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Test 4 > Chapter 55 > Flashcards

Chapter 55 Flashcards

1
Q

Causes of acute gastritis?

A

NSAID, alcohol, radiation, smoking, stress, infection of H.pylori, staph, strep, e.coli, salmonella

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2
Q

Difference in origins between Type A chronic and Type B chronic

A

Type A is genetic, autosomal pattern , presence of antibodies to parietal cells and intrinsic factor

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3
Q

Causes of local irritation in chronic Type B?

A

Caffeine, ETOH, Radiation, smoking

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4
Q

Bacteria most often associated with chronic gastritis?

A

helicobacter pylori

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5
Q

Features of acute gastritis?

A 
rapid onset
nausea, vomiting
hematemesis (vomit blood)
gastric hemorrhage 
dyspepsia
anorexia
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6
Q

Features of chronic gastritis?

A 
vague reports of epigastric pain that is related to foods
anorexia
nausea vomiting 
intolerance of fatty or spicey foods
pernicious anemia
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7
Q

What is pernicious anemia?

A

deficiency of vitamin B12

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8
Q

Interventions for chronic gastritis?

A 
eliminate the disease 
eliminate H. pylori 
H2 agonist
antacids
proton pump inhibitors
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9
Q

Name the H2 agonists

A

famotidine

nizatidine

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10
Q

What class of medds is used as a buffering agent?

A

antacids, magnesium hydroxide, aluminum hydroxide, simethicone

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11
Q

Name the proton pump inhibitors

A

omeprazole

pantoprazole

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12
Q

Whats does H2 agonist do?

A

block gastric secretions

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13
Q

What does proton pump inhibitors do?

A

suppress gastric acid secretions

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14
Q

Hematemesis?

A

vomiting bright red blood or coffee-ground blood

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15
Q

What does hematemesis indicate?

A

bleeding above the duodenojejunal junction, referred to as an upper GI bleed

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16
Q

what is melena?

A

dark tarry stool

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17
Q

symptoms of a hemorrhage due to ulcers

A

Vomits bright red or coffee-ground blood, black tarry stool

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18
Q

What is a perforated ulcer?

A

entire thickness of stomach or duodenum is worn away

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19
Q

Symptoms of perforation

A

sudden sharp pain starts at the mid-epigastric region and spreads over entire abdomen, patient may be in fetal position

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20
Q

Danger of perforation?

A

leakage into the peritoneal cavity causing bacterial septicemia and hypovolemic shock

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21
Q

Where does a pyloric obstruction occur?

A

at the pylorus, the gastric outlet

22
Q

What causes a pyloric obstruction?

A

caused by scarring, edema, inflammation

23
Q

What are the symptoms of pyloric obstruction?

A

bloating, vomiting, hyochloremic alkalosis, hypokalemia

24
Q

When would intractability occur and what are the features?

A

intractability develops from complications of ulcers, stress, non-compliant with treatment, symptoms interfere with ADLs, recurrent pain and discomfort despite treatment

25
Q

Physical assessment findings when a patient has a perforation

A

rigid, broad like abdomen with rebound tenderness and pain

26
Q

What is dyspepsia?

A

sharp, burning, gnawing pain, fullness or hunger

27
Q

Where does general gastric ulcer pain occur?

A

upper epigastrium, left of midline

28
Q

What aggravates a gastric ulcer?

A

food

29
Q

Where is duodenal ulcer pain located?

A

located to right or below epigastrium

30
Q

Generally, what are the symptoms of ulcers?

A 
discomfort/pain/heartburn
melena
vomiting
fluid status
orthostatic vitals 
dizzy
low hgb and hct
31
Q

What aggravates a duodenal ulcer?

A

not food, food relieves it

32
Q

Patient teaching for antacids

A
  • give 2 hours after meals and at bedtime
  • do not give within 1-2 hours of other meds (affects absorption)
  • assess patient for renal disease
33
Q

Patient teaching for H2 antagonists

A

give single dose at bedtime for GI ulcers, PUD, and heartburn

34
Q

Patient teaching for Mucosal Barriers

A
  • give 1 hour before and 2 hours after meals
  • do not give within 30min of giving antacids
  • do not take aspirin with this
  • stools may be black
  • may cause constipation
35
Q

Patient teaching for Proton Pump Inhibitors

A
  • do not crush, take whole

- may cause weakening of bones

36
Q

Patient teaching for antimicrobials

A
  • take with food
37
Q

Steps when patient has a GI bleed?

A
  • ABCs
  • Oxygen
  • Start 2 large bore IVs
    monitor vitals, HCT, O2 sats
38
Q

What causes ACUTE GASTRIC DILATION?

A

clogged NG tube

39
Q

Symptoms of ACUTE GASTRIC DILATION?

A 
abdominal distension
epigastric pain 
tachycardia 
hypotension 
fullness/ hiccups
40
Q

what is a total gastrectomy?

A

Total gastrectomy – growth removed in the proximal upper third of stomach

41
Q

syndrome associated with a total gastrectomy?

A

DUMPING SYNDROME

42
Q

Cause of early dumping syndrome?

A

rapid emptying of food contents into the small intestine causing fluid shift to the gut causing abdominal distension

43
Q

Cause of late dumping syndrome?

A

rapid increase of insulin production

44
Q

Diet for dumping syndrome?

A
  • high fat and protein, low carb diet (atkins)
  • No milk, sweets, or sugars
  • Low roughage
45
Q

Other interventions for dumping syndrome?

A
  • decrease meal size
  • no fluids during meals
  • HOB 45 degrees (Semi-recumbent) eating, flat after eating
  • Sedatives/antispasmodics to delay gastric emptying
46
Q

What is a subtotal gastrectomy?

A

removal of tumor located in the mid-portion distal part of the stomach

47
Q

Syndrome associated with subtotal gastrectomy?

A

Alkaline reflux gastropathy

48
Q

Symptoms of Alkaline reflux gastropathy?

A
  • Early satiety
  • Abdominal discomfort
  • Vomiting
  • Atrophic glossitis
  • Pernicious anemia
49
Q

What is Atrophic glossitis?

A

tongue is shiny, smooth, and beefy due to vitamin B12 deficiency

50
Q

What is Pernicious anemia?

A

decrease in red blood cells when the body can’t absorb enough vitamin B-12

51
Q

Labs associated with alkaline reflux syndrome?

A 
Low B12 
Folic acid 
Iron 
Calcium 
Vitamin D
52
Q

Management for alkaline reflux syndrome?

A

ALL THAT SHIT BITCH

Test 4 (8 decks)

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