ATI GI Flashcards
Randidine (Zantac)
H2 receptor antagonist, used to decrease gastric acid production
bismuth subsalicylate (Pepto Bismol)
destroys the cell wall of helicobacter pylori, doesnt affect gastric acid secretion
aluminum hydroxide (Amphojel)
antacid that neutralizes gastric acid
sucralfate (Carafate)
forms a protective coating over the gastric ulcer.
should be given on an empty stomach one hour before meals.
Mild Diverticulitis teaching
should eat foods that are low in fiber when diverticulitis is active. when inflammation subsides eat a diet high in fiber.
Pain is typically in the left lower quadrant.
Refrain from activity that increases intra-abdominal pressure, can result in perforation of diverticula.
Avoid laxatives b/c they increase intestinal motility.
Chrons Disease
steatorrhea- fatty diarrheal stools.
hypokalemia.
weight loss due to inflammation and malabsorption.
constant pain in the lower right quadrant.
Cholecystitis
dont eat brussel sprouts- cause gas
dont eat eggs- gallstone formation occurs with high cholesterol.
dont drink milk- high fat and cholesterol
GERD
avoid soda- promotes gastric acid secretion.
Chewable antacids should be followed by a glass of water.
Remain upright 1-2 hours after meals.
lactulose (Cephulac) for cirrhosis
expect to have 2-5 soft stools/d. the purpose of lactulose is to promote the excretion of ammonia in the stool. Bloating is common. Eat a low protein diet b/c the pt already has high ammonia.
Preventing dumping syndrome after gastrectomy, eat what food?
eggs- high protein for dumping syndrome.
Foods high in carbs and salty foods lead to rapid gastric emptying due to high osmolarity- dont eat milkshakes, cranberry juice, or broth.
GERD
meds such as oxybutynin (Ditropan) should not be taken, can cause lower esophageal pressure and reflux.
Water aerobics is appropriate exercise- doenst cause straining, lifting, bending over.
Should eat 4-6 small meals/d and sleep with HOB elevated 6 inches on L side.
Cirrhosis
ammonia 180- increased, common in cirrhosis. may indicate portal systemic encephalopathy. report to dr.
Ileostomy
report to dr if stoma is reddish purple color- sign of bowel ischemia.
acute hep B
expected assessment finding- arthralgia- joint pain
Complete bowel obstruction-
expected finding- obstipation- failure to pass stools
Small bowel obstruction
expected finding- epigastric abdominal distention
Intraperitoneal bleeding
expected finding- periumbilical grey-blue discoloration
Ascites, just undergone paracentesis, tx has been effective when?
decreased SOB. increased abdominal fluid limits the expansion of the diaphragm and prevents the pt from taking a deep breath.
Ulcerative colitis
teach pt progressive relaxation techniques, administer mesalamine (Rowasa) rectally at bedtime[it is an aminosalicylate that exerts and antiinflammatory effect on intestinal mucosa], arrange schedule to allow for rest periods to reduce intestinal motility, restrict intake of caffeine, smoking, alcohol. avoid dairy products.
Post Gastrectomy priority
NG tube patency- greatest risk to client is retention of gastric secretions that can lead to gastric dilation.
not priority- incisional drainage, postop pain control, presence of bowel sounds
Peritonitis secondary to ulcer perforation s/s
board like abdomen, distended
Acute pancreatitis priority
provide patient controlled analgesia- pain releif is most important because pancreatitis causes severe unrelenting abdominal pain secondary to autodigestion of the pancreas.
not priority- insert NG(b/c risk for paralytic ileus), administer ceftazidime (Ceptaz)(atbx), monitor for hyperglycemia
Colorectal cancer
hemoglobin 9.1- expected to be decreased because occult intestinal bleeding.
Elevated serum carcinoembryonic antigen (CEA) level.
Decreased hematocrit expected b/c occult bleeding.
Positive fecal occult blood test.
Hep C
avoid meds containing acetaminophen- can cause additional liver damage.
Avoid all alcohol consumption.
May need reduced med dosage b/c many meds are metabolized in the liver.
Duodenal Ulcer
Pain occurs 1.5-3 hours after meals and during the night. occurs when the stomach is empty.
Peptic Ulcer Disease
Avoid taking NSAIDs- can result in mucosal injury.
Post portal systemic shunt for treatment of cirrhosis
measure abdominal girth daily- amount of ascietes should decrease after shunt placement.
Monitor breath sounds more frequently than once/shift- risk of fluid overload from reabsorption of ascietic fluid.
Cirrhosis, priority assessment
bloody stools- greatest risk is hemorrhage due to impaired coagulation.
Expected findings with cirrhosis- spider angiomas, fetor hepaticus, peripheral neuropathy
GERD. metoclopramide (Reglan). adverse effect.
involuntary facial movements- like other dopamine agonists, metoclopramide may cause extrapyramidal symptoms.
carcinoembryonic antigen (CEA)
blood is drawn to test for this even when they know a pt has cancer to test effectiveness of chemotherapy and if it controlling cancer cell growth.
Portal systemic encephalopathy (PSE) pt has elevated ammonia level. diet ?
need to limit protein in diet. cant eat beef and chicken and other protein. eat more fruits and veg.
acute onset bacterial gastroenteritis
avoid meds such as diphenoxylate (Lomotil)- want bacteria to be eliminated, this med decreases gastrointestinal motility
Pancreatitis lab
increased amylase
Appendicitis s/s
high temp, recent history n/v, RLQ pain, wbc 10000-18000
Colonoscopy prep
drink clear liquids 24 hours prior to the procedure, nothing by mouth 6-8 hours before
New colostomy, what food will help avoid flatus and odor
yogurt, can help prevent flatus
