GOODBAN STUDY GUIDE PART2

Question 1

What is Gastroesophageal Reflux Disease (GERD)?

Answer 1

Chronic reflux of gastric contents into the esophagus due to lower esophageal sphincter dysfunction. Epigastric pain, burning.

Question 2

What are the nursing interventions for GERD?

Answer 2

• Diet (non-acidic) * PPIs * Sleeping at an angle * Not eating 2-3 hours before bed

Question 3

Define Hiatal Hernia.

Answer 3

Protrusion of part of the stomach through the esophageal hiatus of the diaphragm.

Question 4

What are the nursing interventions for Hiatal Hernia?

Answer 4

• Diet * Weight loss * Surgical intervention (Nissen fundoplication)

Question 5

What is Peptic Ulcer Disease (PUD)?

Answer 5

Ulceration in the stomach or duodenum due to H. pylori infection or NSAID use. Epigastric pain, gnawing.

Question 6

What are the nursing interventions for Peptic Ulcer Disease?

Answer 6

• H. pylori eradication (PPI + antibiotic therapy) * Stop NSAID use * Diet * Daily PPIs

Question 7

What is Gastritis?

Answer 7

Inflammation of the stomach lining; can be acute or chronic.

Question 8

What are the nursing interventions for Gastritis?

Answer 8

• H. pylori treatment

Question 9

What are Esophageal Varices?

Answer 9

Dilated submucosal veins in the esophagus, typically resulting from portal hypertension.

Question 10

What should be monitored in patients with Esophageal Varices?

Answer 10

Monitor for bleeding.

Question 11

What is Barrett’s Esophagus?

Answer 11

Changes in the structure of the esophagus that predisposes patients to esophageal cancer due to repeated exposure to stomach acids.

Question 12

What is Achalasia?

Answer 12

Failure of the lower esophageal sphincter to relax, causing difficulty swallowing.

Question 13

What are the predisposing and risk factors for upper GI disorders?

Answer 13

• Smoking * Alcohol use * Dietary choices (e.g., spicy/fatty foods) * Obesity * NSAIDs * Corticosteroids * Bisphosphonates * H. pylori infection * Stress * Structural issues

Question 14

List subjective findings related to common upper GI disorders.

Answer 14

• Pain: Epigastric, burning (GERD), gnawing (PUD), postprandial discomfort * Nausea/Vomiting * Heartburn (pyrosis) * Dysphagia * Early satiety * Bloating

Question 15

List objective findings suggestive of GI bleeding.

Answer 15

• Hematemesis * Melena * Weight loss * Pallor or signs of anemia * Visible peristalsis or abdominal distention

Question 16

What laboratory tests are used for upper GI disorders?

Answer 16

• CBC * Stool for occult blood * H. pylori testing * Liver function tests

Question 17

What diagnostic procedures are used for upper GI disorders?

Answer 17

• Esophagogastroduodenoscopy (EGD) * Barium Swallow * pH Monitoring * Gastric emptying studies * Abdominal ultrasound or CT scan

Question 18

What nursing interventions are important for upper GI disorders?

Answer 18

• Monitor vital signs and signs of GI bleeding * Pain assessment and management * Nutritional support * Positioning (elevate HOB) * Medication administration

Question 19

What is Irritable Bowel Syndrome (IBS)?

Answer 19

Functional bowel disorder causing abdominal pain, bloating, and altered bowel habits.

Question 20

What are the nursing interventions for IBS?

Answer 20

Avoid stressors and trigger foods.

Question 21

Define Diverticulosis and Diverticulitis.

Answer 21

Diverticulosis is outpouching of the colon wall; diverticulitis is inflammation or infection of these pouches.

Question 22

What are the nursing interventions for Diverticulitis?

Answer 22

• Antibiotics * NPO diet (high risk for bowel obstruction/perforation) * Gastric rest

Question 23

What is Inflammatory Bowel Disease (IBD)?

Answer 23

Includes Crohn’s disease and ulcerative colitis, marked by chronic inflammation.

Question 24

What are the features of Acute Pancreatitis?

Answer 24

• Sudden and severe onset * Short-term duration * Commonly caused by gallstones, alcohol abuse, infections

Question 25

What are the features of Chronic Pancreatitis?

Answer 25

* Gradual, progressive onset * Long-term, persistent inflammation * Often due to prolonged alcohol use

Question 26

What are the symptoms of Acute Pancreatitis?

Answer 26

* Severe upper abdominal pain radiating to the back * Nausea * Vomiting * Fever

Question 27

What are the complications of Chronic Pancreatitis?

Answer 27

* Pancreatic insufficiency * Diabetes * Increased risk of pancreatic cancer

Question 28

What is the gold standard for diagnosing Colorectal Cancer?

Answer 28

Colonoscopy.

Question 29

What are the nursing interventions for hemorrhoids?

Answer 29

* Sitz baths * Preparation H to decrease inflammation

Question 30

What is Celiac Disease?

Answer 30

Autoimmune disorder triggered by gluten ingestion.

Question 31

What are the symptoms of Celiac Disease?

Answer 31

* Weight loss * Diarrhea * Bloating * Anemia * Osteomalacia * Steatorrhea

Question 32

What dietary modifications are needed for Celiac Disease?

Answer 32

Must avoid gluten.

Question 33

What laboratory tests are used for lower GI disorders?

Answer 33

* CBC * Stool studies * Electrolytes * CRP/ESR * Albumin

Question 34

What are key nursing considerations for antibiotics used in GI disorders?

Answer 34

* Monitor for side effects * Assess for allergies * Administer with meals as appropriate

Question 35

What are the differences in care strategies for Non-Inflammatory Disorders?

Answer 35

* Symptom management * High-fiber diet * Stress management

Question 36

What are the key care strategies for Inflammatory Disorders like Crohn’s disease?

Answer 36

* Anti-inflammatory medications * Nutritional support * Surgical consult if needed

Question 37

What interprofessional team members are involved in GI care?

Answer 37

* Nurses * Physicians/Gastroenterologists * Dietitians * Pharmacists * Social Workers * Surgeons * Wound/Ostomy Care Nurses

Question 38

What is the effect of tetracycline on H. pylori?

Answer 38

Bacteriostatic; eradicates H. pylori in gastric mucosa ## Footnote Tetracycline is effective in treating H. pylori infections.

Question 39

What are common side effects of tetracycline?

Answer 39

* Photosensitivity (use sunscreen) * GI upset * Use with caution in renal/hepatic impairment * Avoid dairy products

Question 40

What is the role of bismuth subsalicylate in H. pylori treatment?

Answer 40

Suppresses H. pylori and aids mucosal healing ## Footnote It is often given with antibiotics and should be taken on an empty stomach.

Question 41

What is the primary action of H2 receptor antagonists like cimetidine?

Answer 41

Blocks histamine on parietal cells, reducing HCl ## Footnote Cimetidine is the least expensive H2 antagonist.

Question 42

What are the potential side effects of cimetidine?

Answer 42

* Confusion/agitation in older adults * Risks with long-term use * Many drug interactions

Question 43

What is a key characteristic of proton pump inhibitors (PPIs) like esomeprazole?

Answer 43

Inhibits H⁺/K⁺ ATPase in parietal cells, reducing acid ## Footnote Esomeprazole is used to treat duodenal ulcers and H. pylori.

Question 44

What is a complication of perforation in the gastrointestinal tract?

Answer 44

A hole or break in the wall of an organ, leading to leakage into the peritoneal cavity ## Footnote Often associated with ulcers, appendicitis, or diverticulitis.

Question 45

What is peritonitis?

Answer 45

Inflammation of the peritoneum, usually due to infection from perforation, trauma, or surgery.

Question 46

What is a stoma?

Answer 46

A surgically created opening on the abdominal wall for the discharge of body wastes.

Question 47

What is the difference between a colostomy and an ileostomy?

Answer 47

* Colostomy: Large intestine (colon), formed to semi-formed stool * Ileostomy: Ileum (small intestine), liquid to semi-liquid stool

Question 48

What are normal findings for a stoma?

Answer 48

* Moist, red or pink * Mild edema initially * Minimal bleeding * No pain

Question 49

What indicates stomal necrosis?

Answer 49

Dark, dusky appearance ## Footnote This condition requires immediate notification of the provider.

Question 50

What are the signs and symptoms of cirrhosis?

Answer 50

* Fatigue * Jaundice * Ascites * Pruritus * Edema * Spider angiomas * Confusion (late stage)

Question 51

What treatment is used for hepatic encephalopathy?

Answer 51

* Lactulose (promotes ammonia excretion) * Rifaximin (reduces ammonia-producing bacteria)

Question 52

What dietary changes are recommended for MASLD (NAFLD)?

Answer 52

* Low-fat, low-sugar diet * Weight loss (5–10%) * Exercise

Question 53

What is the primary pain location for appendicitis?

Answer 53

RLQ (McBurney’s point)

Question 54

What are common causes of upper GI bleeding?

Answer 54

* Peptic ulcers * Esophageal varices * Gastritis * Mallory-Weiss tears

Question 55

What nursing interventions are critical for managing upper GI bleeding?

Answer 55

* Monitor VS (BP ↓, HR ↑) * NPO * IV access * Prep for endoscopy

Question 56

What is hematochezia?

Answer 56

Bright red blood per rectum ## Footnote This is a sign of lower GI bleeding.

Question 57

What are the signs of a parastomal hernia?

Answer 57

Bulging near stoma due to weakened muscle ## Footnote This may require surgical repair or support belt.

Question 58

What are the expected output characteristics of a colostomy?

Answer 58

Formed to semi-formed stool

Question 59

What are the complications of lower GI bleeding?

Answer 59

* Anemia * Hypovolemia * Sepsis (if infected) * Rebleeding

Question 60

True or False: The primary role of a WOC nurse is to specialize in ostomy care.

Answer 60

True