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Nursing of Adults I > Chapter 46: Upper Gastrointestinal Problems > Flashcards

Chapter 46: Upper Gastrointestinal Problems Flashcards

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1
Q

term that describes hot, bitter, or sour liquid coming into the throat or mouth

A

regurgitation

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2
Q

diseases such as __________________________ and other irritating risk factors, such as ____________, ______________, and ____________________ may lead to development of gastritis

A

autoimmune gastritis, endoscopy, NG tube, psychologic stress

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3
Q

(gastric, duodenal) ulcers more likely to cause obstruction

A

gastric

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4
Q

nine drugs that decrease lower esophageal sphincter (LES) pressure (five classes and four specific) (GERD and hiatal hernias)

A

anticholinergics, beta-adrenergic blockers, calcium channel blockers, nitrates, antidepressants
diazepam, morphine sulfate, progesterone, theophylline

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5
Q

emergency management of upper GI bleeding: patient will need these three lab studies

A

CBC, clotting studies, type and crossmatch

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6
Q

peptic ulcer disease teaching: report any of the following three things

A

increased nausea or vomiting
increased epigastric pain
bloody emesis or tarry stools

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7
Q

risk factors for NSAID-induced gastritis include being (male, female), this age group, history of _____________, ____________________ therapy, low-dose ______________, ________________ drugs, and _____________ diseases

A

female, >60 years, peptic ulcer disease, anticoagulant, aspirin, corticosteroid, chronic

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8
Q

five patients at increased risk for stress-related mucosal disease (SRMD)

A

critically ill, coagulopathy, liver disease, organ failure, renal replacement therapy

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9
Q

goal for managing upper GI bleeding with endoscopy

A

coagulate or thrombose bleed

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10
Q

severing of the vagus nerve; decreases gastric acid secretion

A

vagotomy

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11
Q

conservative management of hiatal hernias focuses on reducing _____________________

A

intraabdominal pressure

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12
Q

guaiac test that detects blood in gastric secretions, comitus, or stool

A

occult

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13
Q

in treating/managing perforation, notify _______, take frequent ______________, place on absolute _______ status, ________ management, insert __________ for aspiration and gastric decompression, give IV _______ and __________, and give the drug _____________________

A

HCP, vital signs, NPO, pain, NG tube, fluids, blood, broad spectrum antibiotics

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14
Q

GERD: avoid these three things

A

alcohol, caffeine, smoking

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15
Q

after history and physical, gold standard of diagnosing GERD

A

upper GI endoscopy (with biopsy)

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16
Q

to assess for dehydration and fluid and electrolyte balance in a patient with nausea and vomiting, monitor _____________ and ____________, ___________, and assess for dehydration ___________

A

intake, output, vital signs, manifestations

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17
Q

these three lab tests can be done to help diagnose peptic ulcer disease

A

CBC, liver enzymes, serum amylase

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18
Q

emesis with fecal odor (feces) and bile indicates this

A

obstruction below pylorus (hallmark sign of bowel obstruction)

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19
Q

laboratory tests for upper GI bleeding include CBC for ______________ and ____________; _______ for GI tract bacteria breakdown protein

A

hemoglobin, hematocrit, BUN

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20
Q

two factors that can contribute to hiatal hernias

A

structural changes (weakening of muscles in diaphragm around esophagogastric opening)
increased intraabdominal pressure (from obesity, pregnancy, ascites, tumors, intense physical exertion, heavy lifting)

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21
Q

the gerontologic population has an increased _____________ and ______________ with peptic ulcer disease

A

morbidity, mortality

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22
Q

peptic ulcer disease teaching: __________ can be related to PUD; learn and use management strategies

A

stress

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23
Q

supportive care for acute gastritis involves _______, _______ status, ___________, _______________ drugs, and monitoring for ___________

A

rest, NPO, IV fluids, antiemetic, dehydration

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24
Q

endoscopic therapy for upper GI bleeding: these are used to compress the vessel

A

clips or bands

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25
Q

type of oral cancer that starts in the mouth

A

oral cavity cancer

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26
Q

regurgitation occurs when the ___________________________ didn’t close all the way

A

lower esophageal sphincter

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27
Q

emergency management of upper GI bleeding: watch for this in the older adult

A

fluid overload

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28
Q

risk factors for this location of oral cancer include tobacco and alcohol use, chronic irritation, and syphilis

A

tongue

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29
Q

condition characterized by esophageal metaplasia of cells that increases risk for cancer

A

Barrett’s esophagus

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30
Q

this type of peptic ulcer penetrates the mucosa only

A

erosion

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31
Q

four other diagnostic studies for GERD (other than history, physical, upper GI endoscopy, biopsy)

A

esophagram (barium swallow)
motility (manometry) studies
pH monitoring
radionuclide studies

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32
Q

four lifestyle factors that increase risk for peptic ulcer disease

A

alcohol, smoking, caffeine, psychologic distress

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33
Q

lifestyle modifications for chronic gastritis include avoiding ___________, eating ___ (small, large) meals per day of nonirritating food, and adhering to __________________

A

smoking, 6, small, prescribed drugs

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34
Q

swelling of esophagus due to infiltration of eosinophils

A

eosinophilic esophagitis

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35
Q

GERD is typically diagnosed via __________ and ____________ and response to ___________ and __________ therapies

A

history, physical, behavioral, drug

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36
Q

to prevent aspiration in a patient with nausea and vomiting who cannot manage self-care, place in one of these two positions

A

semi-Fowler’s
side-lying

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37
Q

manifestations of perforation include sudden, severe abdominal _________ that radiates to ______ and ___________; no relief with _______ or ____________; __________, _____________ abdomen; bowel sounds _________; _________ and ________________; respirations _____________; pulse ___________ and ________

A

pain, back, shoulders, food, antacids, rigid, boardlike, absent, nausea, vomiting, shallow, increased, weak

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38
Q

most accurate procedure (gold standard) to determine presence and location of ulcer

A

endoscopy

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39
Q

surgical method for hiatal hernias involving closure of the hiatal defect

A

herniorrhaphy

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40
Q

risk of dumping syndrome is reduced with _______ after eating

A

rest

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41
Q

manifestations of this location of oral cancer include an indurated, painless ulcer

A

lip

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42
Q

manifestations include anorexia, nausea, vomiting, epigastric tenderness, hemorrhage

A

acute gastritis

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43
Q

two complementary therapies that may help nausea and vomiting

A

acupressure, acupuncture

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44
Q

two most common causes of upper gastrointestinal bleeding from stomach and duodenal origin

A

H. pylori, NSAIDs (cause peptic ulcer disease)

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45
Q

two treatments for esophageal strictures

A

dilation with bougies or balloons using endoscopy or fluoroscopy
surgical excision

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46
Q

factors involved in pathogenesis of GERD include impaired __________________ motility, delayed ________________, small intestine reflux of _______, defective ____________ defense, ____________ dysfunction (decreased pressure), and reflux of _______________

A

esophageal, gastric emptying, bile, mucosal, lower esophageal sphincter (LES), gastric contents

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47
Q

surgical method for hiatal hernias involving excision of the hernia sac

A

herniotomy

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48
Q

precancerous lesion due to smoking that becomes hyperkeratosis; characterized by white patch on mouth mucosa or tongue

A

leukoplakia

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49
Q

when taking PPIs and corticosteroids for eosinophilic esophagitis, monitor for this disease

A

candidiasis

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50
Q

four causes of obstruction in distal stomach and duodenum (complication of peptic ulcer disease)

A

edema, inflammation, pylorospasm, scar tissue

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51
Q

physical/objective assessment for upper GI bleeding includes these five things

A
  1. LOC
  2. frequent VS
  3. skin color
  4. capillary refill (shock)
  5. abdomen (distention, guarding, peristalsis)
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52
Q

six factors (foods, substances other than drugs) that decrease lower esophageal sphincter (LES) pressure (increase irritation) (GERD)

A

alcohol, chocolate, fatty foods, nicotine, peppermint/spearmint, tea/coffee (caffeine)

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53
Q

acid reflux into the mouth may lead to _______________

A

dental erosion

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54
Q

these three food items may be given to patients with nausea and vomiting

A

dry toast, crackers, gelatin

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55
Q

endoscopic therapy for GERD in which a biopsy is obtained to determine presence of any cancer

A

endoscopic mucosal resection (EMR)

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56
Q

treatment for large perforations

A

surgery for closure; suctioning of peritoneal cavity

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57
Q

risk factors for this location of oral cancer include constant overexposure to the sun, ruddy and fair complexion, recurrent herpetic lesions, pipe stem irrigation, syphilis, and immunosuppression

A

lip

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58
Q

risk factors for this location of oral cancer include poor oral hygiene, tobacco usage (pipe and cigar smoking, snuff, chewing tobacco), chronic alcohol use, chronic irritation (jagged tooth, ill-fitting prosthesis, chemical or mechanical irritants), HPV

A

oral cavity

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59
Q

postoperative complication of gastric surgery in which uncontrolled high carbohydrate bolus enters small intestine causing excess insulin and resulting in hypoglycemia 2 hours after eating

A

postprandial hypoglycemia (variant of dumping syndrome)

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60
Q

partial gastrectomy with removal of the distal 2/3 of the stomach and anatomosis of the gastric stump to the duodenum

A

gastroduodenostomy or Billroth I

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61
Q

type of oral cancer that develops in the part of the throat just behind the mouth

A

oropharyngeal cancer

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62
Q

two diagnostic studies for eosinophilic esophagitis

A

endoscopy with biopsy
allergy testing

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63
Q

type of hiatal hernia in which the junction of the stomach and esophagus is above the diaphragm, and a part of the stomach slides through the hiatal opening in the diaphragm when supine

A

sliding

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64
Q

prolonged nausea/vomiting can cause _____________________ imbalances, __________ or ___________, decreased __________ volume, and ______________ failure

A

fluid and electrolyte, acidosis, alkalosis (more common), plasma, circulatory (along with renal failure)

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65
Q

those infected with this strain of Helicobacter pylori are more likely to have peptic ulcer disease

A

CagA-positive strain

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66
Q

peptic ulcer disease teaching: follow _____________ drug therapy to prevent relapse, including antisecretory and antibiotic drugs

A

prescribed

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67
Q

treatment/nursing management for gastric outlet obstruction includes decompression/suction with ___________ with __________ per policy; monitoring _________ and __________; ________________ patient; one of two drugs: ________ or _______________; _______ management; __________________ replacement; ____________ or ___________ dilation

A

NG tube, irrigation, intake, output, repositioning, PPI, H2 blocker, pain, fluid and electrolyte, surgery, balloon

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68
Q

first sign of GERD/hiatal hernias in gerontologic population may be severe: ___________________ or _________________

A

esophageal bleeding, aspiration

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69
Q

sense of a lump in the throat

A

globus sensation

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70
Q

pain with (gastric, duodenal) ulcers worsens with food

A

gastric

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71
Q

gastric outlet obstruction: if gastric residual is <_____ mL after clamped for ___________ (time period), begin oral intake and progress to solids

A

200 mL, 8-12 hours

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72
Q

first symptom of peptic ulcer disease in gerontologic population may be one of these two

A

GI bleed, decreased Hct

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73
Q

management of severe acute gastritis includes placing NG tube to monitor for ____________ and perform __________ to empty stomach

A

bleeding, lavage

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74
Q

aspiration from GERD may lead to these three respiratory conditions

A

asthma, chronic bronchitis, pneumonia

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75
Q

pain management for peptic ulcer disease avoids use of _________ or _________ for 4-6 weeks unless administered with one of the drugs _____________, __________________, or _______________

A

NSAIDs, ASA, PPI, H2 blocker, misoprostol

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76
Q

type of peptic ulcer disease characterized by superficial erosion (into submucosa) and minimal inflammation

A

acute

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77
Q

duodenal ulcers manifest as _____________ or _______________ pain in _________________ region or ______; occurs ___________ (time period) after meals

A

burning, cramplike, midepigastric, back, 2-5 hours

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78
Q

precancerous lesion that often progresses to squamous cell carcinoma; characterized by red velvety patch on mouth or tongue

A

erythroplakia

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79
Q

five food triggers for eosinophilic esophagitis

A

milk, eggs, wheat, rye, beef

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80
Q

three manifestations of esophageal strictures

A

dysphagia, regurgitation, weight loss

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81
Q

gastric ulcers are more prevalent in this age/sex group

A

females >50 years

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82
Q

duodenal ulcers have highest incidence in this age group

A

35-45 years

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83
Q

most lethal complication of peptic ulcer disease

A

perforation

84
Q

four conservative care methods for peptic ulcer disease

A

adequate rest
avoid smoking/alcohol/caffeine
stress management
dietary modifications

85
Q

primary tool used for diagnosing source of upper gastrointestinal bleeding

A

endoscopy

86
Q

GERD: stay in __________ position _________ after meals; avoid _______ clothing at waist or ______________ after eating; avoid ______ and eating ________ (time period) before bedtime

A

upright, 2-3 hours, tight, bending over, milk, 3 hours

87
Q

two diet risk factors for gastritis

A

alcohol
spicy, irritating foods

88
Q

manifestations of this location of oral cancer include leukoplakia, erythroplakia, ulcers, sore spot, rough area, pain, dysphagia, lump or thickening in area, sore throat or feeling that something is stuck, difficulty chewing and speaking (later signs)

A

oral cavity

89
Q

postoperative complication of gastric surgery in which bile reflux causes damage to gastric mucosa, chronic gastritis, and peptic ulcer disease

A

bile reflux gastritis

90
Q

identify ___________, ______________, and ____________ of emesis upon assessment

A

source, timing, characteristics

91
Q

the patient with persistent vomiting, possible bowel obstruction, or paralytic ileus may need this

A

NG tube

92
Q

mortality of (gastric, duodenal) ulcers is greater than the other

A

gastric

93
Q

another term for heartburn (burning, tight sensation felt intermittently beneath lower sternum and spreading upward to throat or jaw)

A

pyrosis

94
Q

term for pain or discomfort centered in upper abdomen (mainly in or around the midline)

A

dyspepsia

95
Q

as diet progresses in patient with nausea and vomiting, give _________ diet with ________ carbohydrates and ________ fat

A

bland, high, low

96
Q

manifestations of this gastric surgery postoperative complication include weakness, sweating, palpitations, dizziness, cramping, borborygmi, and defecation urge

A

dumping syndrome

97
Q

medication-induced peptic ulcer disease occurs most often with this medication; higher risk for peptic ulcer disease when combined with at least one of these two medications

A

NSAIDs
corticosteroids, anticoagulants

98
Q

transmission of Helicobacter pylori occurs with these two methods

A

oral-oral, fecal-oral

99
Q

peptic ulcer disease teaching: avoid foods that cause _______________, such as _________ foods

A

epigastric distress, acidic

100
Q

highest incidence of stomach cancer is in these four ethnic groups

A

Asian Americans, Pacific Islanders, Blacks, Hispanics

101
Q

peptic ulcer disease teaching: avoid ______ drugs unless approved by HCP, including __________ and _____________

A

OTC, aspirin, NSAIDs

102
Q

a massive GI bleed is >_______ mL blood loss or ____% intravascular volume

A

1500; 25

103
Q

two ethnic groups in which Helicobacter pylori is most prevalent

A

Hispanic, Black

104
Q

endoscopic therapy for upper GI bleeding: one of these two substances is injected into the site

A

epinephrine, alcohol

105
Q

manifestations include heartburn, dysphagia, food impaction of esophagus, nausea, vomiting, weight loss

A

eosinophilic esophagitis

106
Q

peptic ulcer disease teaching: do not _________________ brands of PPIs, antacids, or H2 receptor blockers bought OTC without checking with HCP; can lead to harmful side effects

A

interchange

107
Q

health promotion for upper GI bleeding: avoid these three gastric irritants

A

smoking, alcohol, OTC medications

108
Q

diagnosis of gastritis is based on ______________, including history of _______ or _________ use; ________________ with _________, ____________ testing, lab test ______, _________________ in stool, __________________ to parietal cells, and __________________

A

symptoms, drug, alcohol, endoscopy, biopsy, H. pylori, CBC, occult blood, antibodies, intrinsic factor

109
Q

clinical manifestations and diagnostic studies of hiatal hernia are similar to those of ________

A

GERD

110
Q

two treatment goals for peptic ulcer disease

A

decreased gastric acidity
enhanced mucosal defense mechanisms

111
Q

manifestations of this gastric surgery postoperative complication include sweating, weakness, confusion, palpitations, tachycardia, anxiety

A

postprandial hypoglycemia

112
Q

three risk factors for gastric ulcers

A

Helicobacter pylori
NSAIDs
bile reflux

113
Q

antireflux surgery reduces reflux and enhances LES function and is reserved for these two patients

A

complications
persistent severe symptoms

114
Q

postoperative complication of gastric surgery in which gastric chyme enters small intestine as large hypertonic bolus; pulls fluid into bowel lumen causing decreased plasma volume, distention of bowel lumen, and rapid transit within 15-30 minutes of eating

A

dumping syndrome

115
Q

type of peptic ulcer disease characterized by erosion of muscular wall with formation of fibrous tissue

A

chronic

116
Q

three risk factors for GERD other than food and drugs

A

obesity, smoking, hiatal hernia

117
Q

pain with (gastric, duodenal) ulcers improves with food

A

duodenal

118
Q

surgical method for hiatal hernias involving attachment of the stomach below the diaphragm to prevent re-herniation

A

gastropexy

119
Q

three noninvasive methods that test for Helicobacter pylori

A

serology, stool, breath test

120
Q

most common risk factor for duodenal ulcers

A

Helicobacter pylori

121
Q

health promotion for upper GI bleeding: avoid __________ drugs

A

GI toxic (ex. NSAIDs, corticosteroids)

122
Q

four susceptible areas of GI tract in developing peptic ulcer disease (PUD)

A

lower esophagus
stomach
duodenum
post-op gastrojejunal anastomosis

123
Q

peptic ulcer disease teaching: avoid _______________, which promotes ulcer development and delays ulcer healing

A

cigarettes/smoking

124
Q

emesis with bright red blood indicates this

A

active bleeding due to Mallory-Weiss tear, varices, ulcers, or cancer (above stomach)

125
Q

complication of peptic ulcer disease in which stomach fills and dilates causing discomfort and pain that is worse at the end of the day; may be visibly dilated

A

gastric outlet obstruction

126
Q

decreased BP; cool, clammy skin; increased HR; decreased LOC; slow capillary refill, and decreased urine output (<0.5 mL/kg/hr) indicate this (in a patient with acute GI bleed)

A

hypovolemic shock

127
Q

pathogen risk factor for gastritis

A

H. pylori

128
Q

two environmental risk factors for gastritis

A

radiation, smoking

129
Q

when clear liquids are started in patients with nausea and vomiting, have patients drink _________ amounts (_______ mL) every ________ minutes with fluids at ___________________

A

small, 5-15, 15-20, room temperature

130
Q

disease characterized by erosion of GI mucosa from HCl acid and pepsin

A

peptic ulcer disease (PUD)

131
Q

in gastric outlet obstruction, belching and vomiting (make symptoms worse, provide relief); constipation and anorexia also occur

A

provide relief

132
Q

term for narrowing of esophagus

A

esophageal stricture

133
Q

emesis with coffee-ground color indicates this

A

gastric bleeding (blood mixes with HCl acid)

134
Q

two treatments for eosinophilic esophagitis

A

avoid known/identified allergens
drug therapy: PPIs, corticosteroids

135
Q

five environmental triggers for eosinophilic esophagitis

A

pollen, mold, cat, dog, dust mite allergens

136
Q

manifestations include abdominal pain, abdominal rigidity, hematemesis, melena, nausea

A

acute GI bleed

137
Q

surgery for GERD and hiatal hernias in which the fundus of the stomach is wrapped around the lower part of the esophagus to reinforce and repair defective barrier

A

laparoscopic fundoplication

138
Q

manifestations of this location of oral cancer include ulcer or area of thickening, soreness, or pain; limited area movement; increased saliva, slurred speech, dysphagia, toothache, earache (later signs)

A

tongue

139
Q

chronic syndrome of mucosal damage due to reflux of stomach acid into lower esophagus

A

gastroesophageal reflux disease (GERD)

140
Q

most common area of stomach in which gastric ulcers occur

A

antrum (lower part of stomach)

141
Q

health promotion for upper GI bleeding: avoid this to avoid bleeding varices

A

pressure (such as severe coughing, sneezing)

142
Q

if perforation is untreated, ___________________ occurs in 6-12 hours

A

bacterial peritonitis

143
Q

emergency management assessment of upper GI bleeding: assess/monitor these eight things

A

airway, breathing, circulation, ECG, vital signs, LOC, abdomen (bowel sounds), intake and output

144
Q

partial gastrectomy with removal of the distal 1/2 of the stomach and anastomosis of the gastric stump to the jejunum

A

gastrojejunostomy or Billroth II

145
Q

surgical therapy is done if bleeding continues despite efforts and more than _________ mL of blood is transfused or _______ occurs

A

2000, shock

146
Q

subjective assessment for upper GI bleed includes history of these four things along with one other thing

A

history of
1. previous bleeds
2. blood transfusions
3. transfusion reactions
4. illnesses/drugs that may contribute to bleeding

religious preference that prohibits blood transfusion

147
Q

peptic ulcer disease teaching: reduce or stop ___________ use

A

alcohol

148
Q

two treatments for all locations of oral cancer

A

surgery, radiation

149
Q

first-line management of upper GI bleeding that is done within 24 hours to determine treatment or need for surgery

A

endoscopy

150
Q

six patient conditions at high risk for duodenal ulcers

A

COPD, cirrhosis, pancreatitis, hyperparathyroidism, Zollinger-Ellison syndrome, chronic renal failure/chronic kidney disease

151
Q

type of hiatal hernia in which the fundus and greater curvature of the stomach roll up through the diaphragm, forming a pocket alongside the esophagus

A

paraesophageal or rolling

152
Q

partially digested emesis indicates one of these two things

A

gastric outlet obstruction
delayed gastric emptying

153
Q

incidence and mortality rates of oral cancer are highest in this group

A

black men

154
Q

mucosal damage in the GI tract associated with serious illness or physiologic stress

A

stress-related mucosal disease (SRMD)

155
Q

enzyme made by Helicobacter pylori bacteria that activates the immune response and release of cytokines, leading to increased gastric secretion and tissue damage, leading to peptic ulcer disease

A

urease

156
Q

a patient who has a LINX reflux management system cannot have this medical test

A

MRI

157
Q

GERD: head of bed increased on _______ inch blocks

A

4-6

158
Q

diagnostic study for peptic ulcer disease that directly visualizes the mucosal lining of the stomach; ulcers or tumors can be directly seen, and biopsies can be taken

A

esophagogastroduodenoscopy (EGD)

159
Q

type of hiatal hernia that can strangle the stomach or have its blood supply cut off; is a medical emergency

A

paraesophageal or rolling

160
Q

many antiemetic drugs act in the _____________________ via the ______________________ to block neurochemicals that trigger nausea and vomiting

A

central nervous system (CNS), chemoreceptor trigger zone (CTZ)

161
Q

highest incidence of esophageal cancer is in this group

A

non-Hispanic white men

162
Q

peptic ulcer disease teaching: frequent use of _____________ for arthritis in gerontologic population can increase incidence

A

NSAIDs

163
Q

acute care management of upper GI bleeding: NG tube management: place in proper __________ and assess aspirate for ________

A

position, blood

164
Q

do not perform endoscopy when ________________ is present and if concerned that ___________ may occur

A

inflammation, perforation

165
Q

diagnostic test used to diagnose source of upper gastrointestinal bleeding when endoscopy cannot be done or when bleeding persists after endoscopy

A

angiography

166
Q

(gastric, duodenal) ulcers are more common than the other

A

duodenal

167
Q

endoscopic therapy for upper GI bleeding: this is used to cauterize the bleed

A

thermal ablation

168
Q

(gastric, duodenal) ulcers cause more bleeding episodes than the other

A

duodenal

169
Q

three methods used to treat varices

A

ligation, sclerotherapy, balloon tamponade

170
Q

two medications that can cause medication-induced esophagitis

A

NSAIDS, potassium

171
Q

esophageal bleeding can be caused by these three things

A

chronic esophagitis, Mallory-Weiss tear, esophageal varices

172
Q

three tests for peptic ulcer disease (other than gold standard and noninvasive H. pylori tests)

A

barium contrast, high fasting serum gastrin levels, secretin stimulation

173
Q

immediate focus of treatment for perforation includes stopping ____________ and restoring _________________

A

spillage, blood volume

174
Q

esophageal strictures occur most often from _________ but can also occur from ___________ ingestion, ______________, _____________, or ______________

A

GERD, chemical, radiation, surgery, trauma

175
Q

GERD: ________ diet and _________ meals with ________ in between meals

A

low-fat, small, fluids

176
Q

health promotion for upper GI bleeding: teach about these three things if patient has blood dyscrasia

A

disease, drugs, risk of GI bleeding

177
Q

repeated esophagitis/ulcerations may lead to these three things

A

scar tissue, stricture, dysphagia

178
Q

management for acute or chronic gastritis involves identifying ______________

A

cause

179
Q

option for GERD patients who have symptoms despite maximum medical management; a ring of titanium beads with magnets are implanted into LES to prevent reflux by keeping it closed when not eating or drinking

A

LINX reflux management system

180
Q

gastric content analysis for peptic ulcer disease involves checking _____ and for ________ or _______

A

pH, blood, bile

181
Q

most common complication of peptic ulcer disease

A

hemorrhage (GI bleeding)

182
Q

two drinks other than water that may be tolerated in patients with nausea and vomiting

A

flat sodas at room temperature
warm tea

183
Q

to prevent stomach distention in patient with nausea and vomiting, tell patient to eat food _________ and in ___________ amounts

A

slowly, small

184
Q

surgical enlargement of the pyloric sphincter to promote the easy passage of contents from the stomach

A

pyloroplasty

185
Q

patient with GERD may report respiratory symptoms such as these three

A

wheezing, coughing, dyspnea

186
Q

peptic ulcer disease: allow _______________ (time period) for healing

A

3-6 months

187
Q

surgical management of hiatal hernias focuses on these three things

A

reduce hernia
optimize LES pressure
prevent movement of gastroesophageal junction

188
Q

GERD: _______ weight

A

lose

189
Q

emergency management of upper GI bleeding: patient will require __________________ IV access for fluids, PPIs, and blood

A

two large bore

190
Q

emergency management/assessment of upper GI bleed involves hourly _____________________ monitoring, ____________________ monitoring, ___________ administration, assessing for ____________ and _____________, administering IV ________, and __________________________________

A

urine output, hemodynamic, oxygen, perforation, peritonitis, fluids, blood/blood product transfusions

191
Q

treatment for small perforations

A

self-sealing; monitor for obstruction

192
Q

dumping syndrome lasts about/less than ________

A

1 hour

193
Q

resection of the lower esophagus, removal of the stomach, and anastomosis of the esophagus to the jejunum

A

gastrectomy

194
Q

emesis with bile indicates this

A

obstruction below ampulla of Vater (small opening that enters into duodenum)

195
Q

term for black, tarry stools from upper GI source

A

melena

196
Q

gastric ulcers manifest as ____________ pain __________ (time period) after meals with complaint of __________ or ____________ pain

A

epigastric, 1-2 hours, burning, gaseous

197
Q

endoscopic therapy for GERD that uses heat energy to create lesions to thicken LES

A

radiofrequency ablation

198
Q

acute care for peptic ulcer disease includes placing on _______ status, placing __________, giving __________, checking ___________, monitoring for _________, ________ and __________ management, and adequate _______

A

NPO, NG tube, IV fluids, vital signs, shock, pain, anxiety, rest

199
Q

manifestations may be ASYMPTOMATIC or may include anorexia, nausea, vomiting, epigastric tenderness, hemorrhage, and pernicious anemia

A

chronic gastritis

200
Q

acute care management of upper GI bleeding: when lavage is used, instill _______ mL at a time into the stomach, then drain

A

50-100

201
Q

two complementary herbs that may help nausea and vomiting

A

ginger, peppermint

202
Q

manifestations of this gastric surgery postoperative complication include epigastric distress temporarily relieved with vomiting

A

bile reflux gastritis

203
Q

when caring for a patient with nausea and vomiting in acute care, keep patient _____ and give ___________ until ______ intake is tolerated

A

NPO, IV fluids, oral

204
Q

seven complications of hiatal hernias

A

GERD, esophagitis, ulcers, hemorrhage, stenosis, strangulation, aspiration

205
Q

complication of peptic ulcer disease in which GI contents spill into peritoneal cavity

A

perforation

Nursing of Adults I (21 decks)

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