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Exam 6 > Nutrition > Flashcards

Nutrition Flashcards

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1
Q

Hiatal Hernia

A

Condition where lower part of esophagus and stomach protrude through the diaphragm’s esophageal hiatus

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2
Q

Hiatal Hernia Contributing Factors

A

Obesity
Pregnancy
Heavy lifting
Trauma

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3
Q

Hiatal Hernia S&S

A 
Heartburn 
Gas
N/V
Pain 
SOB
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4
Q

Nursing Problems of Hiatal Hernias

A 
Aspiration 
Malnutrition 
Pain 
Altered sleep patterns 
Ulcers
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5
Q

Medical Treatment for Hiatal Hernia

A

Antacids
TUMS
Milk of Mag

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6
Q

Nursing Considerations for Hiatal Hernia

A

HOB 6-8 inches
No food close to bedtime
No caffeine or carbonated beverages
No smoking

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7
Q

Post-Op Care for Hiatal Hernia

A

Clear liquid diet
Checking incision site
NG/Chest tube
Monitor VS

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8
Q

Inguinal Hernia

A

Protrusion of part of the abdominal contents through the inguinal canal in the groin
More common in young boys boys and premature babies

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9
Q

Umbilical Hernia

A

Protrusion of a portion of intestine through the umbilical ring
Not a problem unless becomes strangulated

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10
Q

Incarcerated Hernia

A

Through the skin or membrane
Not reducible
Can be any of the hernia places

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11
Q

GERD

A

Incompetent lower esophageal sphincter that allows regurgitation of acidic gastric contents into the esophagus

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12
Q

Factors to determine GERD is present

A

Efficiency of anti-reflex mechanism
Volume of gastric contents
Potency of refluxed material
Resistance of the esophageal tissue to injury and ability to repair tissue

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13
Q

People more apt to have GERD

A

Smokers
Obese
Asthmatics

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14
Q

Symptoms of GERD

A

Heartburn (pyrosis)
Substernal or retrosternal burning, radiating pain upward and may involve neck, jaw, or back
Pain occurring 20 min - 2 hours after eating
Regurgitation
Severe: Painful swallowing, nocturnal cough, wheezing, or hoarseness

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15
Q

Diagnostic Tests for GERD

A

Barium Swallow

Esophagoscopy

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16
Q

Complications of GERD

A 
Esophagitis 
Barret's Esophagus (precancerous) 
Esophageal Cancer
Bronchospasm 
Laryngospasm 
Aspiration pneumonia
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17
Q

NI’s for GERD patients

A

Small, frequent meals
Eliminate foods that aggravate symptoms (hot, spicy, greasy, caffeine, milk products)
Sit up while eating and remain in upright position for at least 1-2 hours after
Stop eating 2-3 hours before bedtimes
Be aware of possibility of aspiration
HOB elevated 6-12 inches (30-40 degrees) (45 degrees)
Weight loss
Stop smoking (nicotine relaxes lower esophageal sphincter)
Low-fat, high-protein diet

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18
Q

Medications for GERD

A

Antacids
Histamine H2 Receptor Antagonists
Proton Pump Inhibitors
Prokinetic Agents

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19
Q

Peptic Ulcer

A

Open sore in the skin or mucous membrane

general term

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20
Q

_______ ulcers are more common than ______ ulcers

A

Duodenal, Gastric

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21
Q

General S&S of ulcers

A 
Frequent dyspepsia
Burning sensation in stomach
Pain relieved by eating or vomiting
Melena
Tenseness
Irritability
Difficulty sleeping
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22
Q

Medical term for indigestion

A

Dyspepsia

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23
Q

Etiology of Gastric Ulcers

A

More common in those over 65
More common in older women
High mortality rate
Higher incidence of malignancy than duodenal ulcers

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24
Q

Risk factors for gastric ulcers

A 
Stress
Alcohol abuse (predisposes one to ulcer formation)
Smoking
NSAID drugs and aspirin
Infection with H. pylori
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25
Those who smoke are ______ as likely to have ulcers
Twice
26
S&S of gastric ulcers
High epigastrium pain 1-2 hours after meals Eating may not relieve pain Weight loss
27
Etiology of duodenal ulcer
More common in individuals under 65 3 times more common in men than women 4 times ore common than gastric ulcers
28
Risk factors for duodenal ulcers
``` Stress Alcohol abuse Smoking Pulmonary disease Cirrhosis of the liver Chronic pancreatitis Chronic renal failure Infection with H. pylori ```
29
S&S of duodenal ulcers
Mild epigastrium pain 2-4 hours after meals and during night Pain often relieved by eating Weight gain
30
Which ulcer type is more likely to perforate?
Duodenal ulcers
31
Screening/Testing for peptic ulcers
Stool for occult blood Breath test for H. pylori Gastroscopy and x-ray exam Gastric mucosal biopsy
32
Nursing problems r/t peptic ulcers
Sleep pattern disturbance Altered nutrition Acute pain Knowledge deficit
33
NI's for peptic ulcers | When it comes to educating client
``` To have 3 meals and a bedtime snack Meal size and portion control Eliminate foods that aggravate symptoms Eat slow and chew well Use methods of relaxation & stress management Balance exercise with physical activity and emotional rest Verbalize concerns Contact physician ```
34
NI's for peptic ulcers | when it comes to preventing irritation of lesion
Lessen acidic secretions Reduce activity of stomach and intestine Manage emotional stress
35
Medical interventions for peptic ulcers
Physician to order tests prn Diet considerations Surgery
36
Peptic ulcer complications
Abdominal infection Hemorrhage Perforation Obstruction
37
Medications for peptic ulcers
``` Antibiotics Antacids Histamine H2 receptor Antagonists Proton-pump inhibitor Mucous enhancer or gastric secretion inhibitor Antipeptic Antiemetic Antispasmodics ```
38
S&S of perforation of an ulcer
Tachycardia Distention BP could drop Firm, hard, board-like abdomen to palpation
39
Dumping Syndrome
Immediate discomofrt casued by overeating or eating foods that are not recommended after surgery
40
S&S of dumping syndrome
``` Occur 5-30 minutes after eating Palpitation/tachycardia Sweating Faintness/dizziness Excessive weakness V/D ***Signs of shock may develop ```
41
NG tube use
Decompression Feeding (gavage) Compression Lavage
42
Decompression NG use | what is it/prevens what/types
Removal of secretions and gaseous substances from GI tract Prevention of relief of abdominal distention Types: salem sump, levin, Miller-abbott
43
Gavae NG use | What is it & Types
Instillation of liquid nutritional supplements for feeding into stomach for patients unable to swallow fluid Types: Duo, Dubhoff, Levin
44
Compression NG use | what is it and types
Internal application of pressure by means of inflated balloon Types: Sengstaken-Blakemore
45
Abnormal Signs of Ostomy/Stoma
``` Excessive bleeding Drying Edema Prolapse Skin irritation Signs of infection ```
46
Routine Assessments of the Ostomy/Stoma
``` Size of appliance I&O's Daily weights VS Amount/character of stools Electrolytes ```
47
Lavage NG use | what is it and types
Irrigation of the stomach In cases of active bleeding, poisoning, gastric dilation Types: Levin, Ewald, Salem sump
48
Administering tubal medications
Prepare medications using the same procedure as liquid meds Gather equipment Place client in high-fowler's Put towel over client's chest Don unsterile gloves Check and recheck placement and patency of tube Clamp tube Attatch syringe to end of tube (with plunger out of syringe) Pour medications into syringe Unclamp tubing to allow medication to flow by gravity Follwo with 30-50 mL of water Clamp tubing Remove towel and gloves Position client comfortably
49
G tubes & Peds
Provide a means of alimentation and to decompress or empty stomach Primarily for gavage feedings
50
Orogastric tubes & Peds
Used in newborn/infants who are obligate nose breathers & Older children who are unconscious, unresponsive, or intubated
51
NG tubes & Peds
Used more frequently than orogastric | Provide alimentation, decompress stomach, empty contents
52
Gavage feeding & Peds
Used in infants with absorption disorders, for supplemental feedings, etc
53
Inflammatory Bowel Disease
General term for ulcerative colits and Crohn's disease
54
Crohn's Disease most common complication:
Fistulas
55
S&S of Ulcerative Colitis
Diarrhea with pus and blood No fat in stools Can have 15-20 liquid stools/day
56
Crohn's Disease can perforate:
All the way through the body
57
S&S Crohn's Disease
``` Insidious onset with nonspecific complaints: Diarrhea Fatigue Abdominal pain Weight loss Fever ```
58
Which quadrant of the abdomen would a person with Crohn's disease experience pain in?
RLQ
59
Characteristics of Crohn's Disease BMs
3-4 semisolid stools/day Can contain mucous or pus but NO blood Steatorrhea
60
Ulcerative Colitis
Recurrent inflammation and ulceration of colon | Usually between 15-40 y/o
61
Crohn's Disease
Acute and chronic inflammation that erodes wall of intestines Diagnoses often between 15-30 y/o
62
Possible cause of Ulcerative Colitis
E. Coli
63
Possible cause of Crohn's Disease
Altered immune system
64
Complication of Ulcerative Colitis
Toxic mega colon (large lazy colon)
65
Complications of Crohn's Disease
Malabsorption and/or fistulas
66
Medical Interventions for Ulcerative Colitis and Crohn's Disease
``` Bowel rest Diet Therapy -Low residue/increased protein/high-calorie -Decreased lactose intake -Vitamin supplements ```
67
Other Diet Modifications for Crohn's Disease
``` Exclude: Vegetables (broccoli, cabbage, brussel sprouts) Caffeine Beer Sugarless gum and mints Concentrated fruit juice Carbonated drinks Foods ```
68
Medications for Ulcerative Colitis and Crohn's Disease
Corticosteroids Antibiotics Sulfonamides (Anti-infective) Antidiarrheal (Imodium)
69
Diverticulosis/Diverticulitis Region of Pain
Steady or cramping pain in LLQ
70
Ostomy
Surgically created opening to divert stool or urine to outside of body
71
Stoma
Portion of bowel sutured onto abdomen
72
3 abdominal ostomies:
Ileostomy Colostomy Urostomy
73
Ileostomy
Terminal ileum to abdominal wall after total colectomy
74
Conventional Ileostomy
Small stoma RLQ | Continuous flow liquid effluent
75
Continent Ileostomy
Internal reservoir with nipple valve | Empty 3-4 times/day
76
Colostomy
Effluent becomes less fluid and more solid as location of ostomy becomes more distal in colon
77
End Stoma
Proximal bowel end brought to abdominal wall
78
Loop Stoma
Loop of bowel outside abdomen with bridge under it
79
Abnormal Signs of Ostomy/Stoma
``` Excessive bleeding Drying of the stoma Edema of the stoma Prolapse Skin irritation Signs of infection ```
80
Routine Care of Ostomy/Stoma
``` Size of appliance I&O records Daily weight VS Amount/character of stool Electrolyte balance/imbalance ```
81
NI's for GI Disorders
``` Dependent on diagnosis and client needs Data collection Monitoring nutritional status Administering meds Promoting health and normal BM elimination Managing pain, fluids, electrolyte balance Prevent wound infections Health Counseling: smoking/alcohol ```

Exam 6 (6 decks)

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