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NUR 111 UNIT 4 > Book Reading A > Flashcards

Book Reading A Flashcards

1
Q

what disease is caused by acid reflux from the stomach (or duodenum) into the esophagus

A

GERD

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2
Q

what disease results from the backward flow of gastroduodenal contents (refluxate) into the esophagus

A

GERD

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3
Q

what disease occurs when the LES is weak or relaxes inappropriately, causing the pressure gradient between the LES and the stomach to be lost.

A

GERD

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4
Q

what is the gold standard for the assessment and measurement of esophageal motor activity.

A

Esophageal manometry or motility testing

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5
Q

what disease has these risk factors?

  • Hiatal hernia
  • LES hypotension
  • Loss of esophageal motility
  • Increased compliance of the hiatal canal
  • Increased states of gastric secretion
  • Eating large meals
  • Delayed emptying of gastric contents
  • Ascites
  • Tight belts or girdles
  • Presence of a nasogastric tube
A

GERD

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6
Q

what disease has this medication?

  • Histamine receptor antagonists
  • Prokinetic medications
  • Proton pump inhibitors
A

GERD

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7
Q

what medication decrease gastric acid production; short acting?

A

Histamine receptor antagonists

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8
Q

what medication increase gastric emptying

A

Prokinetic medications

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9
Q

what medication decrease gastric acid production; long acting

A

Proton pump inhibitors

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10
Q

what is the gold standard for surgery for GERD surgical managment?

A

laparoscopic Nissen fundoplication

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11
Q

what is a complication of GERD?

A

Barrett’s epithelium

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12
Q

what disease has these manifestations?

  • Heartburn (dyspepsia)
  • Severe atypical chest pain
  • Odynophagia (painful swallowing)
  • Hemorrhage
  • Dental caries
  • Aspiration pneumonia
  • Chronic cough
  • Morning hoarseness
  • Adult-onset asthma
  • Laryngitis
  • Pharyngitis
  • Bronchitis
  • Regurgitation
A

GERD

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13
Q

what disease has this assessment?

  • Regurgitation
  • Severe atypical chest pain
  • Hemorrhage
  • CBC
  • Dyspepsia
  • Dysphagia and odynophagia
  • Signs of Barrett’s esophagus
  • Dental caries
  • Water brash
  • Eructation, flatulence, or bloating
  • Nausea
  • Globus (sensation that there is a lump in the throat)
  • pH of gastric aspirate
A

GERD

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14
Q

what disease has these actions?

medical management
patient positioning
*on right side
*HOB 6-12 inches
provide 4-6 meals a day
A

GERD

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15
Q

what disease has this food managment?

spicy/fatty foods,

caffeine,

chocolate,

carbonated beverages,

acidic foods,

peppermint,

alcohol,

certain medications

A

GERD

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16
Q

what medications should me avoided on GERD?

A

calcium channel blockers,

anticholinergic medications,

smooth muscle relaxers.

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17
Q

what disease is localized or patchy inflammation of the gastric mucosa resulting from repeated exposures to irritating agents.

A

gastritis

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18
Q

what disease has

mucosal inflammatory process that may be accompanied by hemorrhage into the mucosa.

thickened, reddened mucous membrane with extrusive rugae, or longitudinal folds.

mucosal necrosis and inflammatory reaction

sloughing of the surface mucosa may lead to acute GI bleeding.

A

acute gastritis

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19
Q

what disease has

prolonged, persistent, or intermittent inflammation

patchy, diffuse inflammation of the mucosal lining of the stomach.

leads to atrophy of the glandular epithelium of the stomach.

A

chronic gastritis

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20
Q

the 3 types of chronic gastritis are…

A

Helicobacter pylori gastritis

  • Most common
  • total loss of fundal glands, minimal inflammation, thinning of the gastric mucosa leading to atrophy, and abnormal cellular changes.
  • transmission is likely person-to-person by vomitus, saliva, feces, or inadequately treated drinking water.
  • contaminated food

autoimmune gastritis

atrophic gastritis

*seen in older adults

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21
Q

what disease is caused by gastric mucosa is damaged by agents such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), ethyl alcohol, or bile salts, this barrier is disrupted, and hydrogen ions move into the tissue.

A

gastritis

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22
Q

what disease has these diagnostic testing?

upper GI x-ray series or endoscopy

histological examination of a tissue specimen

Stool testing

Urea breath testing

A

gastritis

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23
Q

what disease has these as risk factors?

Asprin

NSAID

Ethyl alcohol

Bile salts

Stress

Alchohole

Crohns disease

Tuberculosis

Bile reflux

A

gastritis

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24
Q

what disease has these as medications?

proton pump inhibitors (PPIs)

H2-receptor antagonists.

Maintain ph of intragastic

 * Esomeprazole 
  * Lansoprazole  
  * Pantoprazole

Antacids

Sucralfate (Carafate)

B12 Vit.

Antibiotics

A

gastritis

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25
Q

what disease has these surgical managments?

vagotomy
gastrectomy
pyloroplasty

A

gastritis

vagotomy

-surgery to sever the vagus nerve to reduce secretion of acid within the stomach

gastrectomy

-removal of the stomach

pyloroplasty

-enlarging the pylorus opening

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26
Q

what disease has this teaching?

Avoid

Asprin

Spicy foods

Bland food

Small frequent meals

A

gastritis

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27
Q

what disease has these complications?

peptic ulcers and gastric cancer

Ulceration may occur and can lead to hemorrhage.

A

gastritis

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28
Q

what disease has these manifestations?

epigastric pain

nausea and vomiting

weight loss

decreased appetite

changes in color of the stool

dehydration

upper GI bleeding.

29
Q

what disease has these Interventions Assessment

Vital signs

History of presenting signs and symptoms

Laboratory assessment for H pylori

Serum electrolytes

Intake and output

30
Q

what disease has these Interventions Actions

Administer IV fluids as prescribed

Administer H2-receptor antagonists as prescribed

Administer antacids as prescribed

Administer PPIs as prescribed

A

Administer H2-receptor antagonists as prescribed

—-H2-receptor antagonists block gastric secretions.

Administer antacids as prescribed

—-buffering agents correct PH balance

Administer PPIs as prescribed

—-suppress gastric acid secretion.

31
Q

what disease has this Intervention Teaching

Immediately report hematemesis (vomiting of blood)

Take medications as prescribed

Avoid medications and other irritants that are associated with gastric episodes

Follow prescribed dietary teaching regarding types of foods and how to introduce back into the diet.

32
Q

what disease is an inflammation of the lining of the stomach and small intestines produces watery diarrhea, abdominal pain or cramping, nausea or vomiting, and sometimes fever.

Aka “stomach flu”, traveler’s diarrhea, or food poisoning.

A

Gastroenteritis

33
Q

what disease is caused by a virus, bacteria, or parasite.

A

Gastroenteritis

34
Q

what disease has this as a diagnostic test?

clinical evaluation

stool culture

A

Gastroenteritis

35
Q

what disease has this as a treatment?

Oral rehydration

IV rehydration

A

Gastroenteritis

36
Q

what disease has this diet teaching?

clear liquids

Oral glucose-electrolyte solutions,

broth, or bouillon

easy-to-digest foods

A

Gastroenteritis

37
Q

what disease has this manifestations?

Manifestation

Diarrhea

Nausea

Vometing

Anorexia

Abdominal distention

Poor skin turgor

dehydration,

hyperactive bowel sounds,

decreased blood pressure

dry mucus membranes.

A

Gastroenteritis

38
Q

what disease has these Assessment

Vital signs, including orthostatic measurements

Abdomen for distention

Bowel sounds and bowel elimination pattern

Serum electrolytes, BUN, and creatinine

Intake and output

Perineal skin status

Skin and mucous membranes for signs of dehydration

Pain level and effectiveness of interventions

A

Gastroenteritis

39
Q

what disease has theseActions

Perform hand hygiene

Administer IV fluids if the patient is unable to tolerate clear liquids

Administer prescribed medications, such as antidiarrheals

Give clear liquids or oral rehydration solutions

Allow uninterrupted rest periods

Apply venous thromboembolism (VTE) prophylaxis

Provide meticulous perineal care, including sitz baths if indicated

Provide frequent oral care, including lip emollients

A

Gastroenteritis

40
Q

what disease has this Include the patient’s family or caregiver in teaching

Dietary modifications

Preventive measures, especially when traveling

Proper food preparation

Preventive measures

A

Gastroenteritis

41
Q

what disease has a damaged mucosa cannot secrete enough mucus to act as a barrier against gastric acid.

42
Q

what types of ulcers does PUD have?

A

Duodenal ulcers

Gastric ulcers

43
Q

what disease has these diagnostic test?

upper GI endoscopy is the preferred procedure for evaluation of PUD

barium upper GI x-rays

Endoscopy

Esophagogastroduodenoscopy

Noninvasive testing

44
Q

what disease has this as a risk group?

patients with

Type O blood

chronic obstructive lung disease

chronic renal failure

45
Q

what disease has this as risk factors?

Hpylori infection
-Contaminated food and water

NSAID

exposure to irritants

trauma

psychogenic factors

aging

Alcoholic

Smoking

46
Q

what disease has this as medication?

Antacids

-neutralize gastric acid

H2-receptor antagonists

-decreases acid production

—–ranitidine, nizatidine, cimetidine, or famotidine block gastric acid secretion stimulated by histamine, gastrin, and acetylcholine.

PPIs -Proton pump inhibitors

-block the final stage of hydrogen ion secretion by blocking the action of the gastric parietal cell proton pump.

—–omeprazole, lansoprazole, or pantoprazole

Misoprostol- prostaglandin E analog

-prevent gastric mucosal damage

Sucralfate (Carafate)

-enhance mucosal defenses

—–binds to necrotic ulcer tissue and serves as a barrier to acid, pepsin, and bile and can directly absorb bile salts.

47
Q

what disease has this as surgical management?

bilateral vagotomy

Pyloroplasty

Gastrectomy

parietal cell vagotomy

48
Q

what disease has this as diet teaching?

six small meals

avoid dietary irritants

spices, alcohol, caffeine

adequate fluids

No smoking

49
Q

what disease has this as a complication?

edema

GI hemorrhage

ulceration of the stomach’s lining

abdominal or intestinal infarction

perforation and penetration into attached structures

obstruction

Peritonitis

gastric adenocarcinoma

50
Q

what disease has this as manifestations?

General appearance and height and weight relationship

  • Abdominal examination including shape and contour
  • Bowel sounds and tenderness to palpation
  • Presence of obvious or occult blood in vomitus and stool

Left epigastric pain described as heartburn or indigestion accompanied by feeling of fullness or distention

  • The pain usually is rhythmic and frequently occurs when the stomach is empty—between meals and at 1 or 2 o’clock in the morning.
  • Increasingly severe and constant localized abdominal pain that increases with movement and respirations may indicate progressing peritonitis.
  • Possible referral of pain to the shoulder or thoracic area
  • Anorexia, nausea, and vomiting
  • Inability to pass stools and flatus
  • Hiccups
51
Q

what disease has this a Interventions Assessment

Gastric pH as ordered, check emesis, and feces for occult blood

Use of alcohol or other medications, including aspirin and other NSAIDs

Serum electrolytes and blood urea nitrogen (BUN)

Pain, including exacerbating and relieving factors.

Diet, including pattern of food intake, eating schedule, and foods associated with pain

CBC

Blood culture and/or peritoneal fluid culture

Weight

Clinical manifestations of abscess formation, including persistent abdominal tenderness and fever.

52
Q

what disease has this as Interventions Actions

Maintain IV infusions and administer blood products as prescribed

Administer prescribed medication therapy

Administer medications to reduce gastric acidity as ordered

Assist with gastric lavage, as indicated for GI bleeding; irrigate the nasogastric tube with room temperature saline as ordered

Prepare the patient and his family for upper endoscopy or surgery as planned

Limit food intake after the evening meal; eliminate bedtime snacks

Document and report complaints of anorexia, fullness, nausea, vomiting, or symptoms of dumping syndrome

Pain documentation to include location, character, timing and relationship to meals, and measures that relieve or aggravate the pain;

53
Q

what disease has this as

Intervention Teaching

Take medications as prescribed

H2-receptor

—antagonists block gastric secretions.

Antacids

—buffering agents to correct the pH balance of the acidic gastric environment.

Antisecretory agents (PPIs)

—used to suppress gastric acid secretion.

—Avoid eating within two hours of bedtime.

Advise patients to avoid risk factors such as overuse of aspirin and NSAIDs, spicy foods, and beverages that contain caffeine

54
Q

what disease occurs occurs when a portion of the stomach protrudes upward through the esophageal hiatus (opening in the diaphragm that the esophagus passes through) and into the thoracic cavity

A

Hiatal hernia

55
Q

what is this disease called? the lack of dietary fiber and the “unnatural” sitting position (causes straining) used for defecation.

A

Hiatal hernia

56
Q

what type of disease is this?

(sliding type) is usually acquired through an ongoing process of disruption to the GEJ.

A

Hiatal hernia

type 1

57
Q

what type of disease is this?

(rolling type), or paraesophageal, hernias are thought to occur because of an anatomical defect that causes improper anchoring of the stomach below the diaphragm.

A

Hiatal hernia

type 2

58
Q

in what type of hernia is

Reflux is not usually present!

A

Hiatal hernia

type 2

59
Q

why type of hernia has these manifestations?

  • Feeling full after eating
  • Feeling breathless after eating
  • Feeling of suffocation
  • Chest pain that feels like angina
  • Increased symptoms when lying flat
A

Hiatal hernia

type 2

60
Q

what type of hernia has these manifestations?

  • Heartburn
  • Regurgitation
  • Chest pain
  • Dysphagia
  • Belching
A

Hiatal hernia

type 1

61
Q

what disease has this
• Upper abdominal x-ray

  • Endoscopy
  • Barium swallow with fluoroscopy (most specific diagnostic test)
  • Esophagogastroduodenoscopy, or EGD (views the esophagus and stomach lining)

Medications are used for the symptoms of heartburn and acid reflux. Most people who have a hiatal hernia do not experience these symptoms, but if they do, they may require medication management or surgery.

  • Antacids are used to neutralize stomach acid and are usually obtained over the counter. Common antacids are Mylanta, Maalox, Gelusil, Rolaids, and Tums. Common side effects include diarrhea and constipation.
  • Proton pump inhibitors and H2-receptor antagonists are prescribed to treat GERD
A

Hiatal hernia

62
Q

what disease has this At-
Risk Groups

50 or older

Barrets esophagitis

2cm or more in size

obesity

pregnancy

smoking

A

hiatal hernia

63
Q

what disease type has this surgical managment?

Nissen fundoplication

-Nissen fundoplication is a surgical procedure whereby the surgeon wraps part of the stomach around the distal esophagus to stabilize it and to reinforce the LES

–gold standard for the treatment of a hiatal hernia

laparoscopic antireflux surgeries

  • Gastropexy (attachment of the stomach below the diaphragm to prevent reherniation) is used after reduction if the stomach is unusually movable after reduction is performed. Other surgical procedures for type 2 hernias include:
  • • Herniotomy (surgical removal of the herniated sac)
  • • Herniorrhaphy (repair of the hiatal defect)
  • • Antireflux procedure
  • • Reduction (attachment of the stomach below the diaphragm to prevent reherniation)
A

hiatal hernia

64
Q

what type of hatial hernia has this type of complication?

GERD

coughing, obesity, ascites, and positional changes such as bending and lying supine.

65
Q

what type of hatial hernia has this type of complication?

Supradiaphragmatic volvulus

  • abnormal 180-degree twisting of the stomach above the diaphragm
  • Obstruction
  • Iron-deficiency anemia-caused by gastric ulcers and erosions.
66
Q

what type of hernia has this manifertation?

Heartburn

  • Regurgitation
  • Dysphagia
  • Eructation (belching)
  • Breathlessness
  • Feeling of suffocation
  • Chest pain
  • GERD
  • Iron-deficiency anemia (related to volvulus) blood loss
A

hiatal hernia

67
Q

what type of disease has this type of Assessment

Breathlessness, feelings of suffocation, chest pain, palpitations

Dysphagia

Clinical manifestations of GERD, heartburn

Nausea and vomiting

Eructation

Iron-deficiency anemia

A

hiatal hernia

68
Q

what type of hernia has this Interventions Actions

Antacids

Histamine receptor agonists

Proton pump inhibitors

Prokinetic medications

Position the patient supine on the right side, and elevate the HOB at least 30 degrees after meals.

A

hiatal hernia

69
Q

what type of disease has this Teaching

Encourage the patient to eat meals 2 hours before lying supine.

Educate the patient to limit the following foods and substances: spicy/fatty foods, caffeine, chocolate, carbonated beverages, acidic foods, peppermint, alcohol, caffeinated beverages, and certain medications (if possible), such as calcium channel blockers, anticholinergic medications, and smooth muscle relaxers.

eat meals 2 hours before lying supine.

wear nonrestrictive clothing.

maintaining a normal weight.

proper positioning after eating.

Conduct postoperative education for patients after laparoscopic Nissen fundoplication (LNF)

A

hiatal hernia

NUR 111 UNIT 4 (9 decks)

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