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NCM 116 LEC > Disturbances in Ingestion > Flashcards

Disturbances in Ingestion Flashcards

1
Q

Relaxation, dysfunction and incompetence of Lower Esophageal Spincter

A

GERD

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2
Q

Laparoscopic surgical intervention to wrap around gastric fundus to the lower area of the esophagus

A

Nissen and Toupet Fundoplication

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3
Q

Examples of Proton pump inhibitors and their MOA

A

Omeprazole, Lanzoprazole, rabeprazole

To treat hyperacidity to decrease gastric acid .

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4
Q

AVOID position for patients with GERD

A

Supine/Lie

2-3 after meal

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5
Q

How many inches is HOB elevated in patients with GERD

A

4-8

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6
Q

Adhere to: increase OFI, high protein, low-fat, non-spicy and non irritating foods. What is this diet indicated for

A

GERD

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7
Q

Diagnostic test for GERD (give 2)

A

esophageal pH monitoring

Upper GI endoscopy (barium swallow)

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8
Q

identify the ff clinical manifestations in patients with GERD: 2B, 2R, 2D in

A

Bloating, Belching, Reflux, Regurgitation, Dyspepsia,Dysphagia

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9
Q

12H-36H ambulatory to evaluate the degree of acid reflux

A

Esophageal pH monitoring

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10
Q

Most common manifestation of GERD

A

heartburn

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11
Q

Give the causative factors of GERD

A

age, increased intra-abdominal pressure, lifestyle, stomach problems

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12
Q

Gaviscon, Aluminum,Magnesium Hydroxide are examples of

A

Antacids

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13
Q

Antihistamine drugs give 2

A

Ranitidine, Cemetidine

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14
Q

stricture or ulceration of esophagus

A

Esophagitis

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15
Q

Explain barret’s esophagus

A

chronic irritation and long-standing untreated GERD metaplasia, reversible change in cell type (flat to columnar; pink to red) in cell lining of LES, precancerous lesion

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16
Q

Cancer common in bulimic patients

A

esophageal cancer

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17
Q

Give examples of prokinetic drugs

A

Baclofen, Metoclopramide, Cisapride

18
Q

anti reflux barrier

A

LES

19
Q

correct twisting/torsion of stomach, prevent restriction of blood flow, reduce hernia, increase LES pressure.

A

Gastropexy

20
Q

Complications of hiatal hernia give 3

A

GERD, esophagitis , ulceration, bleeding, hemorrhage

Stenosis, obstruction, regurgitation, strangulation, tracheal aspiration

21
Q

Protrusion/enlargement/moving/pushing upward of stomach and gastric mucosa in the lower thoracic cavity or esophageal hiatus

A

Hiatal hernia

22
Q

most common hernia 90%

A

esophageal hernia

23
Q

Risk factors for hernia

A

increased intra-abdominal pressure, structural changes, lifestyle, physical exertion

24
Q

Clinical manifestations: HERNIA

A 
Heartburn
Epigastric pain
Regurgitation
Nocturnal heartburn
Indigestion
After-eat Dysphagia, Belching, fullness
25
Q

Diagnostic tests of hiatal hernia

A

Barium Swallow-

26
Q

Part of stomach is directly pushed upward or rolled upward through the diaphragm

A

Diaphragmatic hernia

27
Q

Surgical Management for hernia

A

Herniotomy (sac excision)
Herniorrhaphy (defect closure)
Anti-reflux procedure

28
Q

cuts/separate esophageal muscle fibers to relieve stricture, allow food to pass

A

Esophagomyotomy (Heller myotomy)

29
Q

Pharmacologic management for achalasia

A

Botulinum toxin

Calcium Channel blocker, Nitrates

30
Q

Patient with achalasia should sleep with head?

A

elevated

31
Q

ideal consistency of diet for patients with achalasia

A

liquid, soft diet

32
Q

Confirmatory test for achalasia to check for esophageal pressure

A

Manometry

33
Q

endoscopic procedure use balloon to stretch the narrowed esophagus (watch out for perforation- fever, abdominal tenderness), very painful (sedation)

A

Pneumatic dilatation

34
Q

food sticking in lower esophagus

A

sensation globus

35
Q

2 most common symptom of achalasia

A

halitosis, sensation globus

36
Q

Patients with achalasia are prone to

A

aspiration

37
Q

Risk factor of achalasia

A

idiopathic, age

38
Q

Absent or ineffective peristalsis of the distal esophagus;

Esophagus failed to relax, narrows, strictures, dilates, incomplete relax, obstructs, decrease emptying

A

Achalasia

39
Q

dilated tortuous esophagus (food and fluid) or megaesophagus (enlargement of lower esophagus)

A

Advanced stage of achalasia

40
Q

Nursing management for achalasia

A

teach px to eat slowly

NCM 116 LEC (3 decks)

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