Ch 33 Upper Gastrointestinal Disorders Flashcards
Problems with prolonged nausea and vomiting
Dehydration
Electrolyte imbalances
Metabolic acidosis
Anorexia
Lack of appetite
Prolonged anorexia can result in?
Electrolyte imbalances
Cardiac dysrythmias
Nursing actions for anorexia
Document I&O Vital signs Electrolytes Electrocardiogram Rate of IV and tube feedings
Anorexia nervosa
Eating disorder
Anorexia nervosa signs and symptoms
Severe weight loss
Low self-esteem
Compulsive dieting
Altered body image
Progression in anorexia nervosa
Amenorrhea Electrolyte imbalance Dry skin and hair Bradycardia Hypothermia Hypotension Muscle wasting
Complications of anorexia nervosa
Decrease in pulse and blood pressure Heart and renal failure Osteoporosis and muscle loss Vitamin and electrolyte imbalances Diabetes (sugars are unstable if food is consumed or not consumed)
Theraputic measures for anorexia nervosa
Restore nutritional health
Medical and psychological counseling
Bulimia nervosa
Binge and purge
Signs and symptoms of bulimia nervosa
Enamel erosion in teeth Vomiting frequently Electrolyte imbalance Dysrythmias Heart failure
Therapeutic measure for Bulimia nervosa
Medical and psychological counseling
Obesity
BMI should be between 19-24
Therapeutic measure for obesity
Diet exercise
Medications to suppress appetite
Surgery
Roux-en-y
Restrictive and malabsorptive surgery
Stomatitis
Inflammation of the oral cavity
Most common form of stomatitis
Aphthous stomatitis (canker sores)
Herpes simplex virus type 1
ContagiousOral cancer signs and symptoms
Ulcers that don't disappear after 2 weeks should be checked out Painless then tender as it progresses Difficulty chewing Swallowing Speaking Swollen cervical lymph nodes
Esophageal cancer
Associated with use of tobacco and alcohol
Signs and symptoms of esophageal cancer
Dysphasia Feeling of fullness Pain in chest after eating Foul breath GERD if there is an obstruction
Diagnostic test for esophageal cancer
EGD-esophagogastroduodenoscopy
Biopsy
Therapeutic measures for esophageal cancer
Eradication
Chemo
Surgery
Hiatal hernia
Lower esophagus and stomache slides up and through the hiatus of the diaphragm into the thorax
Signs and symptoms of hiatus hernia
Lg hernias causes Pain Heartburn Feeling of fullness Reflux
Diagnostic test for hiatal hernia
X-ray
Fluoroscopy
Therapeutic measures for hiatal hernia
Antacids Eating small meals Not reclining 1 hr after eating Elevating head of bed 6-12 inches Avoid snacks at bed time Smoking Caffeine
Surgical management for hiatal hernia
Nissan fundoplication
Mallory-Weiss tear
Longitudinal tear in the mucous membrane of the esophagus at the stomach junction Results from prolonged coughing Vomiting Seizures CPR
Sign and symptom of Mallory-Weiss Tear
GI bleed
Diagnostic test for MWT
Hemoglobin and hematocrit
EGD
Acute gastritis
Mucosal barrier broken down and allows autodigestion from hydrochloric acid and pepsin to occur
Tissue edema and possible hemorrhage
Signs and symptoms of acute gastritis
Abdominal pain Accompanied with nausea and anorexia Abdominal tenderness Feeling of fullness Reflux Belching Hematemesis
Therapeutic measures for acute gastritis
Bland diet
Soft foods
Antacids
Medication to reduce vomiting
Chronic gastritis type A
Autoimmune
Occurs in the fundus
Can lead to pernicious anemia
Difficulty absorbing B12
Diagnostic test for chronic gastritis type A
Endoscopy
Upper GI X-ray
Gastric aspirate analysis
Chronic gastritis type B
Affects the Antrum and pyloris
Lower end of the stomach and near duodenum
Associated with helicobacter pylora bacterial infection
Most common
Signs and symptoms of chronic gastritis type B
Poor appetite Heartburn Belching Sour taste in mouth Nausea and vomiting
Diagnostic test for chronic gastritis type B
Endoscopy
Upper GI X-ray
Gastric aspirate analysis
Peptic ulcer disease (PUD)
Lining of the stomach, esophagus, duodenum, pyloris erodes
Signs and symptoms of PUD
Pain
Hemorrhage
Obstruction
Perforation
Diagnostic test for PUD
Urea breath test
Biopsy specimens for the Campylobacter-like organism (CLO)
Barium swallow
EGD
Therapeutic measures for peptic ulcers
Antibiotics
Proton pump inhibitor or H2 antagonist
Gastric bleeding
Ulcer perforation
Tumors
Gastric surgery
Most common in stomach and intestines
Signs and symptoms of gastric bleeding
Slight weakness or diaphoresis Hypovolemic shock Hypotension Threads pulse Chills Palpitations
Therapeutic measures for GI bleed
Prevent hypovolemic shock
Prevent dehydration
Electrolyte imbalance
Treatment for GI bleed
NPO IV line for fluids and blood Hematocrit Catheter for output NG tube Monitor pH Decompress stomach
Gastric cancer
Malignant lesions found in the stomach
H. Pylor infection plays a role
Signs and symptoms of gastric cancer
Rarely diagnosed early Indigestion Anorexia Pain relieved by antacid Weight loss Nausea Vomiting Anemia Occult blood in stool
Diagnostic test for gastric cancer
Upper GI X-ray
Gastroscopy
Gastric fluid analysis
Measurement of serum gastrin levels
Therapeutic measures for gastric cancer
Surgery to relieve symptoms
Chemo and radiation but not effective
Dumping syndrome
Rapid entry of food into the jejunum w/o proper mixing of food with digestive juices
Extra cellular fluid into bowel from circulating bv to dilute high concentration of electrolytes and sugars
Decreases circulating bv
Symptoms of dumping syndrome
Dizziness Tachycardia Fainting Sweating Nausea Diarrhea Feeling of fullness Abdominal cramping Increase blood sugar Hypoglycemia
Symptoms old hypoglycemia
Weakness Sweating Anxiety Shakiness Confusion Tachycardia
Treatment for hypoglycemia
Eat sugary candy or sugar juice immediately
Treatment for dumping syndrome
Small frequent meals High in protein and fat Low in carbs Avoid fluids 1 hr before, with, after meals or for 2 hours after meals Lie down after meals
Pernicious anemia
B12 deficiency
Steatorrhea
Excessive fat in stools
Result of dumping syndrome
Controlled by reducing fat
