[Exam 1/Final] Chapter 46 - Management of Patients with Gastric and Duodenal Disorders

Question 1

Functions of the Digestive Tract: What are some of the different functions?

Answer 1

Breakdown for food/digestion

Absorption of nutrients

Elimination of undigested foodstuffs and other waste products

Question 2

Quadrants of Abdomen: RUQ contains what?

Answer 2

The liver

Question 3

Quadrants of Abdomen: LUQ contains what?

Answer 3

The Stomach

Question 4

Gastric Cancer - Risk Factors: What are the biggest risk factors for this?

Answer 4

Smoked, salted, pickled foods

Decreased fruits/vegetables

H. Pylori

Question 5

Gastric Cancer: Why is this a poor prognosis?

Answer 5

Because it is largely asymptomatic in early stages

Question 6

Gastric Cancer: This is typically adenocarcinomas, which arises from what?

Answer 6

Mucus producing cells of the inner-most lining of the stomach.

Question 7

Gastric Cancer - CMs: Symptoms that is seen in early stages?

Answer 7

Indigestion, Early Satiety, Weight Loss, Abdominal Pain, Bloating after Meals, Decreased Appetite, N/V

Question 8

Gastric Cancer - Assessments: What may we be able to assess later on?

Answer 8

Palpable Mass (Late)
Ascites (Metastasis) (caused by portal hypertension)

Question 9

Gastric Cancer - Diagnosis: How will this be diagnosed in an individual?

Answer 9

Through an EGD, Barium X-Ray, and CBC

Question 10

Gastric Cancer - Treatment: Non-Surgical includes whaht?

Answer 10

Chemo, but there is a decreased chance of a cure so this is more palliative to make the patient more comfortable.

Question 11

Gastric Cancer - Surgical Tx: What is a Billroth 1?

Answer 11

They take a portion of the duodenum and connect it to the body of the stomach.

Question 12

Gastric Cancer - Surgical Tx: What is removed in a Billroth I?

Answer 12

A portion of the lower stomach is removed.

Question 13

Gastric Cancer - Surgical Tx: What is a BillRoth II?

Answer 13

A portion of the lower stomach is removed, but is now connected to the jejenum.

Question 14

Gastric Cancer - Surgical Tx: Billroth II is likely to cause what?

Answer 14

Dumping Syndrome, which is the result of patient eating a lot of fluid and drawing fluid to the small intestine. Abdominal cramping with N/V is experienced.

Question 15

Nursing Process for Patient with Gastric Surgery - Diagnosis: This includes what?

Answer 15

Imbalanced Nutrition due to dumping syndrome. Can be coutneracted with small, frequent meals

Acute Pain: Pts given opioids or may be on PCa.

Knowledge Deficit on how to take care of themselves. so educate

Question 16

Nursing Process for Patient with Gastric Surgery - Diagnosis:Why may grieving be a problem?

Answer 16

Because they have had surgery due to having gastric cancer. Cancer diagnosis can be very hard emotionally.

Question 17

Nursing Process for Patient with Gastric Surgery - Goals: This includes what?

Answer 17

Solving nutrition, acute pain, knowledge deficit problems

Question 18

Nursing Process for Patient with Gastric Surgery - Nursing Interventions: THis will focus on what?

Answer 18

Controlling pain, small frequent meals, controlling anxiety.

Also trying to prevent complications

Question 19

Nursing Process for Patient with Gastric Surgery - Complications: What problems may they have after surgery?

Answer 19

Hemorrhage, and this can be seen when checking vital signs. Could also see expanded size

Question 20

Nursing Process for Patient with Gastric Surgery - Complications: Dietary deficiencies can be fixed how?

Answer 20

They may need to take Vit B supplements and can be seen with gastrectomies.

Question 21

Nursing Process for Patient with Gastric Surgery - Complications: Bile Reflux occurs why

Answer 21

Due to dysfunctional pyloric sphincer. which may cause it to be thrown up

Question 22

Nursing Process for Patient with Gastric Surgery - Complications: Major complication of Billroth II procedure?

Answer 22

Dumping Syndrome. Have rapid gastric emptying. Body releases rapid insulin which leads to hypoglycemia. And will also have diarrhea and bloating.

Question 23

Nursing Process for Patient with Gastric Surgery - Complications: How quickly does dumping syndrome occur?

Answer 23

15-30 mins after eating

Question 24

Nursing Process for Patient with Gastric Surgery - Complications: What are some signs of dumping syndrome?

Answer 24

Weakness, dizziness, vertigo, abdominal cramping, and epigastric fullness

Question 25

Nursing Process for Patient with Gastric Surgery - Complications: How to prevent dumping syndrome?

Answer 25

No fluids with meals, no high carbs (bread, potatoes)

Question 26

Nursing Process for Patient with Gastric Surgery - Complications: How long will dumping syndrome last?

Answer 26

Anywhere from months to being a long-term issues.