chapt 46 management of patients with gastric and duodenal disorders Flashcards
Gastritis is characterized by a disruption of the __ barrier that normally protects the stomach tissue from __ juices. The impaired mucosal barrier allows corrosive HCI, __, and other irritating agents to come in contact with the gastric mucosa, resulting in inflammation. In acute gastritis, this inflammation is usually transient and self-limiting in nature. In chronic gastritis persistent or repeated insults lead to chronic inflammatory changes and eventually __ of the gastric tissue
mucosal
digestive juices
pepsin
atrophy
gastritis affects mostly
A. men
B. Women
C. Both equally
both equally
gastritis may be __ lasting several hours to a few days, or __ resulting from repeated exposure to irritating agents or recurring episodes of acute gastritis
acute
chronic
Acute gastritis may be classified as __ or __
erosive or non-erosive
The __ form of acute gastritis is most often caused by local irritants such as aspirin, and other nonsteroidal anti-inflammatory drugs, alcohol consumption, and gastric radiation therapy.
erosive
The __ form of acute gastritis is most often caused by an infection with Helicobacter Pylori (H-Pylori)
non-erosive
A more severe form of acute gastritis is caused by the ingestion of strong __ or alkali, which may cause the __ to become gangrenous or to perforate.
acid
mucosa
Acute gastritis may also develop in acute illnesses, especially when the patient has had major traumatic injuries; burns, severe infection, hepatic, kidney, or respiratory failure, or major surgery. This type of acute gastritis is often referred to as __ __ gastritis
stress-related gastritis
Acute gastritis may have __ onset of symptoms
Complaints of __ discomfort, headache, lassitude, nausea, anorexia, vomiting, and hiccuping lasting from a few hours to a few days
rapid
abdominal
erosive gastritis may cause bleeding which may manifest as blood in vomit, or as __(black tarry stools) or __ (bright red bloody stools).
melena
hematochezia
The patient with chronic gastritis may be __.
complaints of anorexia, heartburn after eating, belching, a sour taste in the mouth, or nausea and vomiting.
May have mild epigastric discomfort, intolerance to spicy or fatty foods, or pain relieved by __
may not be able to absorb vitamin __, and usually having evidence of malabsorption of this vitamin may lead to pernicious anemia.
asymptomatic
eating
B12
Gastritis is sometimes associated with achlorhydria or hypochlorhydria or with high acid levels.
upper gastrointestinal __ series and upper __ are useful
Biopsy with histologic examination are performed
serologic testing for antibodies to the _ __ antigen and a breath test may be performed
A __ may be drawn to assess for anemia as a result of hemorrhage or pernicious anemia
x-ray, endoscopy
H. Pylori
CBC
if the patient has ingested __ or alkalis, emergency measures may be necessary
offer supportive therapy to the patient and family during treatment and after the ingested acid or alkali has been neutralized or diluted.
assess __ to determine whether ingestion may have been intentional
acids
Mood
provide __ and __ support for patients with acute gastritis
help patient __ symptoms
avoid foods and fluids by mouth for hours or days until acute symptoms subside, thus allowing the gastric mucosa to heal
offer ice chips and __ liquids when symptoms subside
Discourage __ beverages, alcohol, and cigarette smoking
physical and emotional
manage
clear
alcoholic
Monitor daily intake and output for dehydration minimal intake of __ L per day and urine output of __mL/kg per hour
- 5 L
0. 5 mL
assess electrolyte values every __ hours for fluid imbalance
24 hours
Be alert for indicators of __ gastritis (hematemesis, tachycardia, hypotension) and notify the physician. Assess vital signs as the patient’s condition warrants.
hemorrhagic
Assess all __ for the presence of frank or occult bleeding
stools
Instruct the patient to avoid foods and beverages that may __ the gastric mucosa
irritate
Instruct the patient in the correct use of __ to relieve chronic gastritis
medications