Chapter 46: Upper Gastrointestinal Problems Flashcards
1
Q
term that describes hot, bitter, or sour liquid coming into the throat or mouth
A
regurgitation
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
3
Q
(gastric, duodenal) ulcers more likely to cause obstruction
A
gastric
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
5
Q
emergency management of upper GI bleeding: patient will need these three lab studies
A
CBC, clotting studies, type and crossmatch
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
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
8
Q
five patients at increased risk for stress-related mucosal disease (SRMD)
A
critically ill, coagulopathy, liver disease, organ failure, renal replacement therapy
9
Q
goal for managing upper GI bleeding with endoscopy
A
coagulate or thrombose bleed
10
Q
severing of the vagus nerve; decreases gastric acid secretion
A
vagotomy
11
Q
conservative management of hiatal hernias focuses on reducing _____________________
A
intraabdominal pressure
12
Q
guaiac test that detects blood in gastric secretions, comitus, or stool
A
occult
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
14
Q
GERD: avoid these three things
A
alcohol, caffeine, smoking
15
Q
after history and physical, gold standard of diagnosing GERD
A
upper GI endoscopy (with biopsy)
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
17
Q
these three lab tests can be done to help diagnose peptic ulcer disease
A
CBC, liver enzymes, serum amylase
18
Q
emesis with fecal odor (feces) and bile indicates this
A
obstruction below pylorus (hallmark sign of bowel obstruction)
19
Q
laboratory tests for upper GI bleeding include CBC for ______________ and ____________; _______ for GI tract bacteria breakdown protein
A
hemoglobin, hematocrit, BUN
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)
21
Q
the gerontologic population has an increased _____________ and ______________ with peptic ulcer disease
A
morbidity, mortality
22
Q
peptic ulcer disease teaching: __________ can be related to PUD; learn and use management strategies
A
stress
23
Q
supportive care for acute gastritis involves _______, _______ status, ___________, _______________ drugs, and monitoring for ___________
A
rest, NPO, IV fluids, antiemetic, dehydration
24
Q
endoscopic therapy for upper GI bleeding: these are used to compress the vessel
A
clips or bands
25
type of oral cancer that starts in the mouth
oral cavity cancer
26
regurgitation occurs when the ___________________________ didn't close all the way
lower esophageal sphincter
27
emergency management of upper GI bleeding: watch for this in the older adult
fluid overload
28
risk factors for this location of oral cancer include tobacco and alcohol use, chronic irritation, and syphilis
tongue
29
condition characterized by esophageal metaplasia of cells that increases risk for cancer
Barrett's esophagus
30
this type of peptic ulcer penetrates the mucosa only
erosion
31
four other diagnostic studies for GERD (other than history, physical, upper GI endoscopy, biopsy)
esophagram (barium swallow)
motility (manometry) studies
pH monitoring
radionuclide studies
32
four lifestyle factors that increase risk for peptic ulcer disease
alcohol, smoking, caffeine, psychologic distress
33
lifestyle modifications for chronic gastritis include avoiding ___________, eating ___ (small, large) meals per day of nonirritating food, and adhering to __________________
smoking, 6, small, prescribed drugs
34
swelling of esophagus due to infiltration of eosinophils
eosinophilic esophagitis
35
GERD is typically diagnosed via __________ and ____________ and response to ___________ and __________ therapies
history, physical, behavioral, drug
36
to prevent aspiration in a patient with nausea and vomiting who cannot manage self-care, place in one of these two positions
semi-Fowler's
side-lying
37
manifestations of perforation include sudden, severe abdominal _________ that radiates to ______ and ___________; no relief with _______ or ____________; __________, _____________ abdomen; bowel sounds _________; _________ and ________________; respirations _____________; pulse ___________ and ________
pain, back, shoulders, food, antacids, rigid, boardlike, absent, nausea, vomiting, shallow, increased, weak
38
most accurate procedure (gold standard) to determine presence and location of ulcer
endoscopy
39
surgical method for hiatal hernias involving closure of the hiatal defect
herniorrhaphy
40
risk of dumping syndrome is reduced with _______ after eating
rest
41
manifestations of this location of oral cancer include an indurated, painless ulcer
lip
42
manifestations include anorexia, nausea, vomiting, epigastric tenderness, hemorrhage
acute gastritis
43
two complementary therapies that may help nausea and vomiting
acupressure, acupuncture
44
two most common causes of upper gastrointestinal bleeding from stomach and duodenal origin
H. pylori, NSAIDs (cause peptic ulcer disease)
45
two treatments for esophageal strictures
dilation with bougies or balloons using endoscopy or fluoroscopy
surgical excision
46
factors involved in pathogenesis of GERD include impaired __________________ motility, delayed ________________, small intestine reflux of _______, defective ____________ defense, ____________ dysfunction (decreased pressure), and reflux of _______________
esophageal, gastric emptying, bile, mucosal, lower esophageal sphincter (LES), gastric contents
47
surgical method for hiatal hernias involving excision of the hernia sac
herniotomy
48
precancerous lesion due to smoking that becomes hyperkeratosis; characterized by white patch on mouth mucosa or tongue
leukoplakia
49
when taking PPIs and corticosteroids for eosinophilic esophagitis, monitor for this disease
candidiasis
50
four causes of obstruction in distal stomach and duodenum (complication of peptic ulcer disease)
edema, inflammation, pylorospasm, scar tissue
51
physical/objective assessment for upper GI bleeding includes these five things
1. LOC
2. frequent VS
3. skin color
4. capillary refill (shock)
5. abdomen (distention, guarding, peristalsis)
52
six factors (foods, substances other than drugs) that decrease lower esophageal sphincter (LES) pressure (increase irritation) (GERD)
alcohol, chocolate, fatty foods, nicotine, peppermint/spearmint, tea/coffee (caffeine)
53
acid reflux into the mouth may lead to _______________
dental erosion
54
these three food items may be given to patients with nausea and vomiting
dry toast, crackers, gelatin
55
endoscopic therapy for GERD in which a biopsy is obtained to determine presence of any cancer
endoscopic mucosal resection (EMR)
56
treatment for large perforations
surgery for closure; suctioning of peritoneal cavity
57
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
lip
58
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
oral cavity
59
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
postprandial hypoglycemia (variant of dumping syndrome)
60
partial gastrectomy with removal of the distal 2/3 of the stomach and anatomosis of the gastric stump to the duodenum
gastroduodenostomy or Billroth I
61
type of oral cancer that develops in the part of the throat just behind the mouth
oropharyngeal cancer
62
two diagnostic studies for eosinophilic esophagitis
endoscopy with biopsy
allergy testing
63
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
sliding
64
prolonged nausea/vomiting can cause _____________________ imbalances, __________ or ___________, decreased __________ volume, and ______________ failure
fluid and electrolyte, acidosis, alkalosis (more common), plasma, circulatory (along with renal failure)
65
those infected with this strain of Helicobacter pylori are more likely to have peptic ulcer disease
CagA-positive strain
66
peptic ulcer disease teaching: follow _____________ drug therapy to prevent relapse, including antisecretory and antibiotic drugs
prescribed
67
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
NG tube, irrigation, intake, output, repositioning, PPI, H2 blocker, pain, fluid and electrolyte, surgery, balloon
68
first sign of GERD/hiatal hernias in gerontologic population may be severe: ___________________ or _________________
esophageal bleeding, aspiration
69
sense of a lump in the throat
globus sensation
70
pain with (gastric, duodenal) ulcers worsens with food
gastric
71
gastric outlet obstruction: if gastric residual is <_____ mL after clamped for ___________ (time period), begin oral intake and progress to solids
200 mL, 8-12 hours
72
first symptom of peptic ulcer disease in gerontologic population may be one of these two
GI bleed, decreased Hct
73
management of severe acute gastritis includes placing NG tube to monitor for ____________ and perform __________ to empty stomach
bleeding, lavage
74
aspiration from GERD may lead to these three respiratory conditions
asthma, chronic bronchitis, pneumonia
75
pain management for peptic ulcer disease avoids use of _________ or _________ for 4-6 weeks unless administered with one of the drugs _____________, __________________, or _______________
NSAIDs, ASA, PPI, H2 blocker, misoprostol
76
type of peptic ulcer disease characterized by superficial erosion (into submucosa) and minimal inflammation
acute
77
duodenal ulcers manifest as _____________ or _______________ pain in _________________ region or ______; occurs ___________ (time period) after meals
burning, cramplike, midepigastric, back, 2-5 hours
78
precancerous lesion that often progresses to squamous cell carcinoma; characterized by red velvety patch on mouth or tongue
erythroplakia
79
five food triggers for eosinophilic esophagitis
milk, eggs, wheat, rye, beef
80
three manifestations of esophageal strictures
dysphagia, regurgitation, weight loss
81
gastric ulcers are more prevalent in this age/sex group
females >50 years
82
duodenal ulcers have highest incidence in this age group
35-45 years
83
most lethal complication of peptic ulcer disease
perforation
84
four conservative care methods for peptic ulcer disease
adequate rest
avoid smoking/alcohol/caffeine
stress management
dietary modifications
85
primary tool used for diagnosing source of upper gastrointestinal bleeding
endoscopy
86
GERD: stay in __________ position _________ after meals; avoid _______ clothing at waist or ______________ after eating; avoid ______ and eating ________ (time period) before bedtime
upright, 2-3 hours, tight, bending over, milk, 3 hours
87
two diet risk factors for gastritis
alcohol
spicy, irritating foods
88
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)
oral cavity
89
postoperative complication of gastric surgery in which bile reflux causes damage to gastric mucosa, chronic gastritis, and peptic ulcer disease
bile reflux gastritis
90
identify ___________, ______________, and ____________ of emesis upon assessment
source, timing, characteristics
91
the patient with persistent vomiting, possible bowel obstruction, or paralytic ileus may need this
NG tube
92
mortality of (gastric, duodenal) ulcers is greater than the other
gastric
93
another term for heartburn (burning, tight sensation felt intermittently beneath lower sternum and spreading upward to throat or jaw)
pyrosis
94
term for pain or discomfort centered in upper abdomen (mainly in or around the midline)
dyspepsia
95
as diet progresses in patient with nausea and vomiting, give _________ diet with ________ carbohydrates and ________ fat
bland, high, low
96
manifestations of this gastric surgery postoperative complication include weakness, sweating, palpitations, dizziness, cramping, borborygmi, and defecation urge
dumping syndrome
97
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
NSAIDs
corticosteroids, anticoagulants
98
transmission of Helicobacter pylori occurs with these two methods
oral-oral, fecal-oral
99
peptic ulcer disease teaching: avoid foods that cause _______________, such as _________ foods
epigastric distress, acidic
100
highest incidence of stomach cancer is in these four ethnic groups
Asian Americans, Pacific Islanders, Blacks, Hispanics
101
peptic ulcer disease teaching: avoid ______ drugs unless approved by HCP, including __________ and _____________
OTC, aspirin, NSAIDs
102
a massive GI bleed is >_______ mL blood loss or ____% intravascular volume
1500; 25
103
two ethnic groups in which Helicobacter pylori is most prevalent
Hispanic, Black
104
endoscopic therapy for upper GI bleeding: one of these two substances is injected into the site
epinephrine, alcohol
105
manifestations include heartburn, dysphagia, food impaction of esophagus, nausea, vomiting, weight loss
eosinophilic esophagitis
106
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
interchange
107
health promotion for upper GI bleeding: avoid these three gastric irritants
smoking, alcohol, OTC medications
108
diagnosis of gastritis is based on ______________, including history of _______ or _________ use; ________________ with _________, ____________ testing, lab test ______, _________________ in stool, __________________ to parietal cells, and __________________
symptoms, drug, alcohol, endoscopy, biopsy, H. pylori, CBC, occult blood, antibodies, intrinsic factor
109
clinical manifestations and diagnostic studies of hiatal hernia are similar to those of ________
GERD
110
two treatment goals for peptic ulcer disease
decreased gastric acidity
enhanced mucosal defense mechanisms
111
manifestations of this gastric surgery postoperative complication include sweating, weakness, confusion, palpitations, tachycardia, anxiety
postprandial hypoglycemia
112
three risk factors for gastric ulcers
Helicobacter pylori
NSAIDs
bile reflux
113
antireflux surgery reduces reflux and enhances LES function and is reserved for these two patients
complications
persistent severe symptoms
114
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
dumping syndrome
115
type of peptic ulcer disease characterized by erosion of muscular wall with formation of fibrous tissue
chronic
116
three risk factors for GERD other than food and drugs
obesity, smoking, hiatal hernia
117
pain with (gastric, duodenal) ulcers improves with food
duodenal
118
surgical method for hiatal hernias involving attachment of the stomach below the diaphragm to prevent re-herniation
gastropexy
119
three noninvasive methods that test for Helicobacter pylori
serology, stool, breath test
120
most common risk factor for duodenal ulcers
Helicobacter pylori
121
health promotion for upper GI bleeding: avoid __________ drugs
GI toxic (ex. NSAIDs, corticosteroids)
122
four susceptible areas of GI tract in developing peptic ulcer disease (PUD)
lower esophagus
stomach
duodenum
post-op gastrojejunal anastomosis
123
peptic ulcer disease teaching: avoid _______________, which promotes ulcer development and delays ulcer healing
cigarettes/smoking
124
emesis with bright red blood indicates this
active bleeding due to Mallory-Weiss tear, varices, ulcers, or cancer (above stomach)
125
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
gastric outlet obstruction
126
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)
hypovolemic shock
127
pathogen risk factor for gastritis
H. pylori
128
two environmental risk factors for gastritis
radiation, smoking
129
when clear liquids are started in patients with nausea and vomiting, have patients drink _________ amounts (_______ mL) every ________ minutes with fluids at ___________________
small, 5-15, 15-20, room temperature
130
disease characterized by erosion of GI mucosa from HCl acid and pepsin
peptic ulcer disease (PUD)
131
in gastric outlet obstruction, belching and vomiting (make symptoms worse, provide relief); constipation and anorexia also occur
provide relief
132
term for narrowing of esophagus
esophageal stricture
133
emesis with coffee-ground color indicates this
gastric bleeding (blood mixes with HCl acid)
134
two treatments for eosinophilic esophagitis
avoid known/identified allergens
drug therapy: PPIs, corticosteroids
135
five environmental triggers for eosinophilic esophagitis
pollen, mold, cat, dog, dust mite allergens
136
manifestations include abdominal pain, abdominal rigidity, hematemesis, melena, nausea
acute GI bleed
137
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
laparoscopic fundoplication
138
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)
tongue
139
chronic syndrome of mucosal damage due to reflux of stomach acid into lower esophagus
gastroesophageal reflux disease (GERD)
140
most common area of stomach in which gastric ulcers occur
antrum (lower part of stomach)
141
health promotion for upper GI bleeding: avoid this to avoid bleeding varices
pressure (such as severe coughing, sneezing)
142
if perforation is untreated, ___________________ occurs in 6-12 hours
bacterial peritonitis
143
emergency management assessment of upper GI bleeding: assess/monitor these eight things
airway, breathing, circulation, ECG, vital signs, LOC, abdomen (bowel sounds), intake and output
144
partial gastrectomy with removal of the distal 1/2 of the stomach and anastomosis of the gastric stump to the jejunum
gastrojejunostomy or Billroth II
145
surgical therapy is done if bleeding continues despite efforts and more than _________ mL of blood is transfused or _______ occurs
2000, shock
146
subjective assessment for upper GI bleed includes history of these four things along with one other thing
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
peptic ulcer disease teaching: reduce or stop ___________ use
alcohol
148
two treatments for all locations of oral cancer
surgery, radiation
149
first-line management of upper GI bleeding that is done within 24 hours to determine treatment or need for surgery
endoscopy
150
six patient conditions at high risk for duodenal ulcers
COPD, cirrhosis, pancreatitis, hyperparathyroidism, Zollinger-Ellison syndrome, chronic renal failure/chronic kidney disease
151
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
paraesophageal or rolling
152
partially digested emesis indicates one of these two things
gastric outlet obstruction
delayed gastric emptying
153
incidence and mortality rates of oral cancer are highest in this group
black men
154
mucosal damage in the GI tract associated with serious illness or physiologic stress
stress-related mucosal disease (SRMD)
155
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
urease
156
a patient who has a LINX reflux management system cannot have this medical test
MRI
157
GERD: head of bed increased on _______ inch blocks
4-6
158
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
esophagogastroduodenoscopy (EGD)
159
type of hiatal hernia that can strangle the stomach or have its blood supply cut off; is a medical emergency
paraesophageal or rolling
160
many antiemetic drugs act in the _____________________ via the ______________________ to block neurochemicals that trigger nausea and vomiting
central nervous system (CNS), chemoreceptor trigger zone (CTZ)
161
highest incidence of esophageal cancer is in this group
non-Hispanic white men
162
peptic ulcer disease teaching: frequent use of _____________ for arthritis in gerontologic population can increase incidence
NSAIDs
163
acute care management of upper GI bleeding: NG tube management: place in proper __________ and assess aspirate for ________
position, blood
164
do not perform endoscopy when ________________ is present and if concerned that ___________ may occur
inflammation, perforation
165
diagnostic test used to diagnose source of upper gastrointestinal bleeding when endoscopy cannot be done or when bleeding persists after endoscopy
angiography
166
(gastric, duodenal) ulcers are more common than the other
duodenal
167
endoscopic therapy for upper GI bleeding: this is used to cauterize the bleed
thermal ablation
168
(gastric, duodenal) ulcers cause more bleeding episodes than the other
duodenal
169
three methods used to treat varices
ligation, sclerotherapy, balloon tamponade
170
two medications that can cause medication-induced esophagitis
NSAIDS, potassium
171
esophageal bleeding can be caused by these three things
chronic esophagitis, Mallory-Weiss tear, esophageal varices
172
three tests for peptic ulcer disease (other than gold standard and noninvasive H. pylori tests)
barium contrast, high fasting serum gastrin levels, secretin stimulation
173
immediate focus of treatment for perforation includes stopping ____________ and restoring _________________
spillage, blood volume
174
esophageal strictures occur most often from _________ but can also occur from ___________ ingestion, ______________, _____________, or ______________
GERD, chemical, radiation, surgery, trauma
175
GERD: ________ diet and _________ meals with ________ in between meals
low-fat, small, fluids
176
health promotion for upper GI bleeding: teach about these three things if patient has blood dyscrasia
disease, drugs, risk of GI bleeding
177
repeated esophagitis/ulcerations may lead to these three things
scar tissue, stricture, dysphagia
178
management for acute or chronic gastritis involves identifying ______________
cause
179
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
LINX reflux management system
180
gastric content analysis for peptic ulcer disease involves checking _____ and for ________ or _______
pH, blood, bile
181
most common complication of peptic ulcer disease
hemorrhage (GI bleeding)
182
two drinks other than water that may be tolerated in patients with nausea and vomiting
flat sodas at room temperature
warm tea
183
to prevent stomach distention in patient with nausea and vomiting, tell patient to eat food _________ and in ___________ amounts
slowly, small
184
surgical enlargement of the pyloric sphincter to promote the easy passage of contents from the stomach
pyloroplasty
185
patient with GERD may report respiratory symptoms such as these three
wheezing, coughing, dyspnea
186
peptic ulcer disease: allow _______________ (time period) for healing
3-6 months
187
surgical management of hiatal hernias focuses on these three things
reduce hernia
optimize LES pressure
prevent movement of gastroesophageal junction
188
GERD: _______ weight
lose
189
emergency management of upper GI bleeding: patient will require __________________ IV access for fluids, PPIs, and blood
two large bore
190
emergency management/assessment of upper GI bleed involves hourly _____________________ monitoring, ____________________ monitoring, ___________ administration, assessing for ____________ and _____________, administering IV ________, and __________________________________
urine output, hemodynamic, oxygen, perforation, peritonitis, fluids, blood/blood product transfusions
191
treatment for small perforations
self-sealing; monitor for obstruction
192
dumping syndrome lasts about/less than ________
1 hour
193
resection of the lower esophagus, removal of the stomach, and anastomosis of the esophagus to the jejunum
gastrectomy
194
emesis with bile indicates this
obstruction below ampulla of Vater (small opening that enters into duodenum)
195
term for black, tarry stools from upper GI source
melena
196
gastric ulcers manifest as ____________ pain __________ (time period) after meals with complaint of __________ or ____________ pain
epigastric, 1-2 hours, burning, gaseous
197
endoscopic therapy for GERD that uses heat energy to create lesions to thicken LES
radiofrequency ablation
198
acute care for peptic ulcer disease includes placing on _______ status, placing __________, giving __________, checking ___________, monitoring for _________, ________ and __________ management, and adequate _______
NPO, NG tube, IV fluids, vital signs, shock, pain, anxiety, rest
199
manifestations may be ASYMPTOMATIC or may include anorexia, nausea, vomiting, epigastric tenderness, hemorrhage, and pernicious anemia
chronic gastritis
200
acute care management of upper GI bleeding: when lavage is used, instill _______ mL at a time into the stomach, then drain
50-100
201
two complementary herbs that may help nausea and vomiting
ginger, peppermint
202
manifestations of this gastric surgery postoperative complication include epigastric distress temporarily relieved with vomiting
bile reflux gastritis
203
when caring for a patient with nausea and vomiting in acute care, keep patient _____ and give ___________ until ______ intake is tolerated
NPO, IV fluids, oral
204
seven complications of hiatal hernias
GERD, esophagitis, ulcers, hemorrhage, stenosis, strangulation, aspiration
205
complication of peptic ulcer disease in which GI contents spill into peritoneal cavity
perforation
