Chapter 28 upper gastro disorders

Question 1

what are the s/s of obesity

Answer 1

more than 20% above ideal weight for height, age, and body type

Question 2

how do you treat obesity

Answer 2

dietary control and exercise are the main treatments for obesity
- bariatric surgery; modify lifestyle, stringent regimen required to lose weight and keep weight off

Question 3

bariatric surgery puts px at greater risk for what?

Answer 3

pulmonary embolism and thrombus formation as well as death

Question 4

complications of gastro surgeries

Answer 4

• leakage of stomach contents
• gastric stretching
• dumping syndrome
• nutritional deficiencies, iron, vit.b12, calcium, and folate

Question 5

what are some common therapies for disorders of gastrointestinal system

Answer 5

• gastrointestinal decompression
• enteral nutrition
• total parenteral nutrition

Question 6

what is stomatitis

Answer 6

inflammation of mucous membranes of the mouth including the inside of cheeks, gums, tongue, lips, and palate

Question 7

s/s of stomatitis

Answer 7

• mild erythema
• edema
• ulcerations (canker sores)
• excessive dryness
• severe halitosis
• secondary infection

Question 8

interventions/treatments for stomatitis

Answer 8

• diet
• artificial saliva
• special mouth care

Question 9

what does the Roux-en-Y gastric bypass (RYGB) do

Answer 9

limits the stomach size and duodenum and part of jejunum are bypassed it limits the absorption of calories

Question 10

total gastric bypass causes what?

Answer 10

severe nutritional deficiencies and is no longer recommended

Question 11

healthy people 2030 goals related to losing weight and obesity

Answer 11

• preventing obesity
• encouraging healthy and nutrition-dense foods

Question 12

what is a hiatal hernia

Answer 12

opening in the diaphragm through which the esophagus passes becomes enlarged and part of the upper stomach move up into the lower portion of the thorax

Question 13

what are some s/s of a hiatal hernia

Answer 13

• pyrosis (heartburn)
• regurgitation
• dysphagia
• intermittent epigastric pain
• fullness
• nausea/vomiting
• nighttime cough
• s/s more severe when supine

Question 14

treatment of a haital hernia

Answer 14

• reduce weight
• avoid tight-fitting clothes around the abdomen
• take antacids and histamine receptor antagonists
• elevate HOB on 6- to 8- inch blocks
• take proton pump inhibitors
• do not eat within 3hr of going to bed
• limit intake of alcohol, chocolate, caffeine, and spicy or fatty foods
• avoid smoking

Question 15

what is GERD

Answer 15

syndrome caused by transient relaxation of the lower esophageal sphincter
- the relaxation allows fluids and food to reflux into the esophagus from the stomach

Question 16

what are some signs and symptoms of GERD

Answer 16

• heartburn (pyrosis) and reflux
• indigestion (dyspepsia)
• chest pain
• coughing
• flatulence
• dysphagia
• bloating after meals

Question 17

what is treatment of GERD

Answer 17

• diet therapy
• lifestyle changes (weight loss for overweight px)
  -drug therapy
• education

Question 18

what is gastroenteritis?

Answer 18

inflammation of the stomach and small intestine

Question 19

what is gastroenteritis caused by

Answer 19

intake of food or water contaminated with a virus pathogenic bacteria or parasites

Question 20

s/s of gastroenteritis

Answer 20

• vomiting, diarrhea
• abdominal cramping, mild abdominal tenderness and distention

Question 21

nursing management of px with gastroenteritis?

Answer 21

NPO until vomiting has stopped
- when tolerated, fluids containing glucose and electrolytes should be started

Question 22

what gastritis?

Answer 22

inflammation of mucous membrane and lining of the stomach causing changes in the tissue
acute: usually after exposure to local irritants
chronic: prolonged inflammation, can progress to ulcer and even hemorrhage

Question 23

s/s of gastritis

Answer 23

• anorexia, nausea, vomiting
• pain tenderness in the stomach region
• hiccups and sometimes diarrhea, abdominal cramping, heartburn
• if untreated- chronic gastritis, ulcerations, gastric hemorrhage

Question 24

treatment and interventions of gastritis

Answer 24

NPO
- refrain from alcohol and food
- nonirritating diet
- iv fluids
- pharmacologic; antacids, histamine receptor antagonists, PPI, abx
- rest
- avoid NSAIDS

Question 25

what is a peptic ulcer

Answer 25

ulceration with loss of tissue of the upper gi tract

Question 26

what can cause a peptic ulcer

Answer 26

tension, anxiety
- prolonged stress, Drug-induced ulcers
- smoking, alcohol, drug abuse
- stress, genetics, illnesses, infectious agents

Question 27

what do you see in gastric, duodenal, and nonspecific ulcers

Answer 27

gastric: pain immediately after eating
duodenal: 2-3 hours AFTER meals, awaken with pain DURING the NIGHT, pain relief AFTER meal or antacid ingestion
nonspecific: pyrosis, vomiting, constipation or diarrhea, bleeding, sour burps

Question 28

s/s of peptic ulcers

Answer 28

• daily pattern of pain
• gastrointestinal bleeding

Question 29

what are some complications of PUD?

Answer 29

• vomiting (gastric outlet obstruction
• severe pain and bloating (relieved by vomiting)
• bleeding PUD (hematemesis, passage of melena (black, tarry stool)
• perforation ( peritonitis, shock)

Question 30

what are the surgical treatments of peptic ulcers

Answer 30

-pyloroplasty with truncal or proximal gastric vagotomy
- subtotal gastroectomy (gastric resection)
- total gastroectomy