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Adult Nursing II > Digestive Test > Flashcards

Digestive Test Flashcards

1
Q

aluminum hydroxide/Amphojel

A

Classification: T- antiulcer agent
P- antacid
Common use:
Time of administration:

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2
Q

aluminum & magnesium hydroxide/Gelusil/Maalox/Mylanta

A

Classification: T- antiulcer
P- antiacids
Common use:
Time of administration:

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3
Q

amoxixillin/Amoxil

A

Classiification: T- antiulcer agent
P- aminopenicillins
Common use:
Time of administration:

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4
Q

azathioprine/Imuran

A

Classification: T- immunosuppressant
P- purine antagonist
Common use:
Time of administration:

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5
Q

bismuth subsalicylate/Pepto-Bismol

A

Classification: T- antidiarrheal, antiulcer agent
P- adsorbents
Common use:
Time of administration:

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6
Q

cimetadine/Tagamet

A

Classification: T- antiulcer agent
P- histamine H2 antagonist
Common use:
Time of administration:

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7
Q

dicyclomine/Bentyl

A

Classification: T- antispasmodics
P- anticholinergics
Common use:
Time of administration:

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8
Q

esmeprazole/Nexium

A

Classification: T- antiulcer agents
P- proton-pump inhibitor
Common use:
Time of administration:

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9
Q

famotidine/Pepcid

A

Classification: T- antiulcer agent
P- histamine H2 antagonist
Common use:
Time of administration:

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10
Q

ibuprofen/Motrin

A

Classification: T- antipyretics, antirheumatics, nonopioid analdesics, nonsteroidal antiinflammatory agents
P- nonopioid analgesics
Common use:
Time of administration:

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11
Q

infliximab/Remicade

A

Classification: T- antirheumatics (DMARDs), gastrointestinal anti-inflammatories
P- monoclonal antibodies
Common use:
Time of administration:

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12
Q

lansoprazole/Prevacid

A

Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:

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13
Q

omeprazole/Prilosec

A

Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:

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14
Q

pantoprazole/Protonix

A

Classification: T- antiulcer agents
P- proton-pump inhibitors
Common use:
Time of administration:

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15
Q

ranitidine/Zantac

A

Classification: T- antiulcer agents
P- histamine H2 antagonist
Common use:
Time of administration:

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16
Q

sulfasalazine/Azulfidine

A

Classification: T- antirheumatics (DMARDs), gastrointestinal anti-inflammatories
Common use:
Time of administration:

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17
Q

sucralfate/Carafate

A

Classification: T- antiulcer agents
P- GI protectants
Common use:
Time of administration:

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18
Q

Teachings & responsibilities for Fecal Occult Blood/Hemoccult testing:

A

Avoid certain foods & meds 2-3 days prior: NSAIDs, Irons, ASA, iodine, anticoagulants, red meat, fish, turnips, horseradish

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19
Q

Teachings & responsibilities for Barium Enema

A

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…

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20
Q

Teachings & responsibilities for UGI/Barium Swallow

A

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.

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21
Q

Teachings & responsibilities for Colonoscopy

A

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.

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22
Q

Teachings & responsibilities for Esophagogastroduodenoscopy (EGD)

A

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.

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23
Q

Teachings & responsibilities for MRI

A

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.

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24
Q

Which foods should be eliminated or decreased in a pt with gastritis in order to provide symptom relief?

A

Milk (dairy), coffee, tea, soda, chocolate, decaf coffee, alcohol, any food in which the pt feels cause noticeable symptoms.

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25
What can cause gastritis?
corticosteroids, NSAIDs, ASA, smoking (nicotine), alcohol, H. pylori bacteria
26
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.
27
What are the most serious risks/complications to a pt with PUD?
Hemorrhage leading to shock. Perforations leading to peritonitis.
28
Surgical procedures that may be performed to treat PUD and/or its complications:
Partial gastrectomy, vagotomy, BilRoth I
29
If a pt did have a gastrectomy or gastric bypass surgery, what are some risks?
Pernicious anemia, dumping syndrome, malnutrition
30
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.
31
Vagotomy
A surgical procedure that involves resection of the vagus nerve
32
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.
33
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).
34
What could indicate a ruptured appendicitis?
Sudden relief of pain followed later by return of pain with symptoms of peritonitis.
35
NG tubes are used to ____ the bowel. This (increases or decreases) work of the bowel.
decompress; decreases
36
The passage of flatus indicates that the bowel is...
working again and the pt may now be able to resume eating.
37
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.
38
Diverticulitis
An inflammation in one or more of the out-pouches, possibly caused by food residue or stool impacting in one of the sacs.
39
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.
40
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.
41
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.
42
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.
43
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.
44
What medical interventions are likely with a mechanical intestinal obstruction?
NPO, IV hydration, NG tube placement & attachment to suction, Analgesia, bed-rest, surgery
45
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.
46
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.
47
What is the most serious risk of peritonitis?
Infection
48
What complication occurs frequently with peritonitis? Why?
Pneumonia/Atelectasis. Inflammation of the peritoneum causes irritation of the diaphragm, causing pain on inspiration, so typically breathing is shallow, leading to hypostatic pneumonia.
49
What instructions can you give a pt with hemorrhoids?
Sitz baths or warm compresses 4x a day, stool softeners to prevent straining, high fiber diet with > fluids. Pain relieving creams and suppositories. Modifications of toilet habits.
50
Warning signs for colorectal cancer
Change in bowel habits, presence of blood in stool, bloating, abdominal pain
51
What teaching points should be included for a post-op colostomy pt?
Expect stoma to be deep red to pink in color. Assure pt it will shrink in size as edema subsides. NPO after surgery until flatus is passing through stoma, indicating that the bowel is functioning again. Normal to see small amounts of sersanguinous drainage n pouch.
52
Sersanguinous drainage
Drainage from a wound or other area of the body that is tinged with blood.the color of the drainage will have a red or pink appearance.
53
Are there any special concerns for a pt with an ileostomy?
Skin around stoma is particularly vulnerable to excoriation and must be protected. Foods must be chewed throughly to prevent obstruction of stoma opening.
54
Key nursing interventions for any pt following abdominal surgery:
NPO until bowel sounds return or passage of flatus. IV hydration maintenance while NPO, possible NG tube. Monitor I&O, weights. Monitor vital signs and pain level. Check for return of bowel sounds. Expect return in 1-2 days (24-48 hours). Check for softness of abdomen. Distention could mean bowel not working yet or development of peritonitis. TCDB, incentive spirometer to prevent atelectasis. Monitor incision. Once eating resumes, observe for normal bowel function.
55
In a pt with gastroenteritis, is it expected to see frequent vomiting and diarrhea? And what is the treatment?
Yes. Treat nausea with anti-emetics, sips of fluid as tolerated to prevent dehydration (potential risk). Depending on cause, may need antibiotics.
56
Character of stools in Crohn's Disease
Semisoft, 3-4/day, possibly with blood
57
Character of stools in Ulcerative Colitis
>10 liquid stools/day with blood
58
Presence of blood in stool in Crohn's Disease
yes, but not as frequent or severe as UC
59
Presence of blood in stool in Ulcerative Colitis
Yes
60
Pain with Crohn's Disease
Cramping
61
Pain with Ulcerative Colitis
Cramping with urgency
62
Presence of steatorrhea in Crohn's Disease
Yes
63
Presence of steatorrea in Ulcerative Colitis
No
64
Bowel sounds in Crohn's Disease
Hyperactive
65
Bowel sounds in Ulcerative Colitis
Hyperactive
66
Data collection: Peritonitis
High fever, severe pain, rigid abdomen, no bowel sounds
67
Data collection: Bowel obstruction
Cramping, nausea, constipation, fecal vomiting
68
Data collection: Hernia, strangulated
Sudden, severe abdominal/groin pain
69
Data collection: Appendicitis
RLQ pain, nausea, vomiting, fever
70
Data collection: Diverticulitis
Cramping pain, left side, nausea
71
Data collection: Colorectal Cancer
Changing in bowel habits, bloating, blood in stool
72
Data collection: Peptic ulcer
Epigastric pain and pressure especially after eating
73
Data collection: Hemorrhoids
Itchy rectal area, rectal bleeding, pain with defecation
74
Data collection: Gastroenteritis
Nausea, frequent vomiting, diarrhea, dehydration risk
75
Antacids are given ___ meals
AFTER
76
Anticholinergics are given ___ meals
BEFORE
77
Cytoprotective agents are given ___ meals
BEFORE
78
Which anti-ulcer medication forms a paste over the stomach mucosa and thereby protects is?
Cytoprotective agents: sucralfate/Carafate
79
Mrs. Jacobs has been taking ranitidine/Zantac BID for several years. Lately she notices episodes of heartburn in the evening after supper, sometimes as often as twice/week. What type of medication would likely be prescribed for Mrs. Jacobs at this point? Why?
A proton pump inhibitor. Histamine receptor blockers such as ranitidine reduce stomach acid secretions while a PPI essentially blocks acid production, relieving heartburn.
80
You are giving Mr. Bellows a dose of chewable Gaviscon. What is important to tell him?
Chew tablets thoroughly before swallowing. Follow with water.
81
Antacids should be given ___ meals. Why?
after, to neutralize acid when acid is being secreted due to food being present in the stomach.
82
Which classification of medications stops nearly ALL gastric acid secretion?
Proton-pump inhibitor (PPI)
83
Which classification inhibits or blocks secretion of gastric hydrochloric acid?
Histamine receptor antagonist
84
Which classification fortifies the gastric mucosal barrier? When should it be administered? Give an example.
They are GI anti-inflammatories, which have a local effect on colon mucosal layer. By reducing inflammation, reduces pain. Many contain both aspirin and sulfa compounds.
85
What are common effects and side effects of anticholinergics? Example.
Slow down peristalsis which then reduces spasms of colon and reduces cramping (which is why also called anti-spasmodics). With peristalsis slowed, constipation may occur. It may also affect urinary system causing urinary retention. Also "dry up" secretions such as gastric secretions improving symptoms by decreasing acid. This can dry up other secretions, leading to dry eyes, dry mouth, thirst, less perspiration. May additionally cause elevated heart rate. dicyclomine/Bentyl
86
Classify: ranitidine/Zantac
Histamine receptor antagonist
87
Classify: sucralfate/Carafate
Cytoprotective agent/Mucosal Barrier Fortifier
88
esomeprazole/Nexium
Proton Pump Inhibitor
89
omeprazole/Prilosec
Proton Pump Inhibitor
90
cimetadine/Tagamet
Histamine receptor antagonist
91
A drug that should be administered cautiously in all pts but particularly the elderly? Why?
cimetadine/Tagamet. It can cause confusion in the elderly. Has many drug-drug interactions.
92
What type of medication is infliximab/Remicade?
Biologic response modifier; DMARD, GI anti-inflammatory
93
For what disorder is infliximab/Remicade prescribed?
Exacerbation of Crohn's disease
94
Data collection: Diverticulitis
Cramping pain, left side, nausea
95
Data collection: Colorectal Cancer
Changing in bowel habits, bloating, blood in stool
96
Data collection: Peptic ulcer
Epigastric pain and pressure especially after eating
97
Data collection: Hemorrhoids
Itchy rectal area, rectal bleeding, pain with defecation
98
Data collection: Gastroenteritis
Nausea, frequent vomiting, diarrhea, dehydration risk
99
Antacids are given ___ meals
AFTER
100
Anticholinergics are given ___ meals
BEFORE
101
Cytoprotective agents are given ___ meals
BEFORE
102
Which anti-ulcer medication forms a paste over the stomach mucosa and thereby protects is?
Cytoprotective agents: sucralfate/Carafate
103
Mrs. Jacobs has been taking ranitidine/Zantac BID for several years. Lately she notices episodes of heartburn in the evening after supper, sometimes as often as twice/week. What type of medication would likely be prescribed for Mrs. Jacobs at this point? Why?
A proton pump inhibitor. Histamine receptor blockers such as ranitidine reduce stomach acid secretions while a PPI essentially blocks acid production, relieving heartburn.
104
You are giving Mr. Bellows a dose of chewable Gaviscon. What is important to tell him?
Chew tablets thoroughly before swallowing. Follow with water.
105
Antacids should be given ___ meals. Why?
after, to neutralize acid when acid is being secreted due to food being present in the stomach.
106
Which classification of medications stops nearly ALL gastric acid secretion?
Proton-pump inhibitor (PPI)
107
Which classification inhibits or blocks secretion of gastric hydrochloric acid?
Histamine receptor antagonist
108
Which classification fortifies the gastric mucosal barrier? When should it be administered? Give an example.
They are GI anti-inflammatories, which have a local effect on colon mucosal layer. By reducing inflammation, reduces pain. Many contain both aspirin and sulfa compounds.
109
What are common effects and side effects of anticholinergics? Example.
Slow down peristalsis which then reduces spasms of colon and reduces cramping (which is why also called anti-spasmodics). With peristalsis slowed, constipation may occur. It may also affect urinary system causing urinary retention. Also "dry up" secretions such as gastric secretions improving symptoms by decreasing acid. This can dry up other secretions, leading to dry eyes, dry mouth, thirst, less perspiration. May additionally cause elevated heart rate. dicyclomine/Bentyl
110
Classify: ranitidine/Zantac
Histamine receptor antagonist
111
Classify: sucralfate/Carafate
Cytoprotective agent/Mucosal Barrier Fortifier
112
esomeprazole/Nexium
Proton Pump Inhibitor
113
omeprazole/Prilosec
Proton Pump Inhibitor
114
cimetadine/Tagamet
Histamine receptor antagonist
115
A drug that should be administered cautiously in all pts but particularly the elderly? Why?
cimetadine/Tagamet. It can cause confusion in the elderly. Has many drug-drug interactions.
116
What type of medication is infliximab/Remicade?
Biologic response modifier; DMARD, GI anti-inflammatory
117
For what disorder is infliximab/Remicade prescribed?
Exacerbation of Crohn's disease

Adult Nursing II (5 decks)

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