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Exam 6 > Nutrition > Flashcards

Nutrition Flashcards

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
Q

Those who smoke are ______ as likely to have ulcers

A

Twice

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26
Q

S&S of gastric ulcers

A

High epigastrium pain 1-2 hours after meals
Eating may not relieve pain
Weight loss

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27
Q

Etiology of duodenal ulcer

A

More common in individuals under 65
3 times more common in men than women
4 times ore common than gastric ulcers

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28
Q

Risk factors for duodenal ulcers

A 
Stress
Alcohol abuse
Smoking
Pulmonary disease
Cirrhosis of the liver
Chronic pancreatitis
Chronic renal failure
Infection with H. pylori
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29
Q

S&S of duodenal ulcers

A

Mild epigastrium pain 2-4 hours after meals and during night
Pain often relieved by eating
Weight gain

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30
Q

Which ulcer type is more likely to perforate?

A

Duodenal ulcers

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31
Q

Screening/Testing for peptic ulcers

A

Stool for occult blood
Breath test for H. pylori
Gastroscopy and x-ray exam
Gastric mucosal biopsy

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32
Q

Nursing problems r/t peptic ulcers

A

Sleep pattern disturbance
Altered nutrition
Acute pain
Knowledge deficit

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33
Q

NI’s for peptic ulcers

When it comes to educating client

A 
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
Q

NI’s for peptic ulcers

when it comes to preventing irritation of lesion

A

Lessen acidic secretions
Reduce activity of stomach and intestine
Manage emotional stress

35
Q

Medical interventions for peptic ulcers

A

Physician to order tests prn
Diet considerations
Surgery

36
Q

Peptic ulcer complications

A

Abdominal infection
Hemorrhage
Perforation
Obstruction

37
Q

Medications for peptic ulcers

A 
Antibiotics
Antacids
Histamine H2 receptor Antagonists
Proton-pump inhibitor
Mucous enhancer or gastric secretion inhibitor
Antipeptic
Antiemetic
Antispasmodics
38
Q

S&S of perforation of an ulcer

A

Tachycardia
Distention
BP could drop
Firm, hard, board-like abdomen to palpation

39
Q

Dumping Syndrome

A

Immediate discomofrt casued by overeating or eating foods that are not recommended after surgery

40
Q

S&S of dumping syndrome

A 
Occur 5-30 minutes after eating
Palpitation/tachycardia
Sweating
Faintness/dizziness
Excessive weakness
V/D
***Signs of shock may develop
41
Q

NG tube use

A

Decompression
Feeding (gavage)
Compression
Lavage

42
Q

Decompression NG use

what is it/prevens what/types

A

Removal of secretions and gaseous substances from GI tract

Prevention of relief of abdominal distention

Types: salem sump, levin, Miller-abbott

43
Q

Gavae NG use

What is it & Types

A

Instillation of liquid nutritional supplements for feeding into stomach for patients unable to swallow fluid

Types: Duo, Dubhoff, Levin

44
Q

Compression NG use

what is it and types

A

Internal application of pressure by means of inflated balloon

Types: Sengstaken-Blakemore

45
Q

Abnormal Signs of Ostomy/Stoma

A 
Excessive bleeding 
Drying 
Edema 
Prolapse 
Skin irritation 
Signs of infection
46
Q

Routine Assessments of the Ostomy/Stoma

A 
Size of appliance 
I&O's
Daily weights
VS
Amount/character of stools
Electrolytes
47
Q

Lavage NG use

what is it and types

A

Irrigation of the stomach
In cases of active bleeding, poisoning, gastric dilation

Types: Levin, Ewald, Salem sump

48
Q

Administering tubal medications

A

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
Q

G tubes & Peds

A

Provide a means of alimentation and to decompress or empty stomach
Primarily for gavage feedings

50
Q

Orogastric tubes & Peds

A

Used in newborn/infants who are obligate nose breathers
&
Older children who are unconscious, unresponsive, or intubated

51
Q

NG tubes & Peds

A

Used more frequently than orogastric

Provide alimentation, decompress stomach, empty contents

52
Q

Gavage feeding & Peds

A

Used in infants with absorption disorders, for supplemental feedings, etc

53
Q

Inflammatory Bowel Disease

A

General term for ulcerative colits and Crohn’s disease

54
Q

Crohn’s Disease most common complication:

A

Fistulas

55
Q

S&S of Ulcerative Colitis

A

Diarrhea with pus and blood
No fat in stools
Can have 15-20 liquid stools/day

56
Q

Crohn’s Disease can perforate:

A

All the way through the body

57
Q

S&S Crohn’s Disease

A 
Insidious onset with nonspecific complaints: 
Diarrhea 
Fatigue 
Abdominal pain 
Weight loss 
Fever
58
Q

Which quadrant of the abdomen would a person with Crohn’s disease experience pain in?

A

RLQ

59
Q

Characteristics of Crohn’s Disease BMs

A

3-4 semisolid stools/day
Can contain mucous or pus but NO blood
Steatorrhea

60
Q

Ulcerative Colitis

A

Recurrent inflammation and ulceration of colon

Usually between 15-40 y/o

61
Q

Crohn’s Disease

A

Acute and chronic inflammation that erodes wall of intestines
Diagnoses often between 15-30 y/o

62
Q

Possible cause of Ulcerative Colitis

A

E. Coli

63
Q

Possible cause of Crohn’s Disease

A

Altered immune system

64
Q

Complication of Ulcerative Colitis

A

Toxic mega colon (large lazy colon)

65
Q

Complications of Crohn’s Disease

A

Malabsorption and/or fistulas

66
Q

Medical Interventions for Ulcerative Colitis and Crohn’s Disease

A 
Bowel rest 
Diet Therapy
  -Low residue/increased protein/high-calorie
  -Decreased lactose intake 
  -Vitamin supplements
67
Q

Other Diet Modifications for Crohn’s Disease

A 
Exclude:
Vegetables (broccoli, cabbage, brussel sprouts) 
Caffeine 
Beer
Sugarless gum and mints
Concentrated fruit juice 
Carbonated drinks 
Foods
68
Q

Medications for Ulcerative Colitis and Crohn’s Disease

A

Corticosteroids
Antibiotics
Sulfonamides (Anti-infective)
Antidiarrheal (Imodium)

69
Q

Diverticulosis/Diverticulitis Region of Pain

A

Steady or cramping pain in LLQ

70
Q

Ostomy

A

Surgically created opening to divert stool or urine to outside of body

71
Q

Stoma

A

Portion of bowel sutured onto abdomen

72
Q

3 abdominal ostomies:

A

Ileostomy
Colostomy
Urostomy

73
Q

Ileostomy

A

Terminal ileum to abdominal wall after total colectomy

74
Q

Conventional Ileostomy

A

Small stoma RLQ

Continuous flow liquid effluent

75
Q

Continent Ileostomy

A

Internal reservoir with nipple valve

Empty 3-4 times/day

76
Q

Colostomy

A

Effluent becomes less fluid and more solid as location of ostomy becomes more distal in colon

77
Q

End Stoma

A

Proximal bowel end brought to abdominal wall

78
Q

Loop Stoma

A

Loop of bowel outside abdomen with bridge under it

79
Q

Abnormal Signs of Ostomy/Stoma

A 
Excessive bleeding 
Drying of the stoma 
Edema of the stoma 
Prolapse 
Skin irritation 
Signs of infection
80
Q

Routine Care of Ostomy/Stoma

A 
Size of appliance 
I&O records 
Daily weight 
VS 
Amount/character of stool 
Electrolyte balance/imbalance
81
Q

NI’s for GI Disorders

A 
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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