GI disorders

Question 1

Describe barium swallow

Answer 1

-fluoroscopy or series of x-rays with barium contrast used to observe pharynx, esophagus and stomach
-looks only at the upper structures during swallowing and is used to assess for aspiration
-used for the diagnosis of causes of dysphagia and motility issues as well as structural abnormalities such as strictures

Question 2

Define achalasia

Answer 2

a condition in which the lower esophageal sphincter muscle doesn’t relax and allow food to pass into the stomach

Question 3

What should be done after a barium swallow?

Answer 3

-drink fluids and eat high fiber foods to prevent constipation or fecal impaction from the barium
-may be given a laxative to help
-BMs may be white

Question 4

What is the nursing care following an endoscopy?

Answer 4

-monitor VS per checklist
-siderails up and NPO until fully alert and gag reflex returns (upper scope)
-verify when medications can be restarted
-pt needs someone to pick them up and are advised not to drive or make any important decisions for 12-24 hours after conscious sedation

Question 5

Describe GERD

Answer 5

-reflux of acidic gastric contents into lower esophagus
-transient weakening of the lower esophageal sphincter (LES), decreased saliva and esophageal motility
-manifestations include heartburn, nausea, chest pain, belching

Question 6

What are the predisposing conditions for GERD?

Answer 6

-hiatal hernia
-incompetent LES
-decreased esophageal clearance related to decreased motility/emptying
-pregnancy
-obesity

Question 7

What are some non-pharm interventions for GERD?

Answer 7

-often responds to lifestyle modifications (diet high in fruit and vegetables, lower in fat, frequent activity to maintain normal weight and avoiding smoking and alcohol)
-timing of meds with meals, positioning, assist informed decision making to promote lifestyle modifications
-elevation of head of the bed
-eliminating diet triggers
-avoiding tight-fitting clothes
-promotion of salivation through gum/lozenge

Question 8

Describe peptic ulcers

Answer 8

-erosion of gastric or duodenal mucosal layer usually associated with inflammation
-hypersecretion of gastric acid or hyposecretion of protective mucous
-ulcer or lesion in stomach or first part of small intestine

Question 9

What are the manifestations of peptic ulcer disease?

Answer 9

-epigastric pain
-belching
-fullness
-N/V

Question 10

What are the risk factors of peptic ulcer disease?

Answer 10

-family hx
-ABO group O
-smoking
-caffeine
-drugs
-stress
-H pylori infection

Question 11

What are the causes of diarrhea?

Answer 11

-decreased fluid absorption
-destruction of normal flora from antibiotics
-increase fluid secretion
-motility disturbances