Med-Surg: GI, Hepatic, Pancreatic/2 Flashcards
(49 cards)
1
Q
GERD contributing factors
6
A
- older
- obese
- smoking
- heavy alcohol use
- ingestion of very large meals
- obstructive sleep apnea
2
Q
GERD manifestations
8
A
- dyspepsia (indigestion)
- regurgitation
- eructation
- flatulence
- coughing, hoarseness, wheezing
- water brash
- dysphagia
- odynophagia
3
Q
GERD - limit or avoid foods that decrease LES pressure
6
A
- chocolate
- caffeine
- fried/fatty foods
- alcohol
- carbonated beverages
- spicy/acidic foods
4
Q
GERD - teach (diet)
4
A
- dietary changes
- eat 4-6 small meals/day
- eat slowly and chew thoroughly
- eating nothing for at least 3 hours before bed
5
Q
GERD - interventions
5
A
- diet
- elevate HOB 6-12 inches
- sleep on right side
- manage weight
- wear loose fitting clothes
6
Q
GERD histamine blockers
2
A
famotidine
ranitidine
7
Q
hiatal hernia
A
portion of the stomach protrudes through the esophageal hiatus of the diaphragm into the chest
8
Q
hiatal hernia contributing factors
5
A
- high fat diet
- caffeinated drinks
- tobacco products
- meds (CCBs, anticholinergics, nitrates)
- obesity
9
Q
hiatal hernia manifestations
8
A
- regurgitation
- persistent heartburn or dysphagia
- belching
- epigastric pain
- dysphagia
- breathlessness or feeling suffocated after eating
- chest pain that mimics angina
- symptoms worsen after a meal or when supine
10
Q
hiatal hernia interventions
7
A
- prepare for barium swallow with fluoroscopy
- assess diet
- small freq meals
- avoid eating 3 hrs before bed
- sit upright 1-2 hour after meal
- avoid straining
- wear loose fitting clothes
11
Q
PUD has a high risk for
A
perforation and bleeding
12
Q
PUD contributing factors
9
A
- NSAIDs
- corticosteroids
- h. pylori infection
- uncontrolled stress
- stress
- caffeine
- alcohol
- type O blood
- ages 40-60
13
Q
PUD manifestations
5
A
- dyspepsia
- dull, gnawing, burning, midepigastric and/or back pain with localized tenderness
- worsen with empty stomach
- relief with antacids
- decreased h and h
14
Q
PUD dietary teaching
3
A
- avoid very cold and very hot foods
- eat 3 regular meals/day
- avoid caffeine, alcohol, decaffeinated coffee, milk, cream
15
Q
PUD meds triple therapy
A
10-14 days - two antibiotics plus one PPI:
metronidazole or amoxicillin and clarithromycin plus PPI
16
Q
PUD quad therapy adds what
A
bismuth salts
17
Q
PUD meds - general
7
A
- antibiotics
- mucosal healing agents
- stool softeners
- antacids
- histamine receptor antagonists
- prokinetic agents
- PPIs
18
Q
IBS
A
chronic disorder with recurrent diarrhea, constipation, and/or abd pain and bloating
19
Q
IBS risk - diet, gender
A
high fat diet
female gender
20
Q
IBS manifestations
7
A
- weight loss
- fatigue and malaise
- erratic bowel patterns
- abd pain relieved by defecation
- abd distention
- mucus with passage of stool
- colicky abd with diffuse tenderness
21
Q
abd pain relieved by defecation
A
IBS
22
Q
colickly abd with diffuse tenderness
A
IBS
23
Q
IBS - nursing interventions
4
A
- encourage a diet high in fiber
- encourage regular exercise
- stress reduction
- eat at regular times
24
Q
psyllium
A
bulk agent for IBS
25
IBS complementary agents
| 3
1. peppermint oil
2. artichoke leaf extract
3. caraway oil
26
IBS and IBD
IBD inflammatory bowel disease is a more severe, autoimmune disorder and includes Crohn's disease and UC
27
IBS stands for
irritable bowel syndrome
28
Crohn's disease
inflammation of GI tract that extends through all layers; can occur anywhere in GI tract; most common in distal/terminal ileum; cobblestone appearance of ulcers that are separated by normal tissue
29
CD contributing factors
| 6
1. family history
2. jewish ancestry
3. bacterial infection
4. smoking
5. 15-40
6. living in urban area
30
abd pain in RLQ that doesn't relieve with defication
CD
31
CD manifestations
| 10
1. abd pain RLQ, not relieved by defecation
2. pain aggravated by eating
3. low grade fever
4. diarrhea, steatorrhea
5. weight loss
6. formation of fistulas
7. usually no bleeding
8. leukocytosis
9. string sign on x ray
10. low H/H, high ESR
32
IBD: CD or UC - no bleeding usually
CD
33
IBD: CD or UC - cobblestone
CD
34
IBD: CD or UC - through all layers
CD
35
CD nursing interventions
| 4
1. promote rest
2. record stools
3. monitor/prevent fluid deficit
4. nutrition - high calorie, high protein, low fiber, no diary
36
CD complications
| 5
1. intestinal obstruction
2. perianal disease
3. fluid electrolyte imbalances
4. malnutrition
5. fistulas, abscess
37
UC
recurrent ulcerative and inflammatory disease of the superficial mucosa of the colon. usually begins in rectum and spreads proximally through the entire colon. characterized by contiguous ulcers
38
UC contributing factors
| 7
1. family hx
2. jewish ancestry
3. isotretinoin/accutane use
4. female 15-25
5. males 55-65
6. white
7. low fiber diet
39
UC manifestations
| 9
1. liquid, bloody stool (10-20 per day)
2. low grade fever
3. abd distention along colon
4. high pitched bowel sounds
5. LLQ pain
6. anorexia, weight loss
7. vomiting, dehydration
8. sensation of urgent need to defecate
9. hypocalcemia, anemia
40
IBD: CD or UC - liquid, blood stools
UC
41
IBD: CD or UC - 10 to 20 stools/day
UC
42
IBD: CD or UC -high pitched bowel sounds
UC
43
IBD: CD or UC - LLQ pain
UC
44
IBD: CD or UC - hypocalcemia
UC
45
IBD: CD or UC - sensation of urgent need to defecate
UC
46
what helps differentiate CD and UC
bleeding is common in UC
47
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UC nursing interventions
4
-promote
-monitor
-maintain
-monitor
```
1. promote rest
2. monitor stool
3. maintain NPO during acute phase
4. monitor for dehydration
48
UC diet mgmt
| 2
1. increase oral fluids
| 2. low residue, high calorie, high protein diet
49
UC intervention - administer
| 2
1. multivitamins
| 2. supplemental iron
