Disorders of the GI System: Upper and Lower Flashcards
Types of Stomatitis:
Herpetic
Fungal: candida
Nutritional deficiency (B vitamins, folate,iron)
Chemical: chemo, alcohol, tobacco
8th cause of death in men
Oral Cancer from tobacco use
Oral Cancer:
Squamous cell>
sores in mouth, leukoplakia(white patches)
Can be a protective mechanism(ANS)
Vomiting
Antiemetics works in the
brain and vagus nerve
First line antiemetic for radiation/chemo
Zofran
Dopamine antagonist for post-op and motion sickness
Reglan
Med sometimes given for chemo related n/v
glucocorticosteroids
Neurokinin 1 receptor antogonist
Emend
Tropane alkaloid and anticholinergic drug used to treat motion sickness and post-op n/v
Scopolamine
What fluid & electrolyte problems would occur with prolonged nausea & vomiting?
Dehydration
K+ & Na+ loss
Metabolic alkalosis
Aspiration
Type of IV fluid that can help pts with stomach virus
NS (2 liters)
Black, tarry stool indicative of GI bleeding
Melena
Color of bile emesis
Green
GI test:
Measures PH of stomach contents
Gastric analysis
Vitamin that helps form RBC’s and hemoglobin
Vit B12
Types of emesis
Coffee ground emesis
bile emesis
hematemesis
melena
Prepping for GI tests
Clear liquids, high fiber
NPO the night before
No meds
No smoking for 24hrs prior
Nursing Diagnosis for the following:
Dehydration
K+ & Na+ loss
Metabolic alkalosis
Aspiration
Fluid volume deficit
Type of illness related to GERD, smoking, or Barrett’s
Esophageal Cancer
Esophageal Disorder:
High mortality
Risk increases >age 70
Squamous cell, adenocarcinoma
Symptom= Dysphagia
Esophageal Cancer
Esophageal Disorder:
long term GERD that changes cells=RISK
Risks – tobacco, age, male, low fiber
Barrett’s Esophagus
Treatment for Barrett’s:
remove/replace esophagus, chemo, radiation
A syndrome of:
any condition that is caused by reflux of stomach contents into the lower esophagus (lower esophageal sphincter (LES)
Gastro-esophageal Reflux Disease (GERD)
Syndrome with many causes:
hiatal hernia, incompetent LES, decreased clearance of esophagus/stomach
Gastro-esophageal Reflux Disease (GERD)
Symptoms: Heartburn (Pyrosis)
respiratory: cough, sneeze
gastric symptoms
Gastro-esophageal Reflux Disease (GERD)
Burning sensation in the esophagus (medical term for heartburn)
Pyrosis
Treatments for GERD:
elevate HOB
no smoking,
antacids, H2 blockers, cholinergics, proton pump inhibitors, small meals/ no caffeine
Weight loss
Surgery for GERD:
Nissen fundoplication
Inflammation of gastric mucosa
Gastritis
Acute Gastritis is due to
A break in mucosa barrier
Superficial ulcerations in gastritis may occur which can lead to
hemorrhage.
Factors that may injure gastric mucosa:
Diet:
ETOH, spicy foods
Factors that may injure gastric mucosa:
meds:
NSAIDS, ASA
EtOH stands for
ethyl alcohol
PH level of stomach
1-2.5
Chemical that stimulates mucus in the stomach
prostaglandin
Major cause of Chronic gastritis
H. pylori
Intrinsic factor is a
natural substance normally found in the stomach
A lack of intrinsic factor leads to
pernicious anemia and vitamin B12 deficiency,
Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate.
pernicious anemia
A condition that occurs when your stomach lining becomes inflamed
Chronic gastritis
Treatment for chronic gastritis
Treat the cause, non-steroid meds, avoid alcohol, spicy foods
Chronic gastritis ABC
Autoimmune
Bacterial (helicobacter)
Chemical
Number 1 cause of GI bleeding
Bleeding ulcers
Stool occult test
Guaiac test
Occult
hidden
Number 1 cause of ulcers
H. pylori
Bacteria that attacks the stomach lining
H. pylori
Accounts for almost 80% of gastric and 95% of duodenal ulcers
H. pylori
GERD pack is
A combo of meds taken for 2 weeks to treat GERD
Frank blood
Bright red blood
The passage of fresh blood through the anus path, usually in or with stools
Hematochezia
H. pylori
Helicobacter pylori
H. pylori is diagnosed with
Biopsy; breath & stool tests
A sudden inflammation or swelling in the lining of the stomach.
Acute gastritis
What is treatment to remove H. pylori?
Antibiotics> 2-3 weeks
Bismuth salts
PPI
PPI
Proton pump inhibitors
PPI meds
omeprazole, protonix, pantoprazole
Erosion of the mucosa anywhere in the GI tract: esophagus, stomach, duodenum, jejunum
Peptic ulcer
PUD
Peptic Ulcer Disease
Most common type of peptic ulcer. Makes up 80% of ulcers
gastric & duodenal
LES
Lower esophageal sphincter
Ulcers of the antrum of stomach, commonly seen in ages 50-60
increased with LES problems, stress ulcers
Gastric ulcers
Type of ulcer where pain increases 1-2 hr after meals or food
Gastric ulcer
Type of ulcer:
age 35-45, PAIN 2-4h AFTER, pain relief with food, antacids,
Duodenal ulcer
Type of ulcer that may cause weight gain from trying to get relief
Duodenal ulcer
Diagnosing ulcers
Endoscopy preferred
Biopsy
Barium study (Upper GI)
Treatment that could be done for ulcers during endoscopy
Cauterization
Can pts eat after an endoscopy?
No food or drink until gag reflex returns
Medications for ulcers
2-3 antibiotics>
proton pump inhibitors
bismuth salts
H2 blockers or PPI
H2 blockers or PPI are used alone to treat
NSAID-induced and other ulcers not associated with h pylori
Treatments for ulcers
Stress Reduction & Rest
Smoking Cessation
Dietary Modifications
Meds
Surgery
Surgical Management of ulcers:
recommended for
intractable ulcers as a last resort
Surgical procedures to treat ulcers include:
vagotomy, with or without pyloroplasty
Billroth I & Billroth II procedures
Gastrectomy that includes removing the part of your stomach with cancer, nearby lymph nodes, and possibly parts of other organs near the tumor
Subtotal gastrectomy
a surgical operation in which one or more branches of the vagus nerve are cut, typically to reduce the rate of gastric secretion
Vagotomy
An operation to widen the pylorus, the opening between your stomach and your small intestine.
Pyloroplasty
an operation in which the pylorus is removed and the distal stomach is anastomosed directly to the duodenum
Billroth I
gastroduodenostomy
Billroth I
reconstruction surgery, in which a loop of jejunum is mobilized and anastomosed to the gastric remnant;
Billroth II
gastrojejunostomy
Billroth II
Second most common cancer in the world
Stomach cancer
Populations at highest risk for stomach cancer
men, Hispanic, African American, Asian American
Lifestyles and conditions with highest risk for stomach cancer
Family history, tobacco, pernicious anemia, H pylori, diet high in smoked/cured meats
Less than 30% of people with this condition live past 5 yr if it spread at diagnosis
Stomach cancer
Vitamin deficiency anemia; a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate
Pernicious anemia
Condition that progresses & causes perforation, bleeding & spreads to liver, bone & peritoneal tissue
Stomach Cancer