encourage close frens to visit Provide a quiet environment Walk and talk to the Orient the client frequently Visual illusions Seizure precautions Anxiolytics : Don't be afraid to five- the client has a tolerance to alcohol and a cross tolerance to other CNS depressants. ```

Answer 12

Individuals are considered to have a substance use disorder when the use of the substance interferes with the ability to fulfill obligations such as work school or home Alcohol is a depressant ``` Treatment: Keep on the light Encourage close frens to visit Provide a quiet environment Walk and talk to the Orient the client frequently Visual illusions Seizure precautions Anxiolytics : Don't be afraid to five- the client has a tolerance to alcohol and a cross tolerance to other CNS depressants. Sedatives like benzos are used because they not only sedate but have short half life. WELL HYDRATED and replace electrolytes Usually low in thiamine, mag, ca, k and phos. can lead to wernickes and korsakoffs. ```

Answer 13

``` Observe for defense mechanisms. Major ones are denial and rationalization. Disulfram is a deterrent to drinking. -Must sign consent Stay away from all forms of alcohol Must have support once detox is over ```

Answer 14

An inguinal hernia is the protrusion of abdominal contents through the inguinal canal, which appears as a bulge in the lateral groin. Herniation occurs spontaneously or results from increased intraabdominal pressure (eg, heavy lifting). Inguinal hernias occur most commonly in male clients and are usually repaired with minimally invasive surgery. If intestinal strangulation develops, the client requires emergency treatment to prevent bowel ischemia or perforation. Strangulation symptoms include abdominal distension, severe pain, nausea, and vomiting. To prevent hernia reoccurrence after surgical repair, the client is taught to avoid activities that increase intraabdominal pressure (eg, coughing, heavy lifting) for 6-8 weeks. If sneezing or coughing are unavoidable, the client should splint incisions and keep the mouth open while sneezing.

Answer 15

experience varying degrees of gastrointestinal symptoms after ingesting milk products, including flatulence, diarrhea, bloating, and cramping. This is due to a deficiency of the enzyme lactase, which is required for digestion of lactose. Treatment includes restricting lactose-containing foods in the diet. These clients may also take lactase enzyme replacements (eg, Lactaid) to decrease symptoms. Supplementation of calcium and vitamin D is recommended due to insufficient intake of fortified milk. Milk and ice cream contain the highest amounts of lactose and should be restricted depending on the client's individual tolerance . Some dairy products, including aged cheeses and live-culture yogurts, contain little to no lactose and can be tolerated by most clients with lactase deficiency. Lactase deficiency is not an immune reaction (allergy) to milk products. Rather, the gastrointestinal symptoms are due to a deficiency of the enzyme lactase and the resultant inability to digest lactose. Educational objective: Clients with lactase deficiency can prevent unpleasant gastrointestinal symptoms by avoiding lactose-containing dairy products (eg, milk, ice cream), eating cheese or yogurt in moderation, and supplementing with lactase enzymes. Vitamin D and calcium supplementation is also recommended.

Answer 16

is a potentially lethal complication of nutritional replenishment in significantly malnourished clients and can occur with oral, enteral, or parenteral feedings. After a period of starvation, carbohydrate-rich nutrition (glucose) stimulates insulin production along with a shift of electrolytes from the blood into tissue cells for anabolism. The key signs of refeeding syndrome are rapid declines in phosphorous, potassium, and/or magnesium (mnemonic PPM). Other findings may include fluid overload, sodium retention, hyperglycemia, and thiamine deficiency. Actions to prevent refeeding syndrome include the following: Obtaining baseline electrolytes Initiating nutrition support cautiously with hypocaloric feedings Closely monitoring electrolytes Increasing caloric intake gradually

Gastrointestinal Flashcards

(40 cards)