Digestive Test Flashcards
aluminum hydroxide/Amphojel
Classification: T- antiulcer agent
P- antacid
Common use:
Time of administration:
aluminum & magnesium hydroxide/Gelusil/Maalox/Mylanta
Classification: T- antiulcer
P- antiacids
Common use:
Time of administration:
amoxixillin/Amoxil
Classiification: T- antiulcer agent
P- aminopenicillins
Common use:
Time of administration:
azathioprine/Imuran
Classification: T- immunosuppressant
P- purine antagonist
Common use:
Time of administration:
bismuth subsalicylate/Pepto-Bismol
Classification: T- antidiarrheal, antiulcer agent
P- adsorbents
Common use:
Time of administration:
cimetadine/Tagamet
Classification: T- antiulcer agent
P- histamine H2 antagonist
Common use:
Time of administration:
dicyclomine/Bentyl
Classification: T- antispasmodics
P- anticholinergics
Common use:
Time of administration:
esmeprazole/Nexium
Classification: T- antiulcer agents
P- proton-pump inhibitor
Common use:
Time of administration:
famotidine/Pepcid
Classification: T- antiulcer agent
P- histamine H2 antagonist
Common use:
Time of administration:
ibuprofen/Motrin
Classification: T- antipyretics, antirheumatics, nonopioid analdesics, nonsteroidal antiinflammatory agents
P- nonopioid analgesics
Common use:
Time of administration:
infliximab/Remicade
Classification: T- antirheumatics (DMARDs), gastrointestinal anti-inflammatories
P- monoclonal antibodies
Common use:
Time of administration:
lansoprazole/Prevacid
Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:
omeprazole/Prilosec
Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:
pantoprazole/Protonix
Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:
ranitidine/Zantac
Classification: T- antiulcer agents
P- histamine H2 antagonist
Common use:
Time of administration:
sulfasalazine/Azulfidine
Classification: T- antirheumatics (DMARDs), gastrointestinal anti-inflammatories
Common use:
Time of administration:
sucralfate/Carafate
Classification: T- antiulcer agents
P- GI protectants
Common use:
Time of administration:
Teachings & responsibilities for Fecal Occult Blood/Hemoccult testing:
Avoid certain foods & meds 2-3 days prior: NSAIDs, Irons, ASA, iodine, anticoagulants, red meat, fish, turnips, horseradish
Teachings & responsibilities for Barium Enema
Exam of colon using X-ray contrast instilled via rectum. Extensive cleaning of bowels through laxatives, enemas. Clear liquids allowed. Support client in bowel evacuation- placement of commode. call-light, privacy, emotional support…
Teachings & responsibilities for UGI/Barium Swallow
X-ray exam of esophagus, stomach, duodenum by swallowed contrast. Pt will be NPO. Must swallow a large amount of liquid barium. Films are taken at intervals as barium passes through the system. Be sure all films are completed before allowing pt to eat. Observe for re-hydration & nutritional status after extended period of being NPO, particularly with elderly pts. Laxatives given following exam to promote evacuation of barium and avoid constipation or development of an obstruction. Assure pt that passage of white stool is normal.
Teachings & responsibilities for Colonoscopy
Direct visualization of pts colon (large intestines). Extensive cleansing of bowel with laxatives, enemas. NPO prior to exam. Sedation given IV. Support pt during bowel prep, clear liquids allowed. Pt may be gassy and have some cramping following test. Observe for post-procedural bleeding, hemorrhage, particularly if polyps removed or biopsies have been performed.
Teachings & responsibilities for Esophagogastroduodenoscopy (EGD)
Direct visualization of esophagus, stomach, and first part of duodenum via a scope. NPO prior to exam. Will be slightly sedated and a topical anesthetic will be sprayed on back of throat to inhibit gag reflex. Following procedure, nurse must check for return of gag reflex before allowing fluids/foods.
Teachings & responsibilities for MRI
Computerized scan utilizing magnets for imaging. Pt cannot wear metal ot have metal in their bodies. Remind pt that the scan takes 30-45 minutes, is loud, and requires the pt to be still within an enclosed space. Sedation or the administration of anti-anxiety medications may be necessary.
Which foods should be eliminated or decreased in a pt with gastritis in order to provide symptom relief?
Milk (dairy), coffee, tea, soda, chocolate, decaf coffee, alcohol, any food in which the pt feels cause noticeable symptoms.
What can cause gastritis?
corticosteroids, NSAIDs, ASA, smoking (nicotine), alcohol, H. pylori bacteria
Other modifications to lifestyle & eating habits should a GERD/gastritis/PUD pt be instructed about?
< or eliminate smoking. Limit alcohol. Avoid eating before bedtime. Sit up for 1-2 hours after eating. Eat smaller meals more frequently (avoid over eating). Raise the head of the bed on blocks to prevent nighttime reflux. Avoid foods containing caffeine. Take medications as directed. Monitor stool for blood.
What are the most serious risks/complications to a pt with PUD?
Hemorrhage leading to shock. Perforations leading to peritonitis.
Surgical procedures that may be performed to treat PUD and/or its complications:
Partial gastrectomy, vagotomy, BilRoth I
If a pt did have a gastrectomy or gastric bypass surgery, what are some risks?
Pernicious anemia, dumping syndrome, malnutrition
Why may a vagotomy be done for a pt with a peptic ulcer?
To remove nerve innervation from the stomach and < acid secretion by reducing the ability of the stomach to produce acid.
Vagotomy
A surgical procedure that involves resection of the vagus nerve
Postprandial dumping syndrome can occur after gasrectomy. How can the pt be instructed to prevent this?
Small, frequent meals of high protein, high fiber foods. Avoid simple carbohydrates. Limit fluids with meals and within one hour of meals. Lie down after eating.
What are nursing responsibilities regarding any pt with undiagnosed abdominal pain? Why?
No oral medications or oral alalgesia (could mask symptoms). No heat to the abdomen (could augment growth of bacteria in appendicitis, diverticulitis). NPO (might be heading to surgery, could worsen a bowel obstruction, would rest irritated bowel). No laxatives, no enemas (could cause rupture of appendix by increasing peristalsis).
What could indicate a ruptured appendicitis?
Sudden relief of pain followed later by return of pain with symptoms of peritonitis.
NG tubes are used to ____ the bowel. This (increases or decreases) work of the bowel.
decompress; decreases
The passage of flatus indicates that the bowel is…
working again and the pt may now be able to resume eating.
Diverticulosis
A condition of the colon, usually the sigmoid, where multiple out-pouches in the wall of the colon are present. Possibly caused by long-term constipation or low-fiber diets.
Diverticulitis
An inflammation in one or more of the out-pouches, possibly caused by food residue or stool impacting in one of the sacs.
What key treatment points are included in the care plan of a pt with diverticulitis?
The bowel must be rested. Pt will be NPO, possibly with a NG suction. IV fluid hydration is necessary. Pt will be on bed-rest. Analgesia, antibiotics are ordered. A temporary colostomy to further rest the bowel may be necessary.
What instructions will be given to prevent further attacks of diverticulosis?
A soft diet, high in fiber is believed to help reduce occurrence of diverticulosis and episodes of diverticulitis. Some physicians recommend adherence to a low residue diet as well as but its effectiveness as a preventative measure for diverticulitis is unclear.
Describe a low-residue, low-fiber diet.
Avoid foods with edible, visible seeds, such as popcorn, cucumbers, raspberries, tomatoes, strawberries. Also avoiding whole grain breads, seeds and nuts, and peelings such as apple and potato peeling and fresh leafy greens such as spinach.
What data is likely to be collected on a pt with an intestinal obstruction?
Distended abdomen, cramping, and increased abdominal pain, no bowel movements, possibly fecal vomiting. In mechanical obstructions, high-pitched bowel sounds. In paralytic obstructions, no or diminished bowel sounds.
Describe a paralytic ileus. What interventions can be expected?
Nerve transmission to part of the bowel (usually ileum) is interrupted which results in immobility of that part of the bowel. This is a non-mechanical or neurogenic obstruction. Increase ambulation to encourage bowel motility, frequent oral care for NPO pt, daily weights, monitoring for return of bowel sounds.
What medical interventions are likely with a mechanical intestinal obstruction?
NPO, IV hydration, NG tube placement & attachment to suction, Analgesia, bed-rest, surgery
What are risk factors for hernias?
Excessive abdominal weight, obesity, pregnancy, genetic susceptibility, poor abdominal muscle tone, increases in intra-abdominal pressure such as heavy lifting and straining.
What are the symptoms of peritonitis?
Abdominal pain that is increasing in severity with a tense or distended, board-like, rigid abdomen. No bowel sounds. Constipation. Nausea and vomiting. Weak and rapid pulse. Elevated WBC. Elevated temp.
