Chapter 55 Flashcards
Clarithromycin nursing implications
Give with caution to patients with renal impairment
monitor renal function lab values
Can increased BUN level
Amoxicillin nursing implications
Take with food or immediately after
side effects G.I. disturbance disturbance;
nausea vomiting diarrhea
Tetracycline nursing implications
Take at least one hour before meals or two hours after meals;Dairy products in other foods may interfere with absorption
avoid direct sunlight and wear sunscreen photosensitivity can occur
Metronidazole nursing implications
Take with food avoid alcohol doing therapy and at least three days
side effects G.I. disturbance; nausea vomiting diarrhea
drug alcohol reaction; severe nausea vomiting and headache
Type A gastritis
Nonerosive
chronic gastritis = inflammation of the glands, fundus body of stomach
has a genetic link
Type B chronic gastritis
Affects the glands of antrum
Does not effect the entire stomach
most common form of gastritis
Caused by H pie Laurie infection
Key features of acute gastritis
Rapid onset of epic gastric pain or discomfort
hematemesis
Gastric hemorrhage
dyspepsia
anorexia
nausea and vomiting
Key features of chronic gastritis
Vague report of epigastric pain that is relieved by food
intolerance of fatty and spicy foods
precocious anemia
anorexia
nausea or vomiting
Interventions for acute gastritis
Collaborate to relieve the symptoms remove or reduce discomfort
blood transfusion may be necessary
fluid/electrolyte replacement with severe loss
Surgery with a major bleeding or aspiration
administer prescribed drugs that block and buffer secretions and relieve pain
intervention for chronic gastritis
elimination of the causative agent
treatment of any underlying disease such as Uremia Crohn’s disease avoid toxic substances such as alcohol tobacco
health Teaching
drugs and nutritional therapy are also used
Vitamin B12 for prevention or treatment of pernicious anemia
Patient teaching for gastritis
Avoid drugs/irritants such as cortisteroid, erythromycin,aspirin ASA,naproxen, ibuprofen (Motrin Advil) OTC should not be used
teach patients to read all labels for aspirin or other NSAIDs
limit intake caffeine or high acid tomato product or citric juices
heavily season stronger/hot spicy foods, bell peppers, onions
choose bland none spicy
small frequent meals
alcohol and tobacco should be avoided
Hematemesis
Massive bleeding patient VOMIT bright red or coffee ground blood usually indicates bleeding at or above the duodenojejunal or upper G.I. bleeding
Granular dark vomitus=coffee ground appearance
Melena
Minimum bleeding is a occult blood in STOOL; dark tarry stool
Digestion of blood within the duodenum and small intestines
most common Duodenal ulcers
Upper G.I. bleeding
Bright red or coffee ground vomitus Melena decrease blood pressure increased heart rate Weak peripheral pulses acute confusion;older adults vertigo dizziness or lightheadedness Syncope decreased hemoglobin or Hematocrit
Red blood cell normal range
4.2 to 6.1
Decreased levels indicate anemia or hemorrhage increase levels indicate possible panic hypoxia or polycythemia
Hemoglobin
Females 12 to 16
males 14-18
decreased levels indicate possible anemia or hemorrhage
Hematocrit levels
Females 37 to 47%
male 42 to 52%
decrease levels indicate anemia or hemorrhage
Peritonitis
Sudden sharp pain beginning in the mid epigastric region and spread over the entire abdomen.
Tender rigid and broad like pain
patient often in fetal position
Severely ill within hours
bacterial septicemia and hypervolemic shock follow
Peristalsis diminishes
paralytic ileus develops
THIS is a life threatening ER- prepare pt for surgery
Symptoms of obstruction
Bloating
nausea vomiting
may have hypochloremic (metabolic alkalosis)
hypokalemia
MISOPROSTOL
A prostaglandin analog
action =Stimulate Mucosal protection & decrease gastric acid secretion
avoid magnesium contain and assess such as myLanta can cause diarrhea
do not administer to pregnant women
Risk factor for peptic ulcer disease
H pylori
NSAIDS
Substancesthat contribute to gastroduodenal author
Corticosteroids
Theophylline
Caffeine
patients receiving radiation therapy
They stimulate hydrochloric acid production
Dyspepsia
Indigestion is the most commonly reported symptoms associated with PD
described as a sharp Burning or gnawing in pain
Where is the gastric pain located
Occurs in the upper epigastric region localized to the left of the midline and it’s aggravated by food
Where is Duodenum pain located
To the right or below the epigastrium
occurs 90 minutes to 3 hours after eating
often awakens the patient at night
What foods would you teach a patient with PD not to eat?
Tomatoes hot spices fried foods onions alcohol caffeine drinks certain drugs like NSAIDs or Corte steroids
How do you assess fluid volume deficit from bleeding ulcer?
Take orthostatic blood pressure
monitor for signs and symptoms of dehydration
Assess for dizziness when upright
Older adults experience dizziness when they get out of the bed= risk for falls
Features of gastric ulcer
No differentiation in blood group may be malnourished normal secretion or hyposecretion Occur 30 to 60 minutes after meal Worse when eating/ingestion of food hematemesis malignant less than 10% atrophic gastritis reoccurring the same location
Mary features of duodenal ulcer
Most often type O blood type usually well nourished hypersecretions occur the 1 1/2-3 hours after a meal occurs at night often to awake patient between 1and 2 AM relieved by ingestion of food Recurring 60% to 90% no gastritis
