ATI GI

Question 1

Randidine (Zantac)

Answer 1

H2 receptor antagonist, used to decrease gastric acid production

Question 2

bismuth subsalicylate (Pepto Bismol)

Answer 2

destroys the cell wall of helicobacter pylori, doesnt affect gastric acid secretion

Question 3

aluminum hydroxide (Amphojel)

Answer 3

antacid that neutralizes gastric acid

Question 4

sucralfate (Carafate)

Answer 4

forms a protective coating over the gastric ulcer.

should be given on an empty stomach one hour before meals.

Question 5

Mild Diverticulitis teaching

Answer 5

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.

Question 6

Chrons Disease

Answer 6

steatorrhea- fatty diarrheal stools.
hypokalemia.
weight loss due to inflammation and malabsorption.
constant pain in the lower right quadrant.

Question 7

Cholecystitis

Answer 7

dont eat brussel sprouts- cause gas
dont eat eggs- gallstone formation occurs with high cholesterol.
dont drink milk- high fat and cholesterol

Question 8

GERD

Answer 8

avoid soda- promotes gastric acid secretion.
Chewable antacids should be followed by a glass of water.
Remain upright 1-2 hours after meals.

Question 9

lactulose (Cephulac) for cirrhosis

Answer 9

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.

Question 10

Preventing dumping syndrome after gastrectomy, eat what food?

Answer 10

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.

Question 11

GERD

Answer 11

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.

Question 12

Cirrhosis

Answer 12

ammonia 180- increased, common in cirrhosis. may indicate portal systemic encephalopathy. report to dr.

Question 13

Ileostomy

Answer 13

report to dr if stoma is reddish purple color- sign of bowel ischemia.

Question 14

acute hep B

Answer 14

expected assessment finding- arthralgia- joint pain

Question 15

Complete bowel obstruction-

Answer 15

expected finding- obstipation- failure to pass stools

Question 16

Small bowel obstruction

Answer 16

expected finding- epigastric abdominal distention

Question 17

Intraperitoneal bleeding

Answer 17

expected finding- periumbilical grey-blue discoloration

Question 18

Ascites, just undergone paracentesis, tx has been effective when?

Answer 18

decreased SOB. increased abdominal fluid limits the expansion of the diaphragm and prevents the pt from taking a deep breath.

Question 19

Ulcerative colitis

Answer 19

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.

Question 20

Post Gastrectomy priority

Answer 20

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

Question 21

Peritonitis secondary to ulcer perforation s/s

Answer 21

board like abdomen, distended

Question 22

Acute pancreatitis priority

Answer 22

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

Question 23

Colorectal cancer

Answer 23

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.

Question 24

Hep C

Answer 24

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.

Question 25

Duodenal Ulcer

Answer 25

Pain occurs 1.5-3 hours after meals and during the night. occurs when the stomach is empty.

Question 26

Peptic Ulcer Disease

Answer 26

Avoid taking NSAIDs- can result in mucosal injury.

Question 27

Post portal systemic shunt for treatment of cirrhosis

Answer 27

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.

Question 28

Cirrhosis, priority assessment

Answer 28

bloody stools- greatest risk is hemorrhage due to impaired coagulation.

Expected findings with cirrhosis- spider angiomas, fetor hepaticus, peripheral neuropathy

Question 29

GERD. metoclopramide (Reglan). adverse effect.

Answer 29

involuntary facial movements- like other dopamine agonists, metoclopramide may cause extrapyramidal symptoms.

Question 30

carcinoembryonic antigen (CEA)

Answer 30

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.

Question 31

Portal systemic encephalopathy (PSE) pt has elevated ammonia level. diet ?

Answer 31

need to limit protein in diet. cant eat beef and chicken and other protein. eat more fruits and veg.

Question 32

acute onset bacterial gastroenteritis

Answer 32

avoid meds such as diphenoxylate (Lomotil)- want bacteria to be eliminated, this med decreases gastrointestinal motility

Question 33

Pancreatitis lab

Answer 33

increased amylase

Question 34

Appendicitis s/s

Answer 34

high temp, recent history n/v, RLQ pain, wbc 10000-18000

Question 35

Colonoscopy prep

Answer 35

drink clear liquids 24 hours prior to the procedure, nothing by mouth 6-8 hours before

Question 36

New colostomy, what food will help avoid flatus and odor

Answer 36

yogurt, can help prevent flatus