WEEK 8 - GI 1 (acids, NVD, constipation) Flashcards
(20 cards)
dysphagia
nutrition
warning signs
swallowing aids
nutrition: ensure hydration, thickening agents, upright,
warning signs: reluctance, throat clearing, fatigue
swallowing aids: think about food, tart, sour, strengthen mouth muscles
GERD
aggravating factors
treatment
nutrition
aggravating factors: reclining, stress, increased abdo pressure
treatment: reduce pressure, reduce acid production, meds
nutrition: avoid high fats, peppermint
gastritis vs gastric cancer vs upper GI bleed
gastritis: NV, anorexia, fullness, due to NSAIDs
gastric cancer: poor appetite, weight loss, fatigue, persistent gastric distress
upper GI bleed: due to NSAIDs, drugs+alcohol, full CVS and GI assessment + fluid replacement
peptic ulcer
cause
treatment
meds
cause: h pylori, NSAIDs, stress
treatment: rest, avoid spicy + caffeine
meds: antibiotics, PPIs, mucosal protectants
example of mucosal protectant
example of acid prevention med
mp: sucralfate
ap: PPI, H2 blocker, antacids
triggers for overproduction of HCl
large fatty meals, excessive alcohol, emotional stress
ANTACIDS
indication
moa
adverse effects
interactions
nursing considerations
indication: peptic ulcer, gastritis, reflux
moa: secretion of mucus, bicarbonate (buffer), prostaglandins (PP)
adverse effects: aluminum + calc: constipation
mg: gi upset calcium: gas (simethacone)
interactions: absorption of ^basic + acidic drugs
nursing considerations:
H2 receptor antagonists (famotidine)
reduced production Hcl
indication: GERD, PUD, bleed etc
adverse: confusion, headache, letharghy, flushing
interaction: meds that absorb in acidic environment
nursing: 30 min pre meal
PPI (lanso, panto, omeprazole)
block PP -> reduced H secretion
indication: GERD, ulcers, esophagitis
adverse: osteo, mg low, AKI, GI upset
interact: diazepam, phenytoin, warfarin, iron, amp
nursing: empty stom, DNC
panto - IV, lanso - tube feeding
ulcer adherent (sucralfate)
breaks to Al (stim mucus+bicarb prod) + S (binds to ulcer)
indication: PUD
adverse: N, const, dry mouth
NV anticholinergic (scopolamine)
block trigger zone
indication: sx, motion sickness CI: glaucoma
adverse: antichol, drowsy dizzy
interact: additive drying with antihistamine, antidepressant
nursing: avoid sun
NV antihistamine H1 (dimenhydrinate)
indication: motion, allergy, cough, rhinitis
interact: ^CNS : barbs, ops, alcohol, tricyc antidep
adverse: dizzy drowsy, dry
nursing: driving, 30 min pre chemo
NV prokinetic (metoclopramide)
promotes motility small intestine
CI: epilepsy, GI bleed
adverse: TREMORS, hypo tachy, const, dry mouth
interact: CNS + antichol
nursing: TD
NV ondansetron (serotonin blocker)
block serotonin in GI, vomiting trigger zone, chemo trigger zone
indication: NV chemo + hyperemisis grav
adverse: QT prolong, headache, diarrhea
nursing: dehydration, CNS depress, driving
diar: probioitics
mild diarrhea
CI: lactose intolerant
adverse: bloating
diar: bismuth subsalicylate
coat walls bind bacteria toxin
CI: flu + varicella
adverse: like aspirin (bleed, const, dark stool)
interact: decrease digoxin, sulfa, antihyperglyc
diar antichol: diphenoxylate atropine (lomotil)
slow GI motility - severe diarrhea
adverse: antichol
nursing: dehydration, cdiff antibx
diar opioid: loperamide
increase absorption of water
CI: colitis, mom
adverse: NVC, resp dep, hypo drowsy dizzy
MOA:
psyllium
docusate
polyethylene
MOM
bisacodyl
psyllium: peristalsis + water
docusate: water + fat
polyethylene: water (quick)
MOM: inhibit water absorption
bisacodyl: peristalsis
psyllium
docusate
polyethylene
MOM
bisacodyl
psyllium: fluids +++, decrease med absorb
docusate: avoid straining
polyethylene
MOM: mg tox renal
bisacodyl: decrease med absorb
