chapter 32,33 Flashcards
Where in the body does digestion start?
The mouth
What significant patient problem can occur in patient with loose teeth?
Risk of aspiration (of a loose tooth)
What organ in the GI tract is where the digestion process ends, where all the necessary nutrients for life have been absorbed?
Small Intestine
When caring for a patient with Gastrointestinal symptoms the nurse will palpate the abdomen. Describe the process of abdominal palpitations:
Light palpitation is done by lightly depressing the abdomen no more than to inch. During the palpitation using the finger pads.
Note: if there is any muscle tension, rigidity, masses, or expression of pain
When a nurse uses percussion to evaluate the patient’s abdomen, what does Tympanic sound indicate?
High pitch sounds indicate the presence of air
When a nurse uses percussion to evaluate the patient’s abdomen, what does Dull sound indicate?
Dull thuds indicate the presence of fluid or solid organs
What is Peristalsis?
Peristalsis of the muscle layer in the wall of the esophagus propels food through the GI system
Describe the process of listening to bowel sounds
The stethoscope is pressed slightly on the abdomen. Bowels are categorized as normal, hyperactive, hypoactive, or absent
About how long could it take to fully listen for bowl sounds in all 4 quadrants?
to fully listen to all 4 quadrants, it can take several minutes: up to 5 minutes or so
What problems might hypoactive bowel sounds indicate?
Decrease peristalsis
Constipation
Bowel obstruction
What problems might hyperactive bowel sounds indicate?
Increased peristalsis
Diarrhea
What is jaundice and what types of diseases will it be seen?
Jaundice is the yellowing of the skin or whites of the eyes, arising from excess of the pigment bilirubin and typically caused by obstruction of the bile duct, by liver disease, or by excessive breakdown of red blood cells
Jaundice has many causes, including hepatitis, gallstones, and tumors
Discuss the following drugs that are prescribed for GERD & PUD, specifically: drug names, indications for use, patient teaching:
Proton Pump Inhibitors (PPI’s)
Histamine Blockers (H2) Receptor Antagonists
Antacids
Mucosal Barrier Fortifiers
What is Prevpac?
Iansoprazole, amoxicillin, and clarithromycin(PREVAC)
What is prevpac used to treat?
treatment for PUD caused by H.Pylori is the PREVPAC. Consists of the following combination of drugs that are to be taken for 10-14 days
Care for a patient with a GI bleed
NPO
IV Fluids
Urinary catheter (for more accurate I &O)
NG tube
Oxygen
Vital signs , 02 saturation
How is stool for Occult blood (stool for guaiac) performed?
The fecal occult blood test (FOBT) is a lab test used to check stool samples for hidden(occult)blood
List causes of GI bleeding
Peptic Ulcer perforation
Tumors
Gastric surgery
Signs and symptoms of GI bleeding
Mild: weakness diaphoresis
Severe: hypovolemic shock (hypotension, tachycardia, tachypnea, weak pulse, chills, palpitations)
Diagnostic test for GI bleeding
Upper GI scope
Blood work, CBC hemoglobin,Hematocrit
Treatment for GI bleed
Surgical repair of bleeding area
Blood transfusions
Oxygen support
Nursing interventions for GI bleed pt.
Turn the patient on their side to protect the patients airway
What should the nurse do next
take the patients vital signs and notify the physician STAT
Complications of GI Bleed
Anemia
Shock
Death
What is pernicious Anemia
lack of production in the stomach of Intrinsic factor
what vitamin is the patient deficient in?
B12
how is b12 deficiency treated?
monthly injections of B12
with the respect to colorectal cancer, discuss the CEA blood test
Carcinoembryonic antigen
What position should the patient be placed in when having an NG tube for feeding or a permanent feeding tube
Position patient sitting up at 45 degrees (unless contradicted by the patients condition), with a pillow under the head and shoulders. This allows the NG tube to pass more easily through the nasopharynx and into the stomach
Why does the nurse check for “residual” before starting a tube feeding or administration of medication via feeding tube?
Excess residual food products from the stomach(>100mL) are an indication that the patient is not digesting the food at the normal pace and is high risk for vomiting and aspiration.
What position should the nurse be placed in during 30-45 minutes post Tube feeding/Med administration??
Minimum of semi-fowlers 30-45 degrees
What is Total Parental Nutrition(TPN)
Total Parental Nutrition is a method of feeding that bypasses the gastrointestinal tract. A special formula given through a vein provides most of the nutrients the body needs. The method is used when someone cant or shouldn’t receive feedings or fluids by mouth or NG/PEG tube
In addition to monitoring the infusion of TPN, what is a important invention(lab value) that the nurse must evaluate: why and how often?
Blood sugar every 6 hours.Report elevation of BS to MD
What is a common medication prescribed for Nausea and vomiting?
Ondansetron(Zofran)
What is a hiatal hernia
lower esophagus/stomach slides through hiatus of diaphragm into throrax
Signs and symptoms of hiatal hernia
Pain
heartburn
Felling of fullness
Reflux
