306 Gastrointestinal And Nutritional Medicines Flashcards
What does GORD stand for?
Gastro Oesophageal Reflux Disease
What is GORD?
The ring of muscle at the bottom of the oesophagus doesn’t work properly and is open even when not eating so allows acid from the stomach to flow back into the oesophagus.
What are the symptoms of GORD?
- heartburn
- Regurgitation of acid (acid reflux)
- Difficulty in swallowing
What causes a duodenal ulcer?
- increased resting acid production
- Twice the amount of acid secreting cells as non ulcer patients
- Prolonged acid secretion
- Duodenal defence mechanisms not as efficient as the stomach
- Decreased amounts of sodium bicarbonate secretion in the duodenum
What are the symptoms of a duodenal ulcer?
- localised pain - relieved by eating and drinking
- Nausea
- Blood in stools
What condition is caused by vitamin C deficiency?
Scurvy
What are symptoms of vitamin C deficiency?
- bleeding/swollen gums
- Problems fighting infections
- Dry skin
- Easy bruising
- Spontaneous bleeding
- Weakness and fatigue
- Joint and muscle pain
- Small red-blue spots on skin
What are contributing factors to vitamin C deficiency developing?
- alcohol misuse
- Drug dependency
- Complex mental health conditions
- Being elderly and unable to maintain a healthy diet
- Treatments that cause nausea as a side effect
- Digestion disorders
- Fad diets
- Smoking
- Pregnancy
What treatment options are there for vitamin C deficiency?
- vitamin C supplements
- Healthy balanced diet
- Referral to a specialist
What dietary advice should be given to someone who is deficient in vitamin C?
- citrus fruit and berries
- Potatoes
- Red and green peppers
- Green veg - particularly broccoli and cabbage
What are symptoms of having too much vitamin C
- nausea
- Flatulence
- Diarrhoea
- Kidney stones
What is vitamin D deficiency called?
Rickets
What are the symptoms of vitamin D deficiency?
- pain
- Skeletal deformities
- Dental problems
- Poor growth and development
- Fragile bones
What are the treatment options for vitamin D deficiency?
- balanced diet
- Supplements
- Vitamin D injection
- Sunlight
What dietary advice should be given to someone with vitamin D deficiency?
- eggs
- Oily fish
- Nuts
- Green veg
- Fortified cereals
- Also obtain calcium from milk and other dairy
What are the symptoms of having too much vitamin D?
- nausea
- Vomiting
- Bone pain
- Headache
- Abdo pain
- Constipation
- Pass lots of urine
- Sight problems
What is enteral nutrition?
Method of nutrition delivery given directly into the gastrointestinal tract
What are the routes of enteral feeding?
- nasogastric tube
- Nasoduodenal tube
- Nasojejunal tube
- Gastrostomy tube
- Jejunostomy tube
Why might enteral feeds be used?
- unconscious patient
- Swallowing disorder (multiple sclerosis)
- Psychological anorexia
- Partial intestinal failure
- Upper gastrointestinal obstruction
What is parenteral nutrition?
Parenteral nutrition is a method of nutrient delivery where fluid of given but not directly into the gastrointestinal tract.
Nutrition is straight into the blood stream votes another route avoiding the GI tract.
What are the indications for a parenteral feed?
- bowel surgery
- Bowel disease
- Severe malnutrition
- Malabsorption (bowel cancer)
- Prolonged intestinal failure
- Crohn’s disease
- Bowel resection
What is a central line?
- can be inserted into a large major vein in the arm or chest
- A long thin flexible tube for administration of medicines, blood or nutrition
- Threaded through until it reaches a long vein near to the heart
- Neck only for inpatients
What are the advantages of a central line?
+ can be placed in a large vein
+ Stays in place for a long period
+ Can tolerate irritant feeds
What are the disadvantages of a central line?
- can become infected
- risk of blood clots (especially in arms)
- pain where the catheter is located under the skin
- catheter can move (may need to be removed and reinserted)
What is a peripheral line?
- small, short plastic catheter that is placed through the skin into smaller veins, usually in the hand or arm
- Line can be used to draw blood
What are the advantages of using a peripheral line?
+ can easily be placed in the hand or arm
+ Made from polymers (less chance of allergies)
+ Able to tolerate neutral pH
+ Useful for taking bloods
What are the disadvantages of using a peripheral line?
- needs to be changed frequently (every 96 hours)
- painful to insert
- can lead to the patient being stressed or anxious
What is neutropenia?
Neutropenia is insuffient neutrophils, can be congenital or acquired
Which drug is used to treat neutropenia?
Filgrastim
What are the symptoms of neutropenia?
- throat infections
- Disease prone
- Fever
- Body aches and pains
What are the alternative treatments of neutropenia?
- granulocyte infusion
* Bone marrow transplant
